当前位置： SCI文献检索 > BMJ Open期刊下所有文献 > Examining protective and buffering associations between sociocultural factors and adverse childhood experiences among American Indian adults with type 2 diabetes: a quantitative, community-based participatory research approach.

Examining protective and buffering associations between sociocultural factors and adverse childhood experiences among American Indian adults with type 2 diabetes: a quantitative, community-based participatory research approach.

Abstract：

OBJECTIVES:The purpose of this study was to determine the frequency of select adverse childhood experiences (ACEs) among a sample of American Indian (AI) adults living with type 2 diabetes (T2D) and the associations between ACEs and self-rated physical and mental health. We also examined associations between sociocultural factors and health, including possible buffering processes. DESIGN:Survey data for this observational study were collected using computer-assisted survey interviewing techniques between 2013 and 2015. SETTING:Participants were randomly selected from AI tribal clinic facilities on five reservations in the upper Midwestern USA. PARTICIPANTS:Inclusion criteria were a diagnosis of T2D, age 18 years or older and self-identified as AI. The sample includes n=192 adults (55.7% female; mean age=46.3 years). PRIMARY MEASURES:We assessed nine ACEs related to household dysfunction and child maltreatment. Independent variables included social support, diabetes support and two cultural factors: spiritual activities and connectedness. Primary outcomes were self-rated physical and mental health. RESULTS:An average of 3.05 ACEs were reported by participants and 81.9% (n=149) said they had experienced at least one ACE. Controlling for gender, age and income, ACEs were negatively associated with self-rated physical and mental health (p<0.05). Connectedness and social support were positively and significantly associated with physical and mental health. Involvement in spiritual activities was positively associated with mental health and diabetes-specific support was positively associated with physical health. Social support and diabetes-specific social support moderated associations between ACEs and physical health. CONCLUSIONS:This research demonstrates inverse associations between ACEs and well-being of adult AI patients with diabetes. The findings further demonstrate the promise of social and cultural integration as a critical component of wellness, a point of relevance for all cultures. Health professionals can use findings from this study to augment their assessment of patients and guide them to health-promoting social support services and resources for cultural involvement.

journal_name

BMJ Open

journal_title

BMJ open

authors

Brockie TN,Elm JHL,Walls ML

doi

10.1136/bmjopen-2018-022265

subject

Has Abstract

pub_date

2018-09-19 00:00:00

pages

e022265

issue

9

issn

2044-6055

pii

bmjopen-2018-022265

journal_volume

8

pub_type

杂志文章

相关文献

BMJ Open文献大全