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The Association of Income with Health Behavior Change and Disease Monitoring among Patients with Chronic Disease

BACKGROUND: Management of chronic diseases requires patients to adhere to recommended health behavior change and complete tests for monitoring. While studies have shown an association between low income and lack of adherence, the reasons why people with low income may be less likely to adhere are un...

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Autores principales: Campbell, David JT., Ronksley, Paul E., Manns, Braden J., Tonelli, Marcello, Sanmartin, Claudia, Weaver, Robert G., Hennessy, Deirdre, King-Shier, Kathryn, Campbell, Tavis, Hemmelgarn, Brenda R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983092/
https://www.ncbi.nlm.nih.gov/pubmed/24722618
http://dx.doi.org/10.1371/journal.pone.0094007
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author Campbell, David JT.
Ronksley, Paul E.
Manns, Braden J.
Tonelli, Marcello
Sanmartin, Claudia
Weaver, Robert G.
Hennessy, Deirdre
King-Shier, Kathryn
Campbell, Tavis
Hemmelgarn, Brenda R.
author_facet Campbell, David JT.
Ronksley, Paul E.
Manns, Braden J.
Tonelli, Marcello
Sanmartin, Claudia
Weaver, Robert G.
Hennessy, Deirdre
King-Shier, Kathryn
Campbell, Tavis
Hemmelgarn, Brenda R.
author_sort Campbell, David JT.
collection PubMed
description BACKGROUND: Management of chronic diseases requires patients to adhere to recommended health behavior change and complete tests for monitoring. While studies have shown an association between low income and lack of adherence, the reasons why people with low income may be less likely to adhere are unclear. We sought to determine the association between household income and receipt of health behavior change advice, adherence to advice, receipt of recommended monitoring tests, and self-reported reasons for non-adherence/non-receipt. METHODS: We conducted a population-weighted survey, with 1849 respondents with cardiovascular-related chronic diseases (heart disease, hypertension, diabetes, stroke) from Western Canada (n = 1849). We used log-binomial regression to examine the association between household income and the outcome variables of interest: receipt of advice for and adherence to health behavior change (sodium reduction, dietary improvement, increased physical activity, smoking cessation, weight loss), reasons for non-adherence, receipt of recommended monitoring tests (cholesterol, blood glucose, blood pressure), and reasons for non-receipt of tests. RESULTS: Behavior change advice was received equally by both low and high income respondents. Low income respondents were more likely than those with high income to not adhere to recommendations regarding smoking cessation (adjusted prevalence rate ratio (PRR): 1.55, 95%CI: 1.09–2.20), and more likely to not receive measurements of blood cholesterol (PRR: 1.72, 95%CI 1.24–2.40) or glucose (PRR: 1.80, 95%CI: 1.26–2.58). Those with low income were less likely to state that non-adherence/non-receipt was due to personal choice, and more likely to state that it was due to an extrinsic factor, such as cost or lack of accessibility. CONCLUSIONS: There are important income-related differences in the patterns of health behavior change and disease monitoring, as well as reasons for non-adherence or non-receipt. Among those with low income, adherence to health behavior change and monitoring may be improved by addressing modifiable barriers such as cost and access.
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spelling pubmed-39830922014-04-15 The Association of Income with Health Behavior Change and Disease Monitoring among Patients with Chronic Disease Campbell, David JT. Ronksley, Paul E. Manns, Braden J. Tonelli, Marcello Sanmartin, Claudia Weaver, Robert G. Hennessy, Deirdre King-Shier, Kathryn Campbell, Tavis Hemmelgarn, Brenda R. PLoS One Research Article BACKGROUND: Management of chronic diseases requires patients to adhere to recommended health behavior change and complete tests for monitoring. While studies have shown an association between low income and lack of adherence, the reasons why people with low income may be less likely to adhere are unclear. We sought to determine the association between household income and receipt of health behavior change advice, adherence to advice, receipt of recommended monitoring tests, and self-reported reasons for non-adherence/non-receipt. METHODS: We conducted a population-weighted survey, with 1849 respondents with cardiovascular-related chronic diseases (heart disease, hypertension, diabetes, stroke) from Western Canada (n = 1849). We used log-binomial regression to examine the association between household income and the outcome variables of interest: receipt of advice for and adherence to health behavior change (sodium reduction, dietary improvement, increased physical activity, smoking cessation, weight loss), reasons for non-adherence, receipt of recommended monitoring tests (cholesterol, blood glucose, blood pressure), and reasons for non-receipt of tests. RESULTS: Behavior change advice was received equally by both low and high income respondents. Low income respondents were more likely than those with high income to not adhere to recommendations regarding smoking cessation (adjusted prevalence rate ratio (PRR): 1.55, 95%CI: 1.09–2.20), and more likely to not receive measurements of blood cholesterol (PRR: 1.72, 95%CI 1.24–2.40) or glucose (PRR: 1.80, 95%CI: 1.26–2.58). Those with low income were less likely to state that non-adherence/non-receipt was due to personal choice, and more likely to state that it was due to an extrinsic factor, such as cost or lack of accessibility. CONCLUSIONS: There are important income-related differences in the patterns of health behavior change and disease monitoring, as well as reasons for non-adherence or non-receipt. Among those with low income, adherence to health behavior change and monitoring may be improved by addressing modifiable barriers such as cost and access. Public Library of Science 2014-04-10 /pmc/articles/PMC3983092/ /pubmed/24722618 http://dx.doi.org/10.1371/journal.pone.0094007 Text en © 2014 Campbell et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Campbell, David JT.
Ronksley, Paul E.
Manns, Braden J.
Tonelli, Marcello
Sanmartin, Claudia
Weaver, Robert G.
Hennessy, Deirdre
King-Shier, Kathryn
Campbell, Tavis
Hemmelgarn, Brenda R.
The Association of Income with Health Behavior Change and Disease Monitoring among Patients with Chronic Disease
title The Association of Income with Health Behavior Change and Disease Monitoring among Patients with Chronic Disease
title_full The Association of Income with Health Behavior Change and Disease Monitoring among Patients with Chronic Disease
title_fullStr The Association of Income with Health Behavior Change and Disease Monitoring among Patients with Chronic Disease
title_full_unstemmed The Association of Income with Health Behavior Change and Disease Monitoring among Patients with Chronic Disease
title_short The Association of Income with Health Behavior Change and Disease Monitoring among Patients with Chronic Disease
title_sort association of income with health behavior change and disease monitoring among patients with chronic disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983092/
https://www.ncbi.nlm.nih.gov/pubmed/24722618
http://dx.doi.org/10.1371/journal.pone.0094007
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