Evidence mapPaperPMID 37507549Full record

Observational studyJournal of general internal medicine2023

Psychosocial Factors Predicting Healthcare Usage in Young Adults with Youth-Onset Type 2 Diabetes: The TODAY2 iCount Observational Study.

Paula M Trief, Diane Uschner, Barbara J Anderson, Hui Wen, Jane D Bulger, Ruth S Weinstock

Open access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Observational
  3. Life Lessons and Diabetes Research.Diabetes spectrum : a publication of the American Diabetes Association · 2025
    Article
  4. Advances in Psychological and Social Aetiology of Patients with Diabetes.Diabetes, metabolic syndrome and obesity : targets and therapy · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Paula M TriefDepartment of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, NY, Syracuse, USA. triefp@upstate.edu.ORCID 0000-0002-2827-5722
Diane UschnerThe Biostatistics Center, George Washington University, Washington, DC, USA.
Barbara J AndersonDepartment of Pediatrics-Psychology, Baylor College of Medicine, Houston, TX, USA.
Hui WenThe Biostatistics Center, George Washington University, Washington, DC, USA.
Jane D BulgerDepartment of Medicine, State University of New York Upstate Medical University, NY, Syracuse, USA.
Ruth S WeinstockDepartment of Medicine, State University of New York Upstate Medical University, NY, Syracuse, USA.
SUNY Upstate Medical University · USGeorge Washington University · USBaylor College of Medicine · US

Funding

Statistics Center for Pediatric Type 2 Diabetes TherapyU01DK061230 · GEORGE WASHINGTON UNIVERSITY · 2001 to 2005
$69.5M
Management of Pediatric Type 2 Diabetes MellitusU01DK061239 · CHILDRENS HOSPITAL OF PHILADELPHIA · 2001 to 2005
$4.6M
Multi-Center Study of the Treatment of T2DM in YouthU01DK061212 · YALE UNIVERSITY · 2001 to 2005
$3.9M
Type 2 Diabetes in Youth: Beta Cell PreservationU01DK061254 · CHILDREN'S HOSP PITTSBURGH/UPMC HLTH SYS · 2001 to 2005
$3.6M
Treatment Alternatives in Pediatric Type 2 DiabetesU01DK061242 · UNIVERSITY OF COLORADO DENVER · 2001 to 2005
$3.5M
New York Regional Center for Diabetes Translation ResearchP30DK111022 · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2025 to 2025
$810k
NIDDK NIH HHS P30 DK111022NIDDK NIH HHS R01 DK110456NIDDK NIH HHS RO1DK110456NIDDK NIH HHS U01 DK061212NIDDK NIH HHS U01 DK061230NIDDK NIH HHS U01 DK061239NIDDK NIH HHS U01 DK061242NIDDK NIH HHS U01 DK061254
6 · The paper itself

Abstract

backgroundEstablished diabetes care ("diabetes home") and regular healthcare visits are important to achieve optimal health. Nothing is known about psychosocial factors that predict healthcare usage (HCU) in young adults with youth-onset type 2 diabetes, at risk for early complications.

objectiveTo identify psychosocial predictors of HCU in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY2) cohort.

designLongitudinal, measured at T1 (baseline) and T2 (1 year later). Logistic and linear regressions, adjusted for potential confounders, identified predictors of sub-optimal HCU (defined as no diabetes home, 0 visits for routine care, or  ≥ 1 urgent care visit in prior 6 months).

participantsN = 366 TODAY2 participants with T1 and T2 data (381 consented). Mean age = 26.0 years, 67.8% female, 37.7% non-Hispanic Black, 35.8% Hispanic, 20.2% non-Hispanic white, 6.3% "other," mean HbA1c = 9.4%. MAIN MEASURES: HCU survey; reliable and valid measures of diabetes self-efficacy, depressive symptoms, anxiety symptoms, diabetes distress, beliefs about medicines, diabetes attitudes, material need insecurities, self-management support. KEY

results25.4% had no diabetes home, 23.7% had 0 routine care visits, 46% had  ≥ 1 urgent care visit (prior 6 months). Beliefs in the necessity of (adjusted odds ratio [OR] = 1.28; 95% confidence interval [CI] = 1.12, 1.46, p < 0.001), and concerns about (OR = 1.29;CI = 1.08,1.54, p = 0.004), diabetes medicines, and its negative psychosocial impacts (OR = 1.57;CI = 1.04, 2.38, p = 0.03), predicted higher odds of having a diabetes home at T2. Beliefs that medicines are harmful predicted lower odds of a diabetes home (OR = 0.56;CI = 0.37,0.85, p = 0.006). Necessity beliefs (OR = 1.2;CI = 1.06,1.36, p = 0.004), and self-management support (OR = 1.5;CI = 1.08,2.07, p = 0.01) predicted higher odds of having  ≥ 1 diabetes care visit, harm beliefs predicted lower odds (OR = 0.6;CI = 0.41,0.88, p = 0.01).

conclusionsSub-optimal healthcare usage, common in young adults with youth-onset type 2 diabetes, is predicted by beliefs about medicines, diabetes impact, and self-management support. We must address these factors to help this vulnerable group establish stable diabetes care.

Indexed as

Diabetes Mellitus, Type 2Self-ManagementAdolescentAdultAnxietyDelivery of Health CareFemaleHealth Care SurveysHumansMaleYoung Adulthealthcare usagepsychologysocial determinants of health.type 2 diabetesyoung adults

Identifiers

PMID37507549
PMCPMC10651562
OpenAlexW4385341398

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.