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Brief ReportBrief Report

Family-Oriented Social Service Touchpoints as Opportunities to Enhance Diabetes Screening following a History of Gestational Diabetes

Maya Venkataramani, Tina L. Cheng, Hsien-Chieh Yeh, Wendy L. Bennett and Nisa M. Maruthur
The Journal of the American Board of Family Medicine July 2020, 33 (4) 616-619; DOI: https://doi.org/10.3122/jabfm.2020.04.190382
Maya Venkataramani
From the Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (MV, HCY, WLB, NMM); Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (MV, TLC, NMM); Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD (MV, HCY, WB, NMM); Johns Hopkins Brancati Center for the Advancement of Community Care, Baltimore, MD (MV, NMA).
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Tina L. Cheng
From the Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (MV, HCY, WLB, NMM); Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (MV, TLC, NMM); Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD (MV, HCY, WB, NMM); Johns Hopkins Brancati Center for the Advancement of Community Care, Baltimore, MD (MV, NMA).
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Hsien-Chieh Yeh
From the Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (MV, HCY, WLB, NMM); Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (MV, TLC, NMM); Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD (MV, HCY, WB, NMM); Johns Hopkins Brancati Center for the Advancement of Community Care, Baltimore, MD (MV, NMA).
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Wendy L. Bennett
From the Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (MV, HCY, WLB, NMM); Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (MV, TLC, NMM); Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD (MV, HCY, WB, NMM); Johns Hopkins Brancati Center for the Advancement of Community Care, Baltimore, MD (MV, NMA).
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Nisa M. Maruthur
From the Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (MV, HCY, WLB, NMM); Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (MV, TLC, NMM); Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD (MV, HCY, WB, NMM); Johns Hopkins Brancati Center for the Advancement of Community Care, Baltimore, MD (MV, NMA).
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    Table 1.

    Selected Characteristics of Women with a History of Gestational Diabetes* from the National Health Interview Survey (2016 and 2017), by Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or Head Start Access Status

    Women Accessing WIC Services†Women Accessing Head Start Services†Women Accessing Neither Service‡
    % of N§ (95% CI)% of N‖ (95% CI)% of N| (95% CI)
    Age, years (mean, (SE))31.8 (0.91)34.5 (1.24)36.8 (0.42)
    Race
        White77.9 (65.3 to 86.9)66.1 (41.2 to 84.4)73.9 (67.2 to 79.6)
        African-American8.0 (4.1 to 15.0)27.1 (10.8 to 53.3)10.6 (7.1 to 15.7)
        Asian, Alaskan Native/American Indian, other¶14.1 (6.4 to 28.1)6.8 (1.7 to 23.9)15.5 (10.5 to 22.2)
    Hispanic Ethnicity#,**38.3 (25.8 to 52.6)39.1 (18.3 to 65.0)15.8 (11.6 to 21.2)
    Income category#,**
        <100% FPL38.9 (26.2 to 53.3)37.4 (18.4 to 61.3)9.5 (6.6 to 13.5)
        100% to <200% FPL42.2 (27.9 to 57.9)26.8 (8.7 to 58.4)17.1 (12.6 to 22.8)
        ≥200% FPL18.9 (10.2 to 32.3)35.8 (18.3 to 58.1)73.4 (67.8 to 78.3)
    Current insurance coverage#,**
        Uninsured15.7 (8.2 to 28.0)5.2 (1.4 to 17.4)8.2 (5.2 to 12.7)
        Public45.6 (31.9 to 60.1)41.0 (20.7 to 64.9)14.0 (9.6 to 20.0)
        Any private38.7 (26.8 to 52.1)53.8 (30.7 to 75.4)77.8 (71.2 to 83.3)
    Had a visit with a medical provider in the past 1 year#85.2 (69.6 to 93.5)57.2 (31.8 to 79.4)86.2 (80.2 to 90.6)
    • FPL, federal poverty level; SE, standard error; CI, confidence interval; NHIS, national health interview survey.

    • All descriptive statistics calculated using NHIS sample weights.

    • ↵* Women ages 18 to 45 years without self-reported diabetes or pre-diabetes with a child linked in the dataset.

    • ↵† WIC services for self or child in prior calendar year; child currently enrolled in Head Start.

    • ↵‡ Women who may or may not have had a child in the dataset.

    • ↵| n = 1,438,683 weighted (316 unweighted).

    • ↵§ n = 434,540 weighted (87 unweighted); for income, race, visit in past year, n = 422,228 weighted (86 unweighted).

    • ↵‖ n = 174,104 weighted (37 unweighted); for race and Hispanic ethnicity, n = 173,025 weighted (36 unweighted).

    • ↵¶ More than 1 race.

    • ↵# Indicates categories with significantly different distribution among women accessing WIC compared to women accessing neither service (by Pearson's χ2 test).

    • ↵** Indicates categories with significantly different distribution among women accessing Head Start compared to women accessing neither service.

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    Table 2.

    Prevalence of Recent Diabetes Screening among Women with a History of Gestational Diabetes* from the National Health Interview Survey (2016 and 2017), by Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or Head Start Access Status

    Women Accessing WIC Services†Women Accessing Head Start Services†
    % of N (95% CI)% of N (95% CI)
    Has NOT had diabetes screening within the past 3 years‡10.5 (5.0 to 20.7)§8.2 (2.9 to 21.0)|
    Sensitivity analysis: Has NOT had diabetes screening within past 3 years or after most recent pregnancy¶35.0 (21.8 to 51.0)#21.2 (9.3 to 41.3)**
    • All descriptive statistics calculated using NHIS sample weights.

    • ↵* Women ages 18 to 45 years without self-reported diabetes or pre-diabetes with a child linked in the dataset.

    • ↵† WIC services for self or child in prior calendar year; child currently enrolled in Head Start.

    • ↵‡ Self report of receipt of “last blood test for high blood sugar/diabetes.”

    • ↵§ n = 422,228 weighted (86 unweighted).

    • ↵| n = 174,104 weighted (37 unweighted).

    • ↵¶ Self-reported screening in past 3 years OR if had a child 2 years or younger, occurring after recent pregnancy; n = 327,874 weighted (64 unweighted).

    • ↵** n = 147,574 weighted (32 unweighted).

    • NHIS, national health interview survey; CI, confidence interval.

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The Journal of the American Board of Family     Medicine: 33 (4)
The Journal of the American Board of Family Medicine
Vol. 33, Issue 4
July-August 2020
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Family-Oriented Social Service Touchpoints as Opportunities to Enhance Diabetes Screening following a History of Gestational Diabetes
Maya Venkataramani, Tina L. Cheng, Hsien-Chieh Yeh, Wendy L. Bennett, Nisa M. Maruthur
The Journal of the American Board of Family Medicine Jul 2020, 33 (4) 616-619; DOI: 10.3122/jabfm.2020.04.190382

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Family-Oriented Social Service Touchpoints as Opportunities to Enhance Diabetes Screening following a History of Gestational Diabetes
Maya Venkataramani, Tina L. Cheng, Hsien-Chieh Yeh, Wendy L. Bennett, Nisa M. Maruthur
The Journal of the American Board of Family Medicine Jul 2020, 33 (4) 616-619; DOI: 10.3122/jabfm.2020.04.190382
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Keywords

  • Follow-Up Care
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  • Health Care Disparities
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  • Pregnancy
  • Risk Factors
  • Screening
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