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Factors affecting screening for diabetic complications in the community: a multilevel analysis
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Jin A Han, Soo Jeong Kim, Gawon Kim, Eun Ji Kim, Soon Young Lee
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Epidemiol Health. 2016;38:e2016017. Published online May 3, 2016
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DOI: https://doi.org/10.4178/epih.e2016017
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Abstract
OBJECTIVES The objective of the present study was to identify the factors that affect screening for diabetic complications by sex in the community.
METHODS This study used individual-level data from the 2013 Community Health Survey (CHS) for 20,806 (male, 9,958; female, 10,848) adults aged 30 years or older who were diagnosed with diabetes. Community-level data for 253 communities were derived from either CHS or national statistics. A chi-square test and multilevel logistic regression analysis was performed.
RESULTS There were significant differences in the rate of screening for diabetic complications according to individual-level and community-level variables. In the multilevel analysis, the community-level variance ratio of the null model was 7.4% and 9.2% for males and females, respectively. With regard to community-level variables, males were affected by the city type, number of physicians, and their living environment, while females were affected by number of physicians, natural and living environments, and public transportation.
CONCLUSIONS The factors that influenced individual willingness to undergo screening for diabetic complications differed slightly by sex; however, both males and females were more likely to undergo screening when they recognized their health status as poor or when they actively sought to manage their health conditions. Moreover, in terms of community-level variables, both males and females were affected by the number of physicians. It is essential to provide sufficient and ongoing opportunities for education on diabetes and its management through collaboration with local communities and primary care medical centers.
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Summary
Korean summary
본 연구는 지역사회의 당뇨병 환자들의 성별에 따른 합병증검사 수진율을 파악하고 개인의 특성과 지역사회의 특성이 합병증 검사 수진여부에 어떻게 영향을 미치는지 다수준 분석을 통해 살펴보고자 하였다. 당뇨병 치료자 중 약 1/3만이 합병증검사를 받았다. 성별에 따라 개인의 당뇨병 합병증 검사 수진행위에 영향을 미치는 요인이 다르긴 하지만 남성과 여성 모두 본인의 건강상태가 좋지 않다고 인지하거나 질병관리에 적극적인 행동을 취하는 경우, 그리고 지역변수로는 내과전문의 수에 영향을 받았다. 이는 지역사회와 1차 의료기관의 협업을 통해 당뇨병과 당뇨병 관리에 대한 충분하고 지속적인 학습기회의 제공이 중요하다고 할 수 있다.
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Citations
Citations to this article as recorded by
- The association between health literacy and screening for disease-specific complications among community-dwelling adults with diabetes
Fatima Nari, Jae Kwan Jun, Kyoung Hee Oh, Wonjeong Jeong Frontiers in Public Health.2024;[Epub] CrossRef - Factors Influencing the Utilization of Diabetes Complication Tests Under the COVID-19 Pandemic: Machine Learning Approach
Haewon Byeon Frontiers in Endocrinology.2022;[Epub] CrossRef - Effects of Diabetes Quality Assessment on Diabetes Management Behaviors Based on a Nationwide Survey
Chang Kyun Choi, Jungho Yang, Ji-An Jeong, Min-Ho Shin International Journal of Environmental Research and Public Health.2022; 19(23): 15781. CrossRef
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Test-retest reliability of health behavior items in the Community Health Survey in South Korea
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Soo Jeong Kim, Jin A Han, Young Hwa Kim, Bo Youl Choi, Su Young Kim, Hun Je Lee, In Hwan Oh, Sung-il Cho, Jakyoung Lee, Soon Young Lee
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Epidemiol Health. 2015;37:e2015045. Published online October 20, 2015
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DOI: https://doi.org/10.4178/epih/e2015045
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Abstract
OBJECTIVES Responses to health-related items on the Community Health Survey (CHS) provide evidence that is used to develop community-based health policy. This study aimed to assess the test-retest reliability of selected health behavioral items on the CHS according to item category, response period, and response scale.
METHODS A sample of 159 men and women 20 to 69 years of age participated in a test-retest with an interval of 14 to 21 days. A total of 28 items relating to smoking, alcohol consumption, diet and weight control, and mental health were selected. We evaluated the test-retest reliability of the items using kappa statistics.
RESULTS Kappa values ranged from 0.44 to 0.93. Items concerning habits had higher kappa values (mean, 0.7; standard error, 0.05) than items concerning awareness or attitudes (p=0.012). The kappa value of items with two- to four-point scales was 0.63, which was higher than the value of 0.59 for items with scales involving five or more points, although this difference was not statistically significant. Different kappa values were observed for each reference period, but no statistically significant differences were noted.
CONCLUSIONS The test-retest reliability of the CHS items that we studied was associated with item category. Further study of the relationship between item category and reliability in domains other than health behaviors is required.
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Summary
Korean summary
이 연구는 지역사회건강조사의 건강행태 문항 중 28개 문항에 대하여 문항의 특성, 준거기간, 보기의 척도에 따라 조사-재조사 신뢰도의 차이를 분석하였다. 전체 문항의 카파값의 범위는 0.44-0.93이었다. 문항의 특성별로는 인지 또는 태도에 비해 습관에 관한 문항의 신뢰도가 높았으며, 보기의 척도가 5점 척도 이상에 비해 2-4점 척도의 신뢰도가 높음을 확인하였다.
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- Change in Denture Procedures after Implementation of National Health Insurance Coverage for the Elderly in Korea: A Nationwide Database
Ye Seol Lee, Juyeong Kim, Yoon Soo Choy, Eunkyong Kim, Jaehyun Yoo International Journal of Environmental Research and Public Health.2021; 18(5): 2283. CrossRef - Influence of dental insurance coverage on access to preventive periodontal care in middle-aged and elderly populations: analysis of representative Korean Community Health Survey Data (2011–2015)
Young-Eun Jang, Chun-Bae Kim, Nam-Hee Kim International Dental Journal.2019; 69(6): 445. CrossRef - Assessment of the validity and reliability of an urban household health expenditure (HHE) questionnaire in Kuala Lumpur, Malaysia
Murallitharan Munisamy, Tharini Thanapalan, Pattaraporn Piwong, Alessio Panza, Sathirakorn Pongpanich Journal of Health Research.2018; 32(1): 24. CrossRef - Effects of living alone versus with others and of housemate type on smoking, drinking, dietary habits, and physical activity among elderly people
Seungmin Jeong, Sung il Cho Epidemiology and Health.2017; 39: e2017034. CrossRef - Tapering Practices of Strongman Athletes: Test-Retest Reliability Study
Paul W Winwood, Hayden J Pritchard, Justin WL Keogh JMIR Research Protocols.2017; 6(10): e211. CrossRef - Low socioeconomic status and suicidal ideation among elderly individuals
Yeong Jun Ju, Eun-Cheol Park, Kyu-Tae Han, Jae Woo Choi, Jeong Lim Kim, Kyoung Hee Cho, Sohee Park International Psychogeriatrics.2016; 28(12): 2055. CrossRef
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Cardiovascular Risk Factors for Incident Hypertension in the Prehypertensive Population
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Soo Jeong Kim, Jakyoung Lee, Sun Ha Jee, Chung Mo Nam, Kihong Chun, Il Soo Park, Soon Young Lee
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Epidemiol Health. 2010;32:e2010003. Published online May 1, 2010
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DOI: https://doi.org/10.4178/epih/e2010003
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19,770
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<sec><title>OBJECTIVES</title><p>The aim of this study was to investigate the effect of changes in cardiovascular disease (CVD) risk factors on progression from prehypertension (PreHTN) to hypertension (HTN) using an 8-yr prospective Korean Cancer Prevention Study (KCPS) by the National Health Insurance Corporation (NHIC) in Korea.</p></sec><sec><title>METHODS</title><p>A total of 16,229 subjects, aged 30 to 54, with new onset preHTN at baseline (1994-1996) in a biennial national medical exam were selected and followed up till 2004 at 2-yr intervals. All subjects underwent a biennial health examination including biochemical measurements and behavior. The log-rank test was performed to assess the relationship between changes in CVD risk factors and progression to HTN. The Cox proportional hazard model was used to identify factors influencing progression to HTN.</p></sec><sec><title>RESULTS</title><p>With regards the progression rate in men, ex-smokers (42.9%), abstainers (37.5%), and regular exercisers (37.6%) showed a slower progression rate than continuous smokers (49.5%) and continuous drinkers (50.9%). In women, those who participated in regular exercise (22.6%) had a lower rate of progression than continuous non-exercisers (36.1%). According to the results of the Cox proportional hazard model, improvements in smoking (hazard ratio [HR], 0.756), drinking (HR, 0.669), regular exercise (HR, 0.653), body mass index (HR, 0.715), and total cholesterol (HR, 0.788) played a protective role in progression to HTN in men, while in women, participating in regular exercise (HR, 0.534) was beneficial.</p></sec><sec><title>CONCLUSION</title><p>Improvements in CVD-related behaviors diminished the progression rate of HTN. This study suggests that individuals with PreHTN should be targeted for specific health behavioral intervention to prevent the progression of HTN.</p></sec>
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The Current System and Future Directions of Health Examination Survey.
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Soon Young Lee, Bo Youl Choi, Kyungwon Oh, Eunkyeong Jeong, Soo Jeong Kim
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Korean J Epidemiol. 2007;29(2):129-138.
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Segregation Analysis of Serum LDL-cholesterol in Korean Families of Coronary Heart Disease Patients.
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Jung Yong Park, Sun Ha Jee, Kyung Soon Song, Won Heum Shim, Soo Jeong Kim
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Korean J Epidemiol. 2000;22(2):116-123.
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PURPOSE S: The aim of this study was to investigate the familial correlation of lipid profile and the mode of inheritance of LDL-cholesterol through segregation analysis.
The study population included 414 family members of 67 Probands who had a coronary heart disease.METHODS Gene frequency(qH) of the allele for high LDL-cholesterol levels, means of each genotypes, and other putative gene related parameters were estimated. Maximum likelihood methods were used to fit several genetic and nongenetic modes of inheritance to these data to determine if an unobserved Mendelian major gene could explain the familial distribution of LDL-cholesterol. LDL-cholesterol levels were adjusted for age, gender, body mass index, smoking and alcohol consumption.RESULTS LDL-cholesterol levels revealed familial correlation among spouses, parent-offsprings and siblings with correlations of 0.10, 0.22, and 0.32, respectively. The heritability of LDL-cholesterol was 53%. Two models of inheritance in LDL-cholesterol distribution, the Mendelian codominant model and the polygenic equal transmission model were found.
Comparison of these two models in each family among 67 families showed that thiry-six families favored the major gene model with Mendelian codominant and thirty-one families favored the polygenic model of equal transmission. In families favoring Mendelian codominant inheritance, means of each genotypes; LL, HL, HH were 102.1, 143.3, 248.4 mg/dl and gene frequency of H allele was 0.08. In families favoring equal transmission inheritance, means of each genotypes were 101.6, 122.7, 185.5 mg/dl and gene frequency of H allele was 0.14.CONCLUSIONS In conclusion, families of coronary heart disease patients of this study showed substantial familial correlation and results suggested that variation in LDL-cholesterol may be influenced by major gene effect.
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