ABSTRACT Background In 2020, Detroit residents’ crude kidney disease mortality rate was 1.48 times the state’s rate. Purpose Evaluated Detroit residents’ chronic kidney disease (CKD) knowledge, risk, belief, and preventative practices. Additionally, it examined the association between residents’ CKD knowledge, their sociodemographics, CKD risk and belief. Methods 378 Detroit residents, ages 20 years or older, were recruited from May 2019-August 2021 to complete the Qualtrics survey on their CKD knowledge, beliefs, and risk. Descriptive statistics and multiple linear regression were conducted to meet the study’s purpose. Results Most participants were unaware of dry and itchy skin as a CKD symptom (60%). African Americans (β = −1.5; p = .002) and those with a high school education or less (β = −1.46; p = .038) had lower knowledge scores than White residents and those with higher education. Participants’ knowledge score increased by 0.64 as CKD risk score increased by 1 (β = 0.64; p = .019). Discussion CKD knowledge is low among Detroit residents and associated with race, education, and risk level. Translation to Health Education Practice: African American Detroit residents would benefit from targeted marketing and communication plans that increase their knowledge of CKD prevention. It also depicts key components (e.g., risks factors) that should be communicated in the messages.

Abstract Compared to Michigan as a state, Detroit, the largest urban city in Michigan, has a substantially higher chronic condition burden. This study examined influential factors, including health beliefs, behavior tracking, and social determinants of health associated with Detroit residents' chronic condition status. Using a cross-sectional community-based study design, 394 Detroit residents were recruited from May 2019-August 2021 to complete a survey. To meet the study objectives, descriptive statistics and binary logistic regression analyses were conducted using STATA MP17. Over 45% of participants self-reported having a chronic condition. Participants reported housing, food, healthcare, and stress as their top social determinants of health. Participants with a chronic condition had significantly higher adjusted odds (AOR = 1.71, 95% CI: 1.01 to 2.89) of requesting assistance with intermediary than structural determinants. This is one of the first studies to describe Detroit residents' self-reported needs by their chronic condition status. Residents' social needs are multifaceted and associated with chronic condition status. Residents would benefit from interprofessional collaborations to address their top social determinants and promote lifestyle changes.

Abstract Background and objective The notion of prediabetes, defined by the ADA as glycated hemoglobin A1c (HbA1c) of 5.7–6.4%, implies increased vascular inflammatory and immunologic processes and higher risk for developing diabetes mellitus and major cardiovascular events. We aimed to determine the risk factors associated with rapid progression of normal and prediabetes patients to type 2 diabetes mellitus (T2DM). Methods Retrospective cohort study in a single 8-hospital health system in southeast Michigan, between 2006 and 2020. All patients with HbA1c <6.5% at baseline and at least 2 other HbA1c measurements were clustered in five trajectories encompassing more than 95% of the study population. Multivariate linear regression analysis was performed to examine the association of demographic and comorbidities with HbA1c trajectories progressing to diabetes. Results A total of 5,347 prediabetic patients were clustered based on their HbA1c progression (C1: 4,853, C2: 253, C66: 102, C12: 85, C68: 54). The largest cluster (C1) had a baseline median HbA1c value of 6.0% and exhibited stable HbA1c levels in prediabetic range across all subsequent years. The smallest cluster (C68) had the lowest median baseline HbA1c value and also remained stable across subsequent years. The proportion of normal HbA1c in each of the pre-diabetic trajectories ranged from 0 to 12.7%, whereas 81.5% of the reference cluster (C68) were normal HbA1c at baseline. The C2 (steady rising) trajectory was significantly associated with BMI (adj OR 1.10, 95%CI 1.03–1.17), and family history of DM (adj OR 2.75, 95%CI 1.32–5.74). With respect to the late rising trajectories, baseline BMI was significantly associated with both C66 and C12 trajectory (adj OR 1.10, 95%CI 1.03–1.18) and (adj OR 1.13, 95%CI 1.05–1.23) respectively, whereas, the C12 trajectory was also significantly associated with age (adj OR 1.62, 95%CI 1.04–2.53) and history of MACE (adj OR 3.20, 95%CI 1.14–8.93). Conclusions We suggest that perhaps a more aggressive preventative approach should be considered in patients with a family history of T2DM who have high BMI and year-to-year increase in HbA1c, whether they have normal hemoglobin A1c or they have prediabetes. KEY MESSAGES Progression to diabetes from normal or prediabetic hemoglobin A1c within four years is associated with baseline BMI. A steady rise in HbA1c during a four-year period is associated with age and family history of T2DM, whereas age and personal history of MACE are associated with a rapid rise in HbA1c. A more aggressive preventative approach should be considered in patients with a family history of T2DM who have high BMI and year-to-year increase in HbA1c.