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Examining the relationship between social risk factors, diabetes prevention recommendations, and behaviors among US adults with prediabetes.

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Titel: Examining the relationship between social risk factors, diabetes prevention recommendations, and behaviors among US adults with prediabetes.
Autoren: Egede C; University of Maryland Medical Center, 22 S. Greene Street, Baltimore, MD, USA., Campbell JA; Division of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA., Wang X; Division of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA., Thorgerson A; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA., Walker RJ; Division of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA., Egede LE; Division of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. legede@buffalo.edu.; Buffalo General Medical Center, 100 High Street, D2-76, Buffalo, NY, USA. legede@buffalo.edu.
Quelle: BMC public health [BMC Public Health] 2025 Sep 30; Vol. 25 (1), pp. 3183. Date of Electronic Publication: 2025 Sep 30.
Publikationsart: Journal Article
Sprache: English
Info zur Zeitschrift: Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE
Imprint Name(s): Original Publication: London : BioMed Central, [2001-
MeSH-Schlagworte: Prediabetic State*/epidemiology , Prediabetic State*/psychology , Diabetes Mellitus*/prevention & control , Health Behavior*, Humans ; Male ; Female ; Middle Aged ; United States/epidemiology ; Risk Factors ; Adult ; Health Surveys ; Aged ; Social Factors ; Exercise ; Cross-Sectional Studies
Abstract: Competing Interests: Declarations. Ethics approval and consent to participate: IRB review and ethics approval was not required as data was publicly available and non-identifiable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
Background: Among US adults with prediabetes, only half engage in recommended prevention behaviors and little has been done to examine the role of multiple social risk factors.
Methods: Data from 4,310 adults with prediabetes (weighted 34,442,989) in the National Health Interview Survey 2016-2017 was used. Predictor variables included six social risk factors. Outcome variables included (1) receiving counseling for lifestyle change and (2) engaging in lifestyle change behaviors. Multiple logistic regression (glm function with poisson family and log link) models were run to estimate prevalence ratios, adjusting for relevant covariates.
Results: In the fully adjusted models, inadequate access to care was associated with lower prevalence of receiving all forms of counseling for physical activity (PR = 0.63; CI 0.51; 0.78), fat/calories (PR = 0.70; CI 0.56; 0.86) and weight loss program (PR = 0.33; CI 0.19; 0.59). Lack of community was associated with lower prevalence of increasing physical activity (PR = 0.94; CI 0.88; 1.00). Educational deficit was associated with lower prevalence of increasing physical activity (PR = 0.88; CI 0.82; 0.94), reducing fat/calories (PR = 0.89; CI 0.83; 0.95) and being in a weight loss program (PR = 0.66; CI 0.51; 0.87). Food insecurity was associated with lower prevalence of reducing fat/calories (PR = 0.91; CI 0.84; 0.98). Inadequate access to care was associated with lower prevalence of being in a weight loss program (PR = 0.43; CI 0.23; 0.81).
Conclusion: This study underscores the role of social risk factors in limiting diabetes prevention at a national level. To effectively address the barriers to diabetes prevention adoption in the US, social risk factors need to be accounted for as a part of a holistic care plan.
(© 2025. The Author(s).)
References: Int J Endocrinol. 2015;2015:903468. (PMID: 26576154)
Front Endocrinol (Lausanne). 2022 Feb 28;13:816385. (PMID: 35295990)
Diabetes Educ. 2009 Sep-Oct;35(5):778-88. (PMID: 19556552)
J Gen Intern Med. 2022 Jun;37(8):1935-1942. (PMID: 34355346)
Lancet. 2009 Nov 14;374(9702):1677-86. (PMID: 19878986)
Diabetes Educ. 2020 Jun;46(3):279-288. (PMID: 32597384)
J Epidemiol Community Health. 2022 Aug 26;:. (PMID: 36028306)
J Gen Intern Med. 2019 Jan;34(1):33-35. (PMID: 30215178)
Milbank Q. 2019 Jun;97(2):407-419. (PMID: 31069864)
Am J Prev Med. 2019 Dec;57(6 Suppl 1):S47-S54. (PMID: 31753279)
Curr Nutr Rep. 2014;3(4):324-332. (PMID: 25383254)
J Acad Nutr Diet. 2023 Mar;123(3):477-491. (PMID: 35961614)
Ethn Dis. 2021 Oct 21;31(4):527-536. (PMID: 34720556)
EClinicalMedicine. 2023 Sep 21;64:102236. (PMID: 37767193)
Diabetes Care. 2024 Jan 1;47(Suppl 1):S43-S51. (PMID: 38078581)
Diabetes Care. 2002 Dec;25(12):2165-71. (PMID: 12453955)
Diabetes Spectr. 2022 Summer;35(3):313-319. (PMID: 36082007)
Diabetes Care. 2023 Sep 1;46(9):1599-1608. (PMID: 37354336)
N Engl J Med. 2001 May 3;344(18):1343-50. (PMID: 11333990)
BMC Med Res Methodol. 2013 Mar 24;13:49. (PMID: 23522349)
Ann Intern Med. 2015 Sep 15;163(6):437-51. (PMID: 26167912)
Contemp Clin Trials. 2023 Jul;130:107212. (PMID: 37121390)
BMC Public Health. 2022 Mar 21;22(1):553. (PMID: 35313859)
Am J Prev Med. 2024 Jun;66(6):1100-1104. (PMID: 38272244)
J Clin Epidemiol. 1996 May;49(5):511-7. (PMID: 8636724)
Am J Prev Med. 2022 Apr;62(4):614-625. (PMID: 35151523)
Annu Rev Public Health. 2024 May;45(1):151-167. (PMID: 38109519)
JAMA Netw Open. 2024 Oct 1;7(10):e2437492. (PMID: 39365580)
Lancet. 2012 Jun 16;379(9833):2279-90. (PMID: 22683128)
Diabetes Care. 2020 Nov 2;:. (PMID: 33139407)
Am J Prev Med. 2010 Apr;38(4):403-9. (PMID: 20307809)
Prev Med Rep. 2022 May 05;27:101821. (PMID: 35656212)
JAMA Netw Open. 2025 Apr 01;8(4):e254253. (PMID: 40168021)
Int J Epidemiol. 2000 Feb;29(1):149-57. (PMID: 10750617)
Prev Med. 2023 May;170:107477. (PMID: 36918070)
Transl Behav Med. 2022 Aug 17;12(8):860-869. (PMID: 35554612)
J Occup Environ Med. 2009 Jul;51(7):786-96. (PMID: 19528832)
Grant Information: K01 DK131319 United States DK NIDDK NIH HHS; R01MD017574 United States MD NIMHD NIH HHS; R01 MD017574 United States MD NIMHD NIH HHS; R01DK118038 United States DK NIDDK NIH HHS; R01MD013826 United States MD NIMHD NIH HHS; K01DK131319 United States DK NIDDK NIH HHS; R01 MD013826 United States MD NIMHD NIH HHS; R01 DK118038 United States DK NIDDK NIH HHS
Contributed Indexing: Keywords: Diabetes prevention; Population health; Pre-diabetes; Social risk factors
Entry Date(s): Date Created: 20251001 Date Completed: 20251001 Latest Revision: 20251004
Update Code: 20251004
PubMed Central ID: PMC12487274
DOI: 10.1186/s12889-025-24551-w
PMID: 41029724
Datenbank: MEDLINE
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  Data: Examining the relationship between social risk factors, diabetes prevention recommendations, and behaviors among US adults with prediabetes.
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  Data: <searchLink fieldCode="AU" term="%22Egede+C%22">Egede C</searchLink>; University of Maryland Medical Center, 22 S. Greene Street, Baltimore, MD, USA.<br /><searchLink fieldCode="AU" term="%22Campbell+JA%22">Campbell JA</searchLink>; Division of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.<br /><searchLink fieldCode="AU" term="%22Wang+X%22">Wang X</searchLink>; Division of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.<br /><searchLink fieldCode="AU" term="%22Thorgerson+A%22">Thorgerson A</searchLink>; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA.<br /><searchLink fieldCode="AU" term="%22Walker+RJ%22">Walker RJ</searchLink>; Division of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.<br /><searchLink fieldCode="AU" term="%22Egede+LE%22">Egede LE</searchLink>; Division of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. legede@buffalo.edu.; Buffalo General Medical Center, 100 High Street, D2-76, Buffalo, NY, USA. legede@buffalo.edu.
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  Data: <searchLink fieldCode="MM" term="%22Prediabetic+State%22">Prediabetic State*</searchLink>/<searchLink fieldCode="MM" term="%22Prediabetic+State+epidemiology%22">epidemiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Prediabetic+State%22">Prediabetic State*</searchLink>/<searchLink fieldCode="MM" term="%22Prediabetic+State+psychology%22">psychology</searchLink> <br /><searchLink fieldCode="MM" term="%22Diabetes+Mellitus%22">Diabetes Mellitus*</searchLink>/<searchLink fieldCode="MM" term="%22Diabetes+Mellitus+prevention+%26+control%22">prevention & control</searchLink> <br /><searchLink fieldCode="MM" term="%22Health+Behavior%22">Health Behavior*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Middle+Aged%22">Middle Aged</searchLink> ; <searchLink fieldCode="MH" term="%22United+States%22">United States</searchLink>/<searchLink fieldCode="MH" term="%22United+States+epidemiology%22">epidemiology</searchLink> ; <searchLink fieldCode="MH" term="%22Risk+Factors%22">Risk Factors</searchLink> ; <searchLink fieldCode="MH" term="%22Adult%22">Adult</searchLink> ; <searchLink fieldCode="MH" term="%22Health+Surveys%22">Health Surveys</searchLink> ; <searchLink fieldCode="MH" term="%22Aged%22">Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Social+Factors%22">Social Factors</searchLink> ; <searchLink fieldCode="MH" term="%22Exercise%22">Exercise</searchLink> ; <searchLink fieldCode="MH" term="%22Cross-Sectional+Studies%22">Cross-Sectional Studies</searchLink>
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  Data: Competing Interests: Declarations. Ethics approval and consent to participate: IRB review and ethics approval was not required as data was publicly available and non-identifiable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.<br />Background: Among US adults with prediabetes, only half engage in recommended prevention behaviors and little has been done to examine the role of multiple social risk factors.<br />Methods: Data from 4,310 adults with prediabetes (weighted 34,442,989) in the National Health Interview Survey 2016-2017 was used. Predictor variables included six social risk factors. Outcome variables included (1) receiving counseling for lifestyle change and (2) engaging in lifestyle change behaviors. Multiple logistic regression (glm function with poisson family and log link) models were run to estimate prevalence ratios, adjusting for relevant covariates.<br />Results: In the fully adjusted models, inadequate access to care was associated with lower prevalence of receiving all forms of counseling for physical activity (PR = 0.63; CI 0.51; 0.78), fat/calories (PR = 0.70; CI 0.56; 0.86) and weight loss program (PR = 0.33; CI 0.19; 0.59). Lack of community was associated with lower prevalence of increasing physical activity (PR = 0.94; CI 0.88; 1.00). Educational deficit was associated with lower prevalence of increasing physical activity (PR = 0.88; CI 0.82; 0.94), reducing fat/calories (PR = 0.89; CI 0.83; 0.95) and being in a weight loss program (PR = 0.66; CI 0.51; 0.87). Food insecurity was associated with lower prevalence of reducing fat/calories (PR = 0.91; CI 0.84; 0.98). Inadequate access to care was associated with lower prevalence of being in a weight loss program (PR = 0.43; CI 0.23; 0.81).<br />Conclusion: This study underscores the role of social risk factors in limiting diabetes prevention at a national level. To effectively address the barriers to diabetes prevention adoption in the US, social risk factors need to be accounted for as a part of a holistic care plan.<br /> (© 2025. The Author(s).)
– Name: Ref
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  Data: Int J Endocrinol. 2015;2015:903468. (PMID: <searchLink fieldCode="PM" term="%2226576154%22">26576154)</searchLink><br />Front Endocrinol (Lausanne). 2022 Feb 28;13:816385. (PMID: <searchLink fieldCode="PM" term="%2235295990%22">35295990)</searchLink><br />Diabetes Educ. 2009 Sep-Oct;35(5):778-88. (PMID: <searchLink fieldCode="PM" term="%2219556552%22">19556552)</searchLink><br />J Gen Intern Med. 2022 Jun;37(8):1935-1942. (PMID: <searchLink fieldCode="PM" term="%2234355346%22">34355346)</searchLink><br />Lancet. 2009 Nov 14;374(9702):1677-86. (PMID: <searchLink fieldCode="PM" term="%2219878986%22">19878986)</searchLink><br />Diabetes Educ. 2020 Jun;46(3):279-288. (PMID: <searchLink fieldCode="PM" term="%2232597384%22">32597384)</searchLink><br />J Epidemiol Community Health. 2022 Aug 26;:. (PMID: <searchLink fieldCode="PM" term="%2236028306%22">36028306)</searchLink><br />J Gen Intern Med. 2019 Jan;34(1):33-35. (PMID: <searchLink fieldCode="PM" term="%2230215178%22">30215178)</searchLink><br />Milbank Q. 2019 Jun;97(2):407-419. (PMID: <searchLink fieldCode="PM" term="%2231069864%22">31069864)</searchLink><br />Am J Prev Med. 2019 Dec;57(6 Suppl 1):S47-S54. (PMID: <searchLink fieldCode="PM" term="%2231753279%22">31753279)</searchLink><br />Curr Nutr Rep. 2014;3(4):324-332. (PMID: <searchLink fieldCode="PM" term="%2225383254%22">25383254)</searchLink><br />J Acad Nutr Diet. 2023 Mar;123(3):477-491. (PMID: <searchLink fieldCode="PM" term="%2235961614%22">35961614)</searchLink><br />Ethn Dis. 2021 Oct 21;31(4):527-536. (PMID: <searchLink fieldCode="PM" term="%2234720556%22">34720556)</searchLink><br />EClinicalMedicine. 2023 Sep 21;64:102236. (PMID: <searchLink fieldCode="PM" term="%2237767193%22">37767193)</searchLink><br />Diabetes Care. 2024 Jan 1;47(Suppl 1):S43-S51. (PMID: <searchLink fieldCode="PM" term="%2238078581%22">38078581)</searchLink><br />Diabetes Care. 2002 Dec;25(12):2165-71. (PMID: <searchLink fieldCode="PM" term="%2212453955%22">12453955)</searchLink><br />Diabetes Spectr. 2022 Summer;35(3):313-319. (PMID: <searchLink fieldCode="PM" term="%2236082007%22">36082007)</searchLink><br />Diabetes Care. 2023 Sep 1;46(9):1599-1608. (PMID: <searchLink fieldCode="PM" term="%2237354336%22">37354336)</searchLink><br />N Engl J Med. 2001 May 3;344(18):1343-50. (PMID: <searchLink fieldCode="PM" term="%2211333990%22">11333990)</searchLink><br />BMC Med Res Methodol. 2013 Mar 24;13:49. (PMID: <searchLink fieldCode="PM" term="%2223522349%22">23522349)</searchLink><br />Ann Intern Med. 2015 Sep 15;163(6):437-51. (PMID: <searchLink fieldCode="PM" term="%2226167912%22">26167912)</searchLink><br />Contemp Clin Trials. 2023 Jul;130:107212. (PMID: <searchLink fieldCode="PM" term="%2237121390%22">37121390)</searchLink><br />BMC Public Health. 2022 Mar 21;22(1):553. (PMID: <searchLink fieldCode="PM" term="%2235313859%22">35313859)</searchLink><br />Am J Prev Med. 2024 Jun;66(6):1100-1104. (PMID: <searchLink fieldCode="PM" term="%2238272244%22">38272244)</searchLink><br />J Clin Epidemiol. 1996 May;49(5):511-7. (PMID: <searchLink fieldCode="PM" term="%228636724%22">8636724)</searchLink><br />Am J Prev Med. 2022 Apr;62(4):614-625. (PMID: <searchLink fieldCode="PM" term="%2235151523%22">35151523)</searchLink><br />Annu Rev Public Health. 2024 May;45(1):151-167. (PMID: <searchLink fieldCode="PM" term="%2238109519%22">38109519)</searchLink><br />JAMA Netw Open. 2024 Oct 1;7(10):e2437492. (PMID: <searchLink fieldCode="PM" term="%2239365580%22">39365580)</searchLink><br />Lancet. 2012 Jun 16;379(9833):2279-90. (PMID: <searchLink fieldCode="PM" term="%2222683128%22">22683128)</searchLink><br />Diabetes Care. 2020 Nov 2;:. (PMID: <searchLink fieldCode="PM" term="%2233139407%22">33139407)</searchLink><br />Am J Prev Med. 2010 Apr;38(4):403-9. (PMID: <searchLink fieldCode="PM" term="%2220307809%22">20307809)</searchLink><br />Prev Med Rep. 2022 May 05;27:101821. (PMID: <searchLink fieldCode="PM" term="%2235656212%22">35656212)</searchLink><br />JAMA Netw Open. 2025 Apr 01;8(4):e254253. (PMID: <searchLink fieldCode="PM" term="%2240168021%22">40168021)</searchLink><br />Int J Epidemiol. 2000 Feb;29(1):149-57. (PMID: <searchLink fieldCode="PM" term="%2210750617%22">10750617)</searchLink><br />Prev Med. 2023 May;170:107477. (PMID: <searchLink fieldCode="PM" term="%2236918070%22">36918070)</searchLink><br />Transl Behav Med. 2022 Aug 17;12(8):860-869. (PMID: <searchLink fieldCode="PM" term="%2235554612%22">35554612)</searchLink><br />J Occup Environ Med. 2009 Jul;51(7):786-96. (PMID: <searchLink fieldCode="PM" term="%2219528832%22">19528832)</searchLink>
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      – BibEntity:
          Dates:
            – D: 30
              M: 09
              Text: 2025 Sep 30
              Type: published
              Y: 2025
          Identifiers:
            – Type: issn-electronic
              Value: 1471-2458
          Numbering:
            – Type: volume
              Value: 25
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: BMC public health
              Type: main
ResultId 1