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Health Place. 2018 Nov;54:164-169. doi: 10.1016/j.healthplace.2018.07.007. Epub 2018 Oct 1.

Geographic variation in the impact of a type 2 diabetes diagnosis on behavioural change: A longitudinal study using random effects within-between (REWB) models.

Author information

1
Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences University of Wollongong, Wollongong, NSW 2522, Australia; Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, NSW 2006, Australia; Illawarra Health and Medical Research Institute, University of Wollongong and lllawarra Shoalhaven Local Health District, Wollongong, NSW 2522, Australia; School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China. Electronic address: thomasab@uow.edu.au.
2
Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences University of Wollongong, Wollongong, NSW 2522, Australia; Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, NSW 2006, Australia; Illawarra Health and Medical Research Institute, University of Wollongong and lllawarra Shoalhaven Local Health District, Wollongong, NSW 2522, Australia.

Abstract

A type 2 diabetes (T2DM) diagnosis has been referred to as a "wake-up call", but subsequent behavioural change may be influenced by place of residence. Random effects within-between regressions were applied to 130,926 participants in the 45 and Up Study. T2DM diagnoses effected change in the odds of short sleeps and meeting vegetable and alcohol consumption guidelines, but not changes in physical activity. Each of these behaviours varied geographically and were patterned by area disadvantage and geographic remoteness. Impacts of T2DM diagnosis on behavioural change were not found to be geographically contingent, though analysis of specific environmental attributes is warranted.

KEYWORDS:

Area disadvantage; Behaviour; Geographic remoteness; Longitudinal analysis; Random effects within-between models; Type 2 diabetes

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