Evidence mapPaperPMID 39313666Full record

ArticleJournal of general internal medicine2024

Homelessness and Type 2 Diabetes: A Qualitative Study of Facilitators and Barriers to Self-Management and Medication Adherence.

Sarah Turcotte Manser, Preethiya Sekar, Zobeida Bonilla, Becky Ford, Nathan Shippee, Andrew M Busch, Lillian Gelberg, Elizabeth A Rogers, Latasha Jennings-Dedina, Victor M Montori and 1 more

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
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

11 authors.

Sarah Turcotte ManserDepartment of Medicine, Division of General Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
Preethiya SekarHealth, Homelessness, and Criminal Justice Lab at the Hennepin Healthcare Research Institute, Minneapolis, MN, USA.
Zobeida BonillaUniversity of Minnesota School of Public Health, Minneapolis, MN, USA.
Becky FordHealth, Homelessness, and Criminal Justice Lab at the Hennepin Healthcare Research Institute, Minneapolis, MN, USA.
Nathan ShippeeUniversity of Minnesota School of Public Health, Minneapolis, MN, USA.
Andrew M BuschBehavioral Health Equity Research Group at the Hennepin Healthcare Research Institute, Minneapolis, MN, USA.
Lillian GelbergDepartment of Family Medicine at the UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
Elizabeth A RogersDepartment of Medicine, Division of General Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
Latasha Jennings-DedinaHealth, Homelessness, and Criminal Justice Lab at the Hennepin Healthcare Research Institute, Minneapolis, MN, USA.
Victor M MontoriKnowledge and Evaluation Research Unit, Mayo Clinic, Minneapolis, MN, USA.
Katherine Diaz VickeryHealth, Homelessness, and Criminal Justice Lab at the Hennepin Healthcare Research Institute, Minneapolis, MN, USA. Katherine.Vickery@hcmed.org.ORCID 0000-0002-1083-838X

Funding

Improving medication adherence among people with diabetes who are homelessK23DK118117 · NIDDK · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI Katherine Diaz Vickery · 2022 to 2023
$325k
NIDDK NIH HHS K23 DK118117NIDDK NIH HHS K23DK118117
6 · The paper itself

Abstract

purposeIn this study, we explore the barriers and facilitators to diabetes medication adherence and self-management for people with type 2 diabetes who have experienced homelessness.

methodsWe conducted five focus groups and two interviews with 26 participants. Our multi-disciplinary analysis team utilized principles of grounded theory and conducted thematic analysis with an inductive, iterative process to identify central themes.

resultsThe majority of participants identified as Black/African American and over half stayed in shelters or had no steady place to stay at enrollment. Three key themes emerged regarding medication adherence and diabetes self-management for people who have experienced homelessness: personal autonomy and security, predictability and stability, and supportive, knowledgeable relationships (both social and medical). We define personal autonomy and security as individual agency and choice when making decisions related to one's health and well-being as well as protection from risk or harm to one's physical or psychological well-being, belongings, or means of income. Predictability and stability take place through the development of a system of connections and routines built over time where individuals can reliably adopt and maintain diabetes self-management activities. Supportive, knowledgeable relationships include medical and social relationships that offer encouragement, information, and hands-on care promoting diabetes self-management and connection to clinical care and resources. Participants also highlighted a "domino effect" where a cascade of events negatively and consequently impacted their health and well-being. We describe the interactions of these themes, the intersection of structural vulnerability and individual social risks, and resulting impacts on medication adherence and diabetes self-management.

conclusionsOur findings highlight the structural vulnerabilities impacting people experiencing homelessness and identify inflection points of opportunity at structural and individual levels to strengthen diabetes medication adherence and self-management. This understanding can inform policy change and future tailored diabetes interventions.

Indexed as

Diabetes Mellitus, Type 2Focus GroupsIll-Housed PersonsMedication AdherenceQualitative ResearchSelf-ManagementAdultAgedFemaleHumansMaleMiddle Agedadherencechronic illnesscompliancediabeteshomelessness

Identifiers

PMID39313666
PMCPMC11618544

What Socratic holds

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Registered trials

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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.