Diabetes is a critical public health concern with considerable financial and personal costs in the United States. Research has identified several interventions available to primary care providers to prevent diabetes. These interventions may prevent diabetes by influencing personal, community, and public health policy factors. These factors are key components of the social ecological model, which examines the influence of diverse social influences on health. Therefore, the purpose of this study was to determine the univariate relationship between PCP density and diabetes prevalence, as well as the multivariate relationship between PCP density and diabetes prevalence with physical inactivity prevalence, obesity prevalence, and social vulnerability scores held constant. This study also accounted for state-level differences in diabetes prevalence through fixed-level state effects. The initial univariate analysis yielded no significant relationship. The final multivariate regression yielded a statistically significant relationship in a model that better fit the data—as seen by p values <0.001 and information criteria decreases from 12,538.67 to 11,099.72 (AIC) and 12,538.67 to 11,099.72 (BIC). In this final multivariate regression, a 1% increase in primary care provider density was associated with a 0.0019% decrease in diabetes prevalence. Meanwhile, a 1%- or 1-point increase in physical inactivity prevalence, obesity prevalence, and social vulnerability scores led to 0.20%, 0.06%, and 0.14% increases in diabetes prevalence respectively. These findings highlight the value of social ecological factors in diabetes research, as well as the increased need for evidence-based diabetes prevention in primary care, including strategies that target personal, community, and public health policy factors related to diabetes.
| Identifer | oai:union.ndltd.org:BGMYU2/oai:scholarsarchive.byu.edu:etd-11497 |
| Date | 27 June 2023 |
| Creators | Kemsley, Robert Alan |
| Publisher | BYU ScholarsArchive |
| Source Sets | Brigham Young University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Theses and Dissertations |
| Rights | https://lib.byu.edu/about/copyright/ |
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