胰岛素依赖型2型糖尿病患者健康和糖尿病相关困扰的社会决定因素卡塔尔世界杯8强波胆分析横断面，混合方法方法%A Levy,Natalie K %A Park,Agnes %A Solis,Daniela %A Hu,Lu %A Langford,Aisha T %A Wang,Binhuan %A Rogers,Erin S %+纽约大学格罗斯曼医学院医学系，纽约第一大道462号，纽约州，10016，美国，1 212 263 8924;natalie.levy@nyulangone.org % K健康问题社会决定因素% K收入% K社会经济% K横断面% K胰岛素% K糖尿病% K糖化血红蛋白% K屏障% K糖尿病引起的痛苦% K 2型糖尿病% K门诊% K医疗% K医疗% K痛苦% K糖尿病流行病学% K 2型糖尿病% K % D原始论文7 12.10.2022 % 9 2022% % J JMIR形式Res % G英语% X背景:健康问题社会决定因素(SDOH)指的是社会、经济、和社会心理疾病,影响健康。低水平的SDOH因素(包括收入、教育和就业)与较高的糖尿病患病率、较差的血糖控制和较高的糖尿病相关死亡率相关。很少有研究对2型糖尿病(T2DM)人群的多种SDOH因素进行综合评估。目的:本研究旨在利用健康人2020计划开发的5域SDOH框架，确定影响城市安全网诊所胰岛素依赖型糖尿病患者的SDOH挑战范围(包括糖尿病相关痛苦)。方法:初步研究采用横断面混合方法。参与者从一个普通内科诊所的3个项目中招募，该诊所为未控制的T2DM患者提供门诊护理。我们基于健康人2020框架和已验证的糖尿病困扰量表(DDS)进行了一项由研究者开发的SDOH调查，该调查评估了糖尿病相关困扰的4个领域。我们进行了一对一的访谈，以获得有关挑战的深入信息。 Results: In total, 57 participants had an average hemoglobin A1c level of 11.0% (SD 2.6%). Overall, 92% (52/57) of participants had a barrier in at least one SDOH domain. SDOH challenges were most commonly reported in the domain of Health and Health Care (84%, 48/57), followed by Economic Stability (54%, n=31), Neighborhood and Built Environment (53%, n=30), Education and Health Literacy (47%, n=27), and Social and Community context (37%, n=21). The mean overall DDS score was 2.09 (SD 0.84), where scores of ≥2 indicate distress. Further, 79% (45/57) of participants had at least moderate diabetes-related distress in one of the 4 DDS domains. General themes that emerged from participant interviews included job interference with healthy behaviors, concerns about burdening others, challenges communicating with providers, and difficulty getting appointments in a timely manner. Conclusions: We found high levels of SDOH barriers across all 5 domains of the Center for Disease Control and Prevention’s Healthy People 2020 framework, including significant levels of diabetes-related distress. Future programs to address SDOH barriers in patients with uncontrolled insulin-dependent diabetes should consider screening for and focusing on a wide range of challenges. %M 36222807 %R 10.2196/40164 %U https://formative.www.mybigtv.com/2022/10/e40164 %U https://doi.org/10.2196/40164 %U http://www.ncbi.nlm.nih.gov/pubmed/36222807