title: Factors affecting screening for diabetic complications in the community: a multilevel analysis.
abstract: OBJECTIVE
  The objective of the present study was to identify the factors that affect screening for diabetic complications by sex in the community.
  
  
  METHODS
  This study used individual-level data from the 2013 Community Health Survey (CHS) for 20,806 (male, 9,958; female, 10,848) adults aged 30 years or older who were diagnosed with diabetes. Community-level data for 253 communities were derived from either CHS or national statistics. A chi-square test and multilevel logistic regression analysis was performed.
  
  
  RESULTS
  There were significant differences in the rate of screening for diabetic complications according to individual-level and community-level variables. In the multilevel analysis, the community-level variance ratio of the null model was 7.4% and 9.2% for males and females, respectively. With regard to community-level variables, males were affected by the city type, number of physicians, and their living environment, while females were affected by number of physicians, natural and living environments, and public transportation.
  
  
  CONCLUSIONS
  The factors that influenced individual willingness to undergo screening for diabetic complications differed slightly by sex; however, both males and females were more likely to undergo screening when they recognized their health status as poor or when they actively sought to manage their health conditions. Moreover, in terms of community-level variables, both males and females were affected by the number of physicians. It is essential to provide sufficient and ongoing opportunities for education on diabetes and its management through collaboration with local communities and primary care medical centers.
authors.affiliation: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Jin A
authors.initials: JA
authors.lastname: Han
authors.affiliation: Department of Health Administration, Dongseo University, Busan, Korea.
authors.forename: Soo Jeong
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Gawon
authors.initials: G
authors.lastname: Kim
authors.affiliation: Gyeonggi Center for Hypertension and Diabetes, Suwon, Korea.
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Soon Young
authors.initials: SY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D048909:Diabetes Complications / Q000175:diagnosis*; D004522:Educational Status; D005260:Female; D006285:Health Planning; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D055361:Multilevel Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Community health planning; Diabetic complication; Multilevel analysis