Table 1. Articles Reviewed that Focused on Racial Differences in Self-Monitoring.
| Study author, year | Adams et al, 2003 [13] | Mah et al, 2006 [14] | Nwasuruba et al, 2009 [12] |
|---|---|---|---|
| Study Design | Cross-sectional | Cohort | Cross-sectional |
| Number of participants (completed) | 4,565 | 2,275 | 1,720 |
| Sample population | Adult managed care (eastern MA) | Adult patients in HMO | 2002-2004 adults with DM in the Texas Behavioral Risk Factor Surveillance Survey (BRFSS) |
| Study Timeframe | N/A | 4 years | N/A |
| Outcome Assessment | Likelihood of any SMBG and regularity (filling scripts for 90 or more test strips) of SMBG* | Incidence (1 or more test strips in a given month) and discontinuation (>6months w/out using test strip) of SMBG after receiving free home blood glucose monitors* | Self-management behaviors (physical activity, home blood glucose test, home foot examinations) and quality of care (HbA1c by provider, foot exam by provider, eye exam by provider, flu shot in last 12m, pneumonia shot) |
| Absolute change in outcome by race (95% confidence interval) | AA: OR 0.46 (0.26-0.81) Other: OR 0.32 (0.09-1.23) |
AA in pre-policy: HR 1.14
(0.86-1.50) AA in post-policy: HR 1.33 (1.01-1.76) |
AA: OR 1.0 (0.49-2.05) HW: OR 0.91 (0.43-1.95) |
| Statistical significance | NR | NR | NR |
| Major Findings | AA and lack of glycemic control were significantly associated with less frequent SMBG | Promoting monitoring had greater effects in motivating new trials of SMBG among AA patients on oral therapy compared to NHW | Differences in home glucose testing and home foot care were no longer significant after controlling for SES and access to care variables |
| Limitations | Study design prevents causal inference; efficacy of SMBG on patient behavior has yet to be determined in literature | No control for other race related sociocultural factors; outcome measure based on test strip dispensing rather than actual use; SES differences between races were small in this study setting, so economic barriers may be greater in general population | Telephone surveys may be more biased due to exclusion of participants without access to phones; physical activity assessed was only leisure time |
AA=African American; HW=Hispanic White; AS=Asians; MA=Mexican American; NR=Not Reported; OR=Odds Ratio; HR=Hazard Ratio; SMBG=self-monitoring blood glucose;
*
compared to NHW