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Title

Self-reported Neighborhood Safety and Nonadherence to Treatment Regimens Among Patients with Type 2 Diabetes (J Gen Intern Med.)

Publication Topics

California Health Interview Survey; 2007 California Health Interview Survey (CHIS 2007); Health Behaviors; Diabetes; Adult; Survey Research

Publication Type

CHIS Journal Article

Publication Date

2012-03-01T08:00:00Z

Author 1

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=701&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=701&RootFolder=*">John Billimek</a>

Author 2

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=662&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=662&RootFolder=*">Dara H. Sorkin, PhD</a>

Author 3

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=0&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=0&RootFolder=*"></a>

Author 4

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=0&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=0&RootFolder=*"></a>

Author 5

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Author 6

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Author 7

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Author 8

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Author 9

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=0&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=0&RootFolder=*"></a>

Author 10

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Author 11

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=0&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=0&RootFolder=*"></a>

Author 12

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Author 13

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=0&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=0&RootFolder=*"></a>

Author 14

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=0&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=0&RootFolder=*"></a>

Abstract

BACKGROUND: Few studies have explored the association between neighborhood characteristics and adherence to diabetes self-management behaviors, and none have examined the influence of neighborhood safety on adherence to treatment regimens among patients with diabetes.

OBJECTIVE: To assess whether neighborhood safety is associated with self-reports of technical quality of care and with nonadherence to diabetes treatment regimens.

DESIGN: A cross-sectional analysis of a populationbased sample of California adults responding to the 2007 California Health Interview Survey. Multivariable
logistic regression models were used to examine the association of self-reported neighborhood safety with technical quality of care and treatment nonadherence, adjusted for sociodemographic characteristics, barriers to access to care, and health status.

PARTICIPANTS: Adults with type 2 diabetes currently receiving medical treatment.

MAIN MEASURES: Patient-reported neighborhood safety, performance of recommended processes of care by provider, treatment nonadherence (patient delays in filling prescriptions and obtaining needed medical care).

KEY RESULTS: Self-reported neighborhood safety was not associated with process measures of technical quality of care, but was associated with treatment nonadherence. Specifically, compared to those who report living in a safe neighborhood, a higher proportion of patients living in unsafe neighborhoods reported delays in filling a prescription for any reason (21.9% vs. 12.8%, aOR=1.69, 95%CI 1.19, 2.40) and delays in filling a prescription due to cost (12.2% vs. 6.8%, aOR=1.63, 95%CI 1.02, 2.62).

CONCLUSIONS: Contextual factors, such as neighborhood safety, may contribute to treatment nonadherence in daily life, even when the technical quality of care delivered in the clinic is not diminished.

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California Health Interview Survey

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Version: 3.0
Created at 7/16/2012 10:54 AM by i:0#.f|uclachissqlmembershipprovider|hdouglas
Last modified at 3/6/2013 2:07 PM by i:0#.f|uclachissqlmembershipprovider|jonathan