Racial/ethnic differences in multiple diabetes outcomes in patients with type 2 diabetes in the southeastern United States.

OBJECTIVE: To determine racial/ethnic differences in control of multiple diabetes outcomes in a large, diverse primary care sample. METHODS: 661 adults with type 2 diabetes (T2DM) were recruited from three primary care settings. The primary outcomes were individual and composite control of multiple diabetes outcomes. Control of individual diabetes outcomes were defined as hemoglobin A1c (HbA1c) < 7%, blood pressure (BP) < 130/80 mmHg and low-density lipoprotein (LDL)-cholesterol < 100 mg/dL. Composite control was defined as having all three outcomes under control. Linear and logistic regression models were used to assess differences in individual means and individual and composite outcomes control between non-Hispanic Blacks (NHB) and Whites (NHW) adjusting for relevant covariates. RESULTS: NHBs were 67% of the sample, -61% earned < $20,000, and 78% earned < $35,000. Unadjusted mean HbA1c (8.0 vs 7.6, P = .024), SBP (134 vs 126 P < .001), DBP (76 vs 69, P < .001) and LDL (96 vs 87, P = .003) levels were significantly higher in NHBs. Adjusted linear regression showed that SBP (beta = 9.4; 4.5-8.6) and DBP (beta = 5.7; 3.5-7.9) were significantly higher in NHBs. 12.6% had composite control and NHBs had lower composite control (10.0% vs 17.6%). Adjusted logistic models showed that BP control (OR .45; .30-.67) and composite control (OR .57; .33-.98) were significantly lower in NHBs. CONCLUSIONS: In this diverse sample of primary care patients with T2DM, NHBs had significantly lower BP control and composite outcome control compared to NHWs adjusting for relevant confounding factors. Strategies are needed to optimize control of multiple outcomes and reduce disparities in patients with T2DM.

Factors Associated with Engaging in Bystander Intervention Behavior Among College Students.

Sexual violence (SV) is a well-documented and highly prevalent issue on college campuses that disproportionately impacts women, students of color, and students who identify as lesbian, gay, bisexual, transgender, queer (LGBTQ). In recent years, bystander intervention programming has emerged as a promising prevention strategy for colleges due to its success in preventing SV before it occurs using community involvement; however, little consideration has been given to the power, status, or position that a bystander has when deciding whether to intervene and weighing the potential consequences of their actions. In order to inform university campus bystander intervention programming and increase its effectiveness, more work is needed to understand specific student characteristics (e.g., race/ethnicity, gender identity, sexual orientation, history of SV) that may be associated with engaging in bystander behavior in SV risk situations. Using cross-sectional data from a large west-coast university, 592 students were surveyed about their SV-related experiences. Poisson regression models were utilized to determine the relative risk of engaging in bystander behavior by sociodemographic identities and history of SV victimization. Our fully adjusted model indicated that experiencing attempted and completed sexual assault was associated with engaging in bystander behavior; belonging to specific minority groups was differentially associated with engaging in bystander behavior, as was belonging to a minority group and having a history of SV. Personal histories, identities, and power inequity matter when deciding to engage in bystander behavior. Additional research is needed to create more well-rounded and population-specific bystander intervention programs that are inclusive of diverse student voices and experiences.