Factors Associated With Control of Diabetes and Hypertension Among Patients Seen as Part of a Longitudinal Medical School Service-Learning Program From 2018-2019: An Exploratory Analysis

Raelynn Vigue; Waleem E Hernandez; Ashley L Ramirez; Grettel Castro; Noel C Barengo; David R Brown; Juan Ruiz-Pelaez

doi:10.7759/cureus.28225

Factors Associated With Control of Diabetes and Hypertension Among Patients Seen as Part of a Longitudinal Medical School Service-Learning Program From 2018-2019: An Exploratory Analysis

Cureus. 2022 Aug 21;14(8):e28225. doi: 10.7759/cureus.28225. eCollection 2022 Aug.

Authors

Raelynn Vigue¹, Waleem E Hernandez¹, Ashley L Ramirez¹, Grettel Castro², Noel C Barengo^{3

1}, David R Brown^{4

5}, Juan Ruiz-Pelaez^{1

6}

Affiliations

¹ Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, USA.
² Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, USA.
³ Department of Health Policy and Management, Robert Stempel College of Public Health, Florida International University, Miami, USA.
⁴ Department of Family Medicine, West Kendall Baptist Hospital, Miami, USA.
⁵ Department of Humanities, Health, and Society, Herbert Wertheim College of Medicine, Florida International University, Miami, USA.
⁶ KMC Senior Researcher, Kangaroo Foundation, Bogota, COL.

Abstract

Introduction The Florida International University (FIU) Green Family Neighborhood Health Education Learning Program (NeighborhoodHELP) in Miami-Dade County serves communities impacted by adverse social determinants of health. This study identified sociodemographic factors affecting control of diabetes and hypertension among NeighborhoodHELP patients. Methods This non-concurrent cohort study evaluated NeighborhoodHELP patients who received care at mobile health centers (MHCs) utilizing de-identified data extracted from the MHCs' clinical quality metrics data set for the 2018-2019 fiscal year. A total of 143 eligible adults with diabetes and 222 adults with hypertension were identified. Condition control was defined as blood pressure ≤ 130 mmHg (systolic) and ≤ 80 mmHg (diastolic) or hemoglobin A1c (HbA1c) ≤ 7% (diabetes). Association with age, gender, ethnicity, marital status, language, service area, income per-capita, and medical student assignment was explored using logistic regression. Results The model showed decreased diabetes control likelihood among Haitian-Creole speakers (OR: 0.13; 95% CI: 0.02-0.75). Odds of diabetes control were greater in two discrete areas serviced by the program, one known as Hippocrates (OR: 4.9; 95% CI: 1.23-19.37) and the other Semmelweis (OR: 3.71; 95% CI: 1.07-12.83). Income greater than $10,000 increased hypertension control likelihood (OR: 2.22; 95% CI: 1.03-4.8). Conclusions Among NeighborhoodHELP patients, geographic region and language impact diabetes control, while income affects hypertension control. Further research is warranted to identify the role of other factors.

Keywords: diabetes mellitus type 2; hypertension control; public health care; social determinant of health; socio demographic factors.