Objectives:
1) To examine socio-demographic disparities in hypertension control (HTC) among Maccabi members with diabetes.
2) To identify explanatory factors of these disparities.
Hypothesis:
1) Disparities in HTC among diabetic Maccabi members are associated with basic socio-demographic variables: gender, ethnicity/nationality and socio-economic position: HTC will be higher among males than females, among veteran Jewish members in comparison with other population groups, and among those at higher socio-economic position.
2) The associations between socio-demographic characteristics and HTC are (at least partially) explained by cognitive factors, stress, depression and doctor-patient relationship.
Methods:
Cross-sectional survey. The study population includes Maccabi members aged 30-70 years, listed in the plan's diabetes and hypertension registers at two time points - January 2005 and January 2008. Two random samples of 400 patients each will be selected, of members with controlled HT and of those with uncontrolled HT (HT control value = below 130/80 mm mercury). Telephone interviews will be conducted using a structured questionnaire: socio-demographic variables – gender, ethnicity/nationality, education, income, car ownership and additional variables; explanatory variables - knowledge, beliefs about the disease, self-efficacy regarding HT, stress, depression. Additional items from Maccabi database - use of plan services, purchase of HTC medications during the 3-year interval. Statistical analyses will test the contribution of the explanatory factors to the socio-demographic - HTC associations using logistic models (age adjusted).
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