No thesis has been selected yet. However, I do have interest in exploring a gender analysis of chronic disease diagnosis and management. Diabetes mellitus is among the top 5 causes of morbidity and mortality in countries that have substantively achieved the demographic and epidemiological transitions. Community surveys have indicated no statistically significant gender differentials in the prevalence of diabetes mellitus in the community. Yet an analysis of reported morbidity and mortality in many countries of the Caribbean reveal a two to one female excess in the diagnosis and treatment of diabetes. Diabetes is one condition where appropriate management in a partnership between patient and provider can significantly improve quantity and quantity of life. My broad objective is to narrow the gender differential in the diagnosis and management of diabetes, and to improve the proportion of diabetes diagnosed and managed appropriately in men.
The specific aims are to devise, test, implement and evaluate community based mechanism for identifying undiagnosed diabetes in communities, and to ensure gender equity in seeking out the underdiagnosed male diabetic. Having identified this population, to create, test, implement and evaluate innovative communications interventions at mass media and at the individual level, to improve the yield of biochemically controlled diabetics in the community. This will be achieved through the introduction and field testing of a Diabetes Passport, similar to the Child Health Passport now in common use. This Diabetes Passport would request that the medical practitioner to fill in pertinent information on it at each visit, and this passport would be the permanent record of his status and control over time. Focusing primary health care (PHC) on women and children is justified, given the vulnerability of these populations. However this focus has resulted in a PHC health sector that is woman and child centered, as health messages and programs have been largely geared toward mothers. However social marketing teaches the primacy of market segmentation, and the necessity of developing specific messages targeted at specific audiences. The male diabetic presents us with a challenge.
| Bolen, Shari Danielle; Bricker, Eric; Samuels, T Alafia et al. (2009) Factors associated with intensification of oral diabetes medications in primary care provider-patient dyads: a cohort study. Diabetes Care 32:25-31 |
| Bolen, Shari Danielle; Samuels, T Alafia; Yeh, Hsin-Chieh et al. (2008) Failure to intensify antihypertensive treatment by primary care providers: a cohort study in adults with diabetes mellitus and hypertension. J Gen Intern Med 23:543-50 |
| Samuels, T Alafia; Bolen, Shari; Yeh, H C et al. (2008) Missed opportunities in diabetes management: a longitudinal assessment of factors associated with sub-optimal quality. J Gen Intern Med 23:1770-7 |
