In:
Public Health Nutrition, Cambridge University Press (CUP), Vol. 20, No. 1 ( 2017-01), p. 183-189
Abstract:
To examine the association between level of food security and diabetes self-management among food pantry clients, which is largely not possible using clinic-based sampling methods. Design Cross-sectional descriptive study. Setting Community-based food pantries in California, Ohio and Texas, USA, from March 2012 through March 2014. Subjects Convenience sample of adults with diabetes queuing at pantries ( n 1237; 83 % response). Sampled adults were stratified as food secure, low food secure or very low food secure. We used point-of-care glycated Hb (HbA 1c ) testing to determine glycaemic control and captured diabetes self-management using validated survey items. Results The sample was 70 % female, 55 % Latino/Hispanic, 25 % white and 10 % black/African American, with a mean age of 56 years. Eighty-four per cent were food insecure, one-half of whom had very low food security. Mean HbA 1c was 8·1 % and did not vary significantly by food security status. In adjusted models, very-low-food-secure participants, compared with both low-food-secure and food-secure participants, had poorer diabetes self-efficacy, greater diabetes distress, greater medication non-adherence, higher prevalence of severe hypoglycaemic episodes, higher prevalence of depressive symptoms, more medication affordability challenges, and more food and medicine or health supply trade-offs. Conclusions Few studies of the health impact of food security have been able to examine very low food security. In a food pantry sample with high rates of food insecurity, we found that diabetes self-management becomes increasingly difficult as food security worsens. The efficacy of interventions to improve diabetes self-management may increase if food security is simultaneously addressed.
Type of Medium:
Online Resource
ISSN:
1368-9800
,
1475-2727
DOI:
10.1017/S1368980016001786
Language:
English
Publisher:
Cambridge University Press (CUP)
Publication Date:
2017
detail.hit.zdb_id:
2016337-X
SSG:
21
