{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:30:02Z","timestamp":1791549002201,"version":"4.3.4"},"reference-count":38,"publisher":"American Diabetes Association","issue":"5","license":[{"start":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T00:00:00Z","timestamp":1587340800000},"content-version":"vor","delay-in-days":47,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Daily foot self-inspection may permit earlier detection and treatment of a foot lesion, reducing the risk of infection and lower-limb amputation (LLA). Though race and ethnicity are strongly associated with LLA risk, with higher risk seen in African Americans (AA), American Indians\/Alaska Natives (AI\/AN), and Native Hawaiians\/Pacific Islanders (NH\/PI), associations between foot self-inspection and racial and ethnic groups are inconsistent. We aimed to assess differences in foot self-inspection among people with diabetes by race\/ethnicity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>Using national, cross-sectional data from the 2015\u20132017 Behavioral Risk Factor Surveillance System surveys and including 88,424 individuals with diabetes, we estimated prevalence ratios (PRs) and associated 95% CIs of daily foot checking for sores or irritation by racial and ethnic groups using log-binomial linear regression models, after accounting for survey weights.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Compared with whites (who had a weighted prevalence [P] of daily foot self-inspection of 57%), AA (P 67%, PR 1.18 [95% CI 1.14, 1.23]), AI\/AN (P 66%, PR 1.15 [95% CI 1.07, 1.25]), and NH\/PI (P 71%, PR 1.25 [95% CI 1.03, 1.52]) had higher prevalences of daily foot self-inspection. The prevalence of daily foot inspection was significantly lower among Asians (P 35%, PR 0.62 [95% CI 0.48, 0.81]) and Hispanics (P 53%, PR 0.93 [95% CI 0.88, 0.99]) compared with whites. Associations did not vary importantly by insulin use, years since diabetes diagnosis, or having received diabetes self-management education.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The higher frequency of foot self-inspection in racial and ethnic groups at elevated risk of diabetes-related LLA is not sufficient to eliminate LLA disparities; additional interventions are needed to achieve this aim.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc19-1486","type":"journal-article","created":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T23:44:27Z","timestamp":1583365467000},"page":"956-963","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":23,"title":["Associations Between Racial and Ethnic Groups and Foot Self-Inspection in People With Diabetes"],"prefix":"10.2337","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4247-8286","authenticated-orcid":false,"given":"Alyson J.","family":"Littman","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of Washington School of Public Health, Seattle, WA"},{"name":"Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA"},{"name":"Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine J.","family":"Knott","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington School of Public Health, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3695-192X","authenticated-orcid":false,"given":"Edward J.","family":"Boyko","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington School of Public Health, Seattle, WA"},{"name":"Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA"},{"name":"Department of Medicine, University of Washington School of Medicine, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen E.","family":"Hawes","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington School of Public Health, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2020,3,4]]},"reference":[{"key":"2022031300351541000_B1","first-page":"954","article-title":"Hospital discharge rates for nontraumatic lower extremity amputation by diabetes status--United States, 1997","volume":"50","author":"Centers for Disease Control and Prevention (CDC)","year":"2001","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022031300351541000_B2","article-title":"National Diabetes Statistics Report","author":"Centers for Disease Control and Prevention","year":"2017"},{"key":"2022031300351541000_B3","doi-asserted-by":"crossref","first-page":"513","DOI":"10.2337\/diacare.13.5.513","article-title":"Pathways to diabetic limb amputation. 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