641-P: Relative Contribution of Individual, Community, and Health System Factors on Glycemic Control among Inner-City African Americans with Type 2 Diabetes

Background: Health disparities are disproportionately impacting inner-city African Americans, however limited information exists on the contribution of individual, community, and health system barriers on diabetes outcomes. Methods: A cross-sectional study collected primary data from 241 inner-city African Americans with type 2 diabetes. A theoretical model was used to specify measurements across the individual level, such as age and comorbidities, community level, such as neighborhood factors and support, and health systems level such as access, trust, and provider communication. Based on current best practices, four regression approaches were used: sequential, stepwise with forward selection, stepwise with backward selection, and all possible subsets. Variables were entered in blocks based on the theoretical framework in the order of individual, community, and health systems factors and regressed against HbA1c. Results: In the final adjusted model across all four approaches, individual level factors like age (β=-0.05; p