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Kollannoor-Samuel G.,University of Connecticut | Kollannoor-Samuel G.,Connecticut Center for Eliminating Health Disparities Among Latinos | Vega-Lopez S.,Connecticut Center for Eliminating Health Disparities Among Latinos | Vega-Lopez S.,Arizona State University | And 5 more authors.
Journal of Immigrant and Minority Health | Year: 2012

Racial/ethnic minorities are disproportionately affected by barriers to health care access and utilization. The primary objective was to test for an independent association between household food insecurity and health care access/utilization. In this cross-sectional survey, 211 Latinos (predominantly, Puerto-Ricans) with type 2 diabetes (T2D) were interviewed at their homes. Factor analyses identified four barriers for health care access/utilization: enabling factor, doctor access, medication access and forgetfulness. Multivariate logistic regression models examined the association between each of the barrier factors and food insecurity controlling for sociodemographic, cultural, psychosocial, and diabetes self-care variables. Higher food insecurity score was a risk factor for experiencing enabling factor (OR = 1.46; 95% CI = 1.17-1.82), medication access (OR = 1.26; 95 CI% = 1.06-1.50), and forgetfulness (OR = 1.22; 95 CI% = 1.04-1.43) barriers. Higher diabetes management self-efficacy was protective against all four barriers. Other variables associated with one or more barriers were health insurance, perceived health, depression, blood glucose, age and education. Findings suggest that addressing barriers such as food insecurity, low self-efficacy, lack of health insurance, and depression could potentially result in better health care access and utilization among low income Puerto-Ricans with T2D. © Springer Science+Business Media, LLC 2011. Source


Kollannoor-Samuel G.,University of Connecticut | Kollannoor-Samuel G.,Connecticut Center for Eliminating Health Disparities Among Latinos | Wagner J.,Connecticut Center for Eliminating Health Disparities Among Latinos | Wagner J.,University of Connecticut Health Center | And 7 more authors.
Journal of Immigrant and Minority Health | Year: 2011

Prevalence of depression is high among individuals with type 2 diabetes (T2D). The objective of the current study was to identify the socio-demographic, psychosocial, cultural, and clinical risk factors that predispose to depression, and resources that protect from depression among low income Latinos with T2D. Participants (N = 211) were interviewed in their homes upon enrollment. Multivariate logistic regression was used to identify factors associated with depressive symptoms based on a score of ≥21 on the Center for Epidemiological Studies Depression scale. Lower household income, interference of diabetes with daily activities, and more T2D clinical symptoms were associated with depression risk in the multivariate analyses. At each level of food insecurity the risk of depression was lower the higher the level of social support (P < 0.05). Findings suggest that social support buffers against the negative influence of household food insecurity on depression risk. A comprehensive approach is necessary to address the mental health needs of low income Latinos with T2D. © 2011 Springer Science+Business Media, LLC. Source


Kollannoor-Samuel G.,University of Connecticut | Kollannoor-Samuel G.,Connecticut Center for Eliminating Health Disparities Among Latinos | Chhabra J.,Connecticut Center for Eliminating Health Disparities Among Latinos | Fernandez M.L.,University of Connecticut | And 11 more authors.
Journal of Immigrant and Minority Health | Year: 2011

The objective of this study was to identify demographic, socio-economic, acculturation, lifestyle, sleeping pattern, and biomedical determinants of fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c), among Latinos with type 2 diabetes (T2D). Latino adults (N = 211) with T2D enrolled in the DIALBEST trial were interviewed in their homes. Fasting blood samples were also collected in the participants' homes. Because all participants had poor glucose control, above-median values for FPG (173 mg/dl) and HbA1c (9.2%) were considered to be indicative of poorer glycemic control. Multivariate analyses showed that receiving heating assistance (OR: 2.20; 95% CI: 0.96-4.96), and having a radio (3.11, 1.16-8.35), were risk factors for higher FPG levels, and lower income (10.4, 1.54-69.30) was a risk factor for higher HbA1c levels. Lower carbohydrate intake during the previous day (0.04; 0.005-0.37), as well as regular physical activity (0.30; 0.13-0.69), breakfast (2.78; 1.10-6.99) and dinner skipping (3.9; 1.03-14.9) during previous week were significantly associated with FPG concentrations. Being middle aged (2.24, 1.12-4.47), 30-60 min of sleep during the day time (0.07, 0.01-0.74) and having medical insurance (0.31, 0.10-0.96) were predictors of HbA1c. Results suggest that contemporaneous lifestyle behaviors were associated with FPG and contextual biomedical factors such as health care access with HbA1c. Lower socio-economic status indicators were associated with poorer FPG and HbA1c glycemic control. © Springer Science+Business Media, LLC 2010. Source

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