scholarly journals Impact of rurality on diabetes screening in the US

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Phoebe Tran ◽  
Lam Tran ◽  
Liem Tran
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Urban Areas ◽  
National Level ◽  
Diabetes Risk ◽  
Behavioral Risk ◽  
Diabetes Screening ◽  
Rural Residents ◽  
Diabetes Risk Factors ◽  
The Us

Abstract Background Due to the high prevalence of diabetes risk factors in rural areas, it is important to identify whether differences in diabetes screening rates between rural and urban areas exist. Thus, the purpose of this study is to examine if living in a rural area, rurality, has any influence on diabetes screening across the US. Methods Participants from the 2011, 2013, 2015, and 2017 nationally representative Behavioral Risk Factor Surveillance System (BRFSS) surveys who responded to a question on diabetes screening were included in the study (n = 1,889,712). Two types of marginal probabilities, average adjusted predictions (AAPs) and average marginal effects (AMEs), were estimated at the national level using this data. AAPs and AMEs allow for the assessment of the independent role of rurality on diabetes screening while controlling for important covariates. Results People who lived in urban, suburban, and rural areas all had comparable odds (Urban compared to Rural Odds Ratio (OR): 1.01, Suburbans compared to Rural OR: 0.95, 0.94) and probabilities of diabetes screening (Urban AAP: 70.47%, Suburban AAPs: 69.31 and 69.05%, Rural AAP: 70.27%). Statistically significant differences in probability of diabetes screening were observed between residents in suburban areas and rural residents (AMEs: − 0.96% and − 1.22%) but not between urban and rural residents (AME: 0.20%). Conclusions While similar levels of diabetes screening were found in urban, suburban, and rural areas, there is arguably a need for increased diabetes screening in rural areas where the prevalence of diabetes risk factors is higher than in urban areas.

scholarly journals Acceptability and Use of Interactive Voice Response Mobile Phone Surveys for Noncommunicable Disease Behavioral Risk Factor Surveillance in Rural Uganda: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Charles Ssemugabo ◽  
Elizeus Rutebemberwa ◽  
Dan Kajungu ◽  
George W Pariyo ◽  
Adnan A Hyder ◽  
...  
Keyword(s):  
Risk Factors ◽  
Qualitative Study ◽  
Mobile Phone ◽  
Rural Areas ◽  
Urban Areas ◽  
Interactive Voice Response ◽  
Noncommunicable Disease ◽  
Behavioral Risk Factors ◽  
Behavioral Risk ◽  
Community Members

BACKGROUND There is need for more timely data to inform interventions that address the growing noncommunicable disease (NCD) epidemic. With a global increase in mobile phone ownership, mobile phone surveys can bridge this gap. OBJECTIVE This study aimed to explore the acceptability and use of interactive voice response (IVR) surveys for surveillance of NCD behavioral risk factors in rural Uganda. METHODS This qualitative study employed user group testing (UGT) with community members. The study was conducted at the Iganga-Mayuge Health and Demographic Surveillance Site (IM-HDSS) in Eastern Uganda. We conducted four UGTs which consisted of different categories of HDSS members: females living in urban areas, males living in urban areas, females living in rural areas, and males living in rural areas. Participants were individually sent an IVR survey, then were brought in for a group discussion using a semistructured guide. Data were analyzed thematically using directed content analysis. RESULTS Participants perceived that IVR surveys may be useful in promoting confidentiality, saving costs, and raising awareness on NCD behavioral risk factors. Due to the clarity and delivery of questions in the local language, the IVR survey was perceived as easy to use. Community members suggested scheduling surveys on specific days and sending reminders as ways to improve their use for surveillance. Social issues such as domestic violence and perceptions toward unknown calls, technological factors including poor network connections and inability to use phones, and personal issues such as lack of access to phones and use of multiple networks were identified as barriers to the acceptability and use of mobile phone surveys. However, incentives were reported to motivate people to complete the survey. CONCLUSIONS Community members reflected on contextual and sociological implications of using mobile phones for surveillance of NCD behavioral risk factors. The opportunities and challenges that affect acceptability and use of IVR surveys should be considered in designing and implementing surveillance programs for NCD risk factors.

Status and disparities of diabetes among urban and rural residents aged 40 years and older: insight from a population-based study in northeast China, 2017–2019

2021 ◽  
pp. jech-2020-213755
Author(s):  
Liying Xing ◽  
Yuanmeng Tian ◽  
Li Jing ◽  
Min Lin ◽  
Zhi Du ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Urban Areas ◽  
Northeast China ◽  
Population Based ◽  
Cross Sectional Study ◽  
Haemoglobin A1c ◽  
Rural Residents ◽  
Cross Sectional ◽  
High Prevalence

ObjectivesTo evaluate the up-to-date epidemiology of diabetes in northeast China.MethodsThe cross-sectional study was conducted between September 2017 and March 2019 using a multistage, stratified and cluster random sampling method. 18 796 participants (28.9% urban and 71.1% rural) aged ≥40 years were enrolled. Diabetes and pre-diabetes were diagnosed according to the history, fasting plasma glucose (FPG) and glycosylated haemoglobin A1c (HbA1c) levels.ResultsThe prevalence of diabetes was 17.1%, higher in urban than in rural residents (20.2% vs 15.8%, p<0.001). Meanwhile, the prevalence of pre-diabetes was 44.3%, higher in rural than in urban areas (49.4% vs 31.8%, p<0.001). The overall FPG and HbA1c were 6.10±1.94 mmol/L and 5.59%±1.08%. The FPG level was higher in rural area than in urban areas (6.15±1.83 mmol/L vs 5.97±2.18 mmol/L, p<0.001). Among participants with diabetes, 47.5% were aware of their diabetes condition; 39.5% were taking antidiabetic medications and 36.8% of people had their diabetes controlled. The awareness and treatment rates in rural areas were lower than those in urban areas (47.3% vs 57.5%, 34.4% vs 49.5%, p<0.001). Patients with diabetic, especially those in rural areas, tended to have multiple risk factors including hypertension (71.7%), overweight or obesity (69.6%) and dyslipidaemia (52.8%).ConclusionA considerable burden of diabetes was observed in northeast China, with high percentage of untreated diabetes, high prevalence of pre-diabetes, high overall FPG level and multiple uncontrolled risk factors in patients with diabetics. Therefore, region-specific strategies on prevention and management of diabetes should be emphasised.

scholarly journals A Comparison on Prevalence of Hypertension and Related Risk Factors between Island and Rural Residents of Dalian City, China

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Baiting Liu ◽  
Hainiang Liu ◽  
Rongmei Na ◽  
Xiaofei Li ◽  
Qianxiao Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
National Level ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Treatment Rate ◽  
Rural Residents ◽  
Increased Risk ◽  
Dalian City ◽  
And Control

This study aimed to compare the prevalence of hypertension between the island and rural residents in Dalian, China, and to explore associated risk factors of hypertension in order to provide evidence for the establishment of targeted strategy of hypertension prevention and treatment for island and rural residents. The modified MONICA questionnaire survey was performed on 7764 island and rural residents aged ≥40 years (including 2652 island residents and 5112 rural residents). Our data showed that totally weighted prevalence of hypertension was significantly higher in rural residents than in island residents (61.9% vs. 55.2%, P<0.001). Multivariate binary logistic regression analysis showed that older age, higher BMI, lower education level, and higher LDL-C and UA levels were independently associated with increased risk of having hypertension both in island and in rural residents. The weighted awareness rate (29.9% vs. 17.3%, P<0.001), treatment rate (51.4% vs. 28.5%, P<0.001), and control rate (36.3% vs. 24.0%, P=0.001) of hypertension were all significantly higher in island residents than those in rural residents. In conclusion, our survey shows that the epidemics of hypertension are extremely high in surveyed residents in island and rural areas of Dalian city, while awareness, treatment, and control rats of hypertension in these residents are much lower than the national level. The scenario is even worse in rural residents as compared with island residents of Dalian, China.

scholarly journals Identification of Risk Factors for Diabetes Disability Among Bangladeshi Adults

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Bhuyan KC
Keyword(s):  
Risk Factors ◽  
Sex Ratio ◽  
Rural Areas ◽  
Urban Areas ◽  
Smoking Habit ◽  
National Level ◽  
Correlation Coefficients ◽  
Obese Adults ◽  
Rural People ◽  
Urban And Rural Areas

The paper was to throw some light on the risk factors for diabetes disability among Bangladeshi adults of 18 years and above residing in both urban and rural areas. In investigating the adults, it was decited to cover 50.1% males and 49.9% females to maintain the national level of sex ratio in the sample. The respondents were interviewed when they were visiting some diagnostic centres in urban and semi-urban areas. The percentage of diabetic respondents included in the sample was 67% and 25.5% of them were suffering for 10 years and above, 6.4% were disable against 4.8% total disable respondents in the sample, and obese adults were 30.2%. Diabetic disable adults in the sample were 4.3%. The most responsible variable for diabetes disability was obesity followed by longer duration of diabetes, sedentary activity, smoking habit, being housewife, being married, etc. These variables were identified on the basis of risk ratio and correlation coefficients of variables and discriminant function scores. Beside these variables, rural people, Muslims, adults of ages 40-50 years, illiterate people had more risk of facing the problem of diabetes disability.

scholarly journals Identification of Risk Factors for Diabetes Disability among Bangladeshi Adults

2022 ◽  
Vol 5 (1) ◽  
pp. 01-07
Author(s):  
K.C. Bhuyan
Keyword(s):  
Risk Factors ◽  
Sex Ratio ◽  
Rural Areas ◽  
Urban Areas ◽  
Smoking Habit ◽  
National Level ◽  
Correlation Coefficients ◽  
Obese Adults ◽  
Rural People ◽  
Urban And Rural Areas

The paper was to throw some light on the risk factors for diabetes disability among Bangladeshi adults of 18 years and above residing in both urban and rural areas. In investigating the adults, it was decided to cover 50.1% males and 49.9% females to maintain the national level of sex ratio in the sample. The respondents were interviewed when they were visiting some diagnostic centres in urban and semi-urban areas. The percentage of diabetic respondents included in the sample was 67% and 25.5% of them were suffering for 10 years and above, 6.4% were disable against 4.8% total disable respondents in the sample, and obese adults were 30.2%. Diabetic disable adults in the sample were 4.3%. The most responsible variable for diabetes disability was obesity followed by longer duration of diabetes, sedentary activity, smoking habit, being housewife, being married, etc. These variables were identified on the basis of risk ratio and correlation coefficients of variables and discriminant function scores. Beside these variables, rural people, Muslims, adults of ages 40 – 50 years, illiterate people had more risk of facing the problem of diabetes disability.

scholarly journals Acceptability and Use of Interactive Voice Response Mobile Phone Surveys for Noncommunicable Disease Behavioral Risk Factor Surveillance in Rural Uganda: Qualitative Study

10.2196/15000 ◽  
2019 ◽  
Vol 3 (4) ◽  
pp. e15000 ◽  
Author(s):  
Charles Ssemugabo ◽  
Elizeus Rutebemberwa ◽  
Dan Kajungu ◽  
George W Pariyo ◽  
Adnan A Hyder ◽  
...  
Keyword(s):  
Risk Factors ◽  
Qualitative Study ◽  
Mobile Phone ◽  
Rural Areas ◽  
Urban Areas ◽  
Interactive Voice Response ◽  
Noncommunicable Disease ◽  
Behavioral Risk Factors ◽  
Behavioral Risk ◽  
Community Members

Background There is need for more timely data to inform interventions that address the growing noncommunicable disease (NCD) epidemic. With a global increase in mobile phone ownership, mobile phone surveys can bridge this gap. Objective This study aimed to explore the acceptability and use of interactive voice response (IVR) surveys for surveillance of NCD behavioral risk factors in rural Uganda. Methods This qualitative study employed user group testing (UGT) with community members. The study was conducted at the Iganga-Mayuge Health and Demographic Surveillance Site (IM-HDSS) in Eastern Uganda. We conducted four UGTs which consisted of different categories of HDSS members: females living in urban areas, males living in urban areas, females living in rural areas, and males living in rural areas. Participants were individually sent an IVR survey, then were brought in for a group discussion using a semistructured guide. Data were analyzed thematically using directed content analysis. Results Participants perceived that IVR surveys may be useful in promoting confidentiality, saving costs, and raising awareness on NCD behavioral risk factors. Due to the clarity and delivery of questions in the local language, the IVR survey was perceived as easy to use. Community members suggested scheduling surveys on specific days and sending reminders as ways to improve their use for surveillance. Social issues such as domestic violence and perceptions toward unknown calls, technological factors including poor network connections and inability to use phones, and personal issues such as lack of access to phones and use of multiple networks were identified as barriers to the acceptability and use of mobile phone surveys. However, incentives were reported to motivate people to complete the survey. Conclusions Community members reflected on contextual and sociological implications of using mobile phones for surveillance of NCD behavioral risk factors. The opportunities and challenges that affect acceptability and use of IVR surveys should be considered in designing and implementing surveillance programs for NCD risk factors.

scholarly journals Risk Factors of Fall-Related Emergency Department Visits by Fall Location of Older Adults in the US

2021 ◽  
Vol 22 (4) ◽  
pp. 988-999
Author(s):  
Uma Kelekar ◽  
Debasree Das Gupta ◽  
Jewel Shepherd ◽  
Anupam Sule
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Emergency Department ◽  
Rural Areas ◽  
National Level ◽  
Multivariable Analysis ◽  
Geographic Area ◽  
Emergency Department Visits ◽  
Primary Data ◽  
The Us

Introduction: Prior evidence indicates that predictors of older adult falls vary by indoor-outdoor location of the falls. While a subset of United States’ studies reports this finding using primary data from a single geographic area, other secondary analyses of falls across the country do not distinguish between the two fall locations. Consequently, evidence at the national level on risk factors specific to indoor vs outdoor falls is lacking. Methods: Using the 2017 Nationwide Emergency Department Sample (NEDS) data, we conducted a multivariable analysis of fall-related emergency department (ED) visits disaggregated by indoor vs outdoor fall locations of adults 65 years and older (N = 6,720,937) in the US. Results: Results are compatible with findings from previous primary studies. While women (relative risk [RR] = 1.43, 95% confidence interval [CI], 1.42-1.44) were more likely to report indoor falls, men were more likely to present with an outdoor fall. Visits for indoor falls were highest among those 85 years and older (RR = 2.35, 95% CI, 2.33-2.37) with outdoor fall visits highest among those 84 years and younger. Additionally, the probabilities associated with an indoor fall in the presence of chronic conditions were consistently much higher when compared to an outdoor fall. We also found that residence in metropolitan areas increased the likelihood of an indoor elderly fall compared to higher outdoor fall visits from seniors in non-core rural areas, but both indoor and outdoor fall visits were higher among older adults in higher income ZIP codes. Conclusion: Our findings highlight the contrasting risk profile for elderly ED patients who report indoor vs outdoor falls when compared to the elderly reporting no falls. In conjunction, we highlight implications from three perspectives: a population health standpoint for EDs working with their primary care and community care colleagues; an ED administrative vantage point; and from an individual emergency clinician’s point of view.

scholarly journals CVD risk factors and surrogate markers - Urban-rural differences

2019 ◽  
Vol 48 (7) ◽  
pp. 752-761
Author(s):  
Joel Nuotio ◽  
Lauri Vähämurto ◽  
Katja Pahkala ◽  
Costan G. Magnussen ◽  
Nina Hutri-Kähönen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Rural Areas ◽  
Urban Areas ◽  
Left Ventricular ◽  
Surrogate Markers ◽  
Rural Residents ◽  
Urban Rural

Aims: Disparity in cardiovascular disease (CVD) mortality and risk factor levels between urban and rural regions has been confirmed worldwide. The aim of this study was to examine how living in different community types (urban–rural) in childhood and adulthood are related to cardiovascular risk factors and surrogate markers of CVD such as carotid intima-media thickness (IMT) and left ventricular mass (LVM). Methods: The study population comprised 2903 participants (54.1% female, mean age 10.5 years in 1980) of the Cardiovascular Risk in Young Finns Study who had been clinically examined in 1980 (age 3–18 years) and had participated in at least one adult follow-up (2001–2011). Results: In adulthood, urban residents had lower systolic blood pressure (–1 mmHg), LDL-cholesterol (–0.05 mmol/l), lower body mass index (–1.0 kg/m2) and glycosylated haemoglobin levels (–0.05 mmol/mol), and lower prevalence of metabolic syndrome (19.9 v. 23.7%) than their rural counterparts. In addition, participants continuously living in urban areas had significantly lower IMT (–0.01 mm), LVM (1.59 g/m2.7) and pulse wave velocity (–0.22 m/s) and higher carotid artery compliance (0.07%/10 mmHg) compared to persistently rural residents. The differences in surrogate markers of CVD were only partially attenuated when adjusted for cardiovascular risk factors. Conclusions: Participants living in urban communities had a more favourable cardiovascular risk factor profile than rural residents. Furthermore, participants continuously living in urban areas had less subclinical markers related to CVD compared with participants living in rural areas. Urban–rural differences in cardiovascular health might provide important opportunities for optimizing prevention by targeting areas of highest need.

scholarly journals Prevalence of behavioral risk factors of non-communicable diseases among urban and rural population in the Federation of Bosnia and Herzegovina

2014 ◽  
Vol 4 (2) ◽  
pp. 83-89
Author(s):  
Aida Pilav ◽  
Aida Rudić ◽  
Suada Branković ◽  
Vildana Doder
Keyword(s):  
Risk Factors ◽  
Bosnia And Herzegovina ◽  
Rural Areas ◽  
Urban Areas ◽  
Adult Population ◽  
Behavioral Risk Factors ◽  
Behavioral Risk ◽  
Men And Women ◽  
Significant Difference ◽  
Urban And Rural Areas

Introduction The objective of the paper is to analyze and to assess prevalence of the major behavioral risk factors among adult population (25-64 years of age) in the rural and urban areas in the Federation of Bosnia and Herzegovina (FBIH).Methods Data were taken from cross-sectional population survey on the health status population in the FBIH. To ensure a sample representative for the adult population in the FBIH it was applied the two-stage stratified systematic sample. The survey covered a total of 2735 adult population aged 25-64 years, of which 1087 in the urban areas and 1648 in rural areas.Results. The prevalence of smoking among men in rural areas is significantly higher than among men in urban areas (69% vs. 55%), while the prevalence of smoking among women is higher in urban than in rural areas (45% vs. 31%). There is no statistically significant difference in prevalence of obesity and physical activity according to the age groups among men and women in the urban and rural areas. The frequency of changes in behavior related to acquiring healthy living habits in the rural areas is statistically significant among men and women, while in the urban areas there is no statistical significance among the sexes.Conclusions. The results indicate that there are no significant differences in prevalence of factor risks in urban and rural areas. Prevalence of unhealthy lifestyles is high, and the results should be used to improve standard planning of health promotion-prevention programs.

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