"Contribution Of Income To Self-Management And Health Outcomes In Pedia" by Kaitlyn Rechenberg

Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Robin Whittemore

Second Advisor

Rafael Perez-Escamilla

Abstract

Low income has been established as a risk factor for poorer outcomes in

youth with type 1 diabetes; however, the effect of moderate income has not

been studied. The purpose of this secondary analysis of baseline data from a multi-site study was to compare glycemic control, self-management, and

psychosocial outcomes [depression, stress, and quality of life (QOL)] at

different income levels in adolescents with type 1 diabetes. Youth (n=320,

mean age=12.3+1.1, 55% female, 64% white, mean A1C=8.3±1.4)

completed established self-management and psychosocial measures. A1C

levels were collected from medical records. Caregivers reported annual family income, categorized as high (>$80K), moderate ($40-80K), or low (<$40K). Youth from high-income families had significantly lower A1C

(mean=7.9±1.2) than those from the moderate-income group (8.6±1.7,

p<0.001) or the low-income group (mean A1C=8.6±1.5, p=0.003). Youth

from the high-income group reported significantly better diabetes problem

solving and more self-management goals than those from the moderate- or

low-income groups (both p<0.01). Youth from the high-income group also

reported significantly fewer symptoms of depression, lower levels of perceived stress, and better QOL than those in the moderate or low-income groups (all p<0.05). Multivariate linear regression models were used to test

psychological and behavioral predictors of A1C and QOL. Parents' education

status (p<0.05) and self-management activities (p<0.01) were significant

predictors of hemoglobin A1c, while income (p<0.01) and self-management

activities (p<0.05) were significant predictors of QOL.

Comments

This is an Open Access Thesis.

Open Access

This Article is Open Access

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