Barrett, The Honors College Thesis/Creative Project Collection
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- All Subjects: Diabetes
- All Subjects: community
- Creators: Shaibi, Gabriel
Description
Background: The prevalence of childhood obesity has disproportionately affected Latino youth. This increase in obesity is seen with an increased incidence of Type 2 Diabetes. Objective/Hypothesis: The objective of this study was to determine the effects of a community based lifestyle intervention, which encompassed nutrition education and physical activity, on diabetes risk in pre-diabetic Latino adolescents. Diabetes risk was assessed using pancreatic beta cell function as measured by proinsulin: insulin ratio. It was hypothesized that reductions in added sugar intake and reductions in saturated fat intake will be associated with improved beta cell function as measured by proinsulin: insulin ratio. Study Design/Participants: In this quasi-experimental study design, n=17 pre-diabetic Latino adolescents between the ages of 14-16 participated in a lifestyle intervention. Methods: Anthropometric measurements (weight, height, waist circumference, BMI) and body composition (body %) were determined for all participants at baseline and post intervention. Fasting proinsulin (PI), fasting insulin (I) and 2hr-OGTT were also determined. Dietary intake was measured using the Block Kids Food Screener for kids ages 2-17y (2007). The intervention consisted of nutrition education classes and physical activity sessions for 12 weeks. Results: We found significant decreases in body fat % following the intervention. There were no significant decreases in fasting insulin. Proinsulin significantly decreased. However we did no see a significant change in PI/I (p= 0.003). Dietary behaviors of added sugar (p=0.03) and saturated fat (p=0.04) showed significant decreases. No significant associations were found between changes in added sugar to improvements in beta cell function, r=0.072, p-value= 0.7. We also did not observe significant associations between reductions in saturated fat intake and improvements in beta cell function, r=0.152, p-value =0.6. Conclusions: We concluded that a 12-week lifestyle intervention resulted in significant changes in dietary behaviors. These changes were not however associated with improvements in beta cell function.
ContributorsKaur, Manroop (Author) / Shaibi, Gabriel (Thesis director) / Bruening, Meredith (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2015-05
Description
Background:
Pediatric obesity is associated with lower quality of life (QOL) and populations with high obesity rates, such as Latinos, are especially vulnerable. We examined the effects of a 12-week diabetes prevention program on changes in weight-specific QOL in Latino youth.
Method:
Fifteen obese Latino adolescents (BMI%=96.3±1.1;age=15.0±1.0) completed a 12-week intervention. Youth completed weight-specific QOL measures at baseline, post intervention, and 1-year follow-up. For comparison purposes, intervention youth were matched for age and gender with lean controls.
Results:
At baseline, obese youth exhibited significantly lower weight-specific QOL compared with lean youth (70.8±5.4 to 91.2±2.2, p<0.005). The intervention did not significantly impact weight (90.6±6.8 to 89.9±7.2kg, p=0.44). However, significant increases in weight-specific QOL were observed (70.8±20.9 to 86.2±16.9, p<0.001). Post-intervention QOL scores were no longer significantly different than lean controls (P=0.692). Data from nine youth who returned for follow-up indicated that increases in weight-specific QOL were maintained over time (90.5±4.5 to 85.8±5.9, p=0.74).
Conclusion:
These results indicate that a community-based diabetes prevention program can result in sustained improvements in weight-specific QOL among obese Latino youth. Lifestyle interventions that focus on social interaction and physical activity, rather than weight-loss per se, may help improve the psychosocial health of obese Latino youth.
Pediatric obesity is associated with lower quality of life (QOL) and populations with high obesity rates, such as Latinos, are especially vulnerable. We examined the effects of a 12-week diabetes prevention program on changes in weight-specific QOL in Latino youth.
Method:
Fifteen obese Latino adolescents (BMI%=96.3±1.1;age=15.0±1.0) completed a 12-week intervention. Youth completed weight-specific QOL measures at baseline, post intervention, and 1-year follow-up. For comparison purposes, intervention youth were matched for age and gender with lean controls.
Results:
At baseline, obese youth exhibited significantly lower weight-specific QOL compared with lean youth (70.8±5.4 to 91.2±2.2, p<0.005). The intervention did not significantly impact weight (90.6±6.8 to 89.9±7.2kg, p=0.44). However, significant increases in weight-specific QOL were observed (70.8±20.9 to 86.2±16.9, p<0.001). Post-intervention QOL scores were no longer significantly different than lean controls (P=0.692). Data from nine youth who returned for follow-up indicated that increases in weight-specific QOL were maintained over time (90.5±4.5 to 85.8±5.9, p=0.74).
Conclusion:
These results indicate that a community-based diabetes prevention program can result in sustained improvements in weight-specific QOL among obese Latino youth. Lifestyle interventions that focus on social interaction and physical activity, rather than weight-loss per se, may help improve the psychosocial health of obese Latino youth.
ContributorsBrito, Elizabeth (Author) / Shaibi, Gabriel (Thesis director) / Barroso, Cristina (Committee member) / Patrick, Donald (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2013-05
Description
The purpose of this study was to examine the association between VLDL and diabetes risk factors, and the impact of a lifestyle intervention on VLDL levels in obese Latino youth. Participants (N=160) in this study were taken from a lager diabetes prevention program for Latino adolescents (Age=14.8±0.8 years, BMI=98.2±1.4). Youth participated in a 12-week lifestyle intervention that included physical activity (60 minutes, 3x/week) and nutrition education sessions (60 minutes, 1x/week) that were delivered to families at the downtown Phoenix YMCA. Primary outcomes included VLDL and diabetes risk factors including fasting and 2-hour glucose and insulin which were measured at baseline and 12-weeks post-intervention. Baseline VLDL levels were significantly correlated with fasting insulin (r =.270, P<0.01) and youth who were more insulin resistant displayed higher VLDL levels compared to youth who were less insulin resistant derived from fasting insulin levels (M=29.8±14.7 mg/dl vs. M=21.6±9.6 mg/dl, P<0.01). In total, 77 participants completed the lifestyle intervention. At post-intervention, VLDL levels were significantly reduced (M=26.0±13.3 mg/dl to M=23.3±11.6 mg/dl, P=0.02). Culturally-grounded, community-based, family-focused lifestyle interventions are a promising approach for reducing cardiovascular disease risk factors in high-risk youth at risk for diabetes.
ContributorsNavabi, Neeku Ariana (Author) / Shaibi, Gabriel (Thesis director) / Soltero, Erica (Committee member) / Ryder, Justin (Committee member) / School of Nutrition and Health Promotion (Contributor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
This project aimed to identify barriers to participation and develop strategies to increase the accessibility of a diabetes prevention program in the Latino community. Surveys were administered to past participants of a randomized control trial at a community event where study results were shared. The top concerns expressed by respondents were related to the use of personal information. Primary barriers to participation included work/school commitments and transportation issues. Strategies to increase accessibility included providing flexible class times, having bilingual research staff, and using multiple forms of community outreach such as flyers, health events, phone calls, texts, and social media. Expanding community partners was also identified as a primary strategy for increasing program reach. Researchers should focus on addressing confidentiality concerns, providing financial compensation for attendance, flexible scheduling, and utilizing diverse outreach methods to enhance access to diabetes prevention programs in the Latino community
ContributorsHouck, Kassidy (Author) / Shaibi, Gabriel (Thesis director) / Williams, Allison (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2023-05
Description
Although evidence from previous studies suggests a correlation between Adverse
Childhood Experiences (ACEs) and the risk of Type 2 Diabetes (T2D), research efforts have yet
to fully explore this association among Latino young adults. The objective of this longitudinal study was to assess the potential influence of ACEs scores on the diabetes risk among Latino adults who previously engaged in a diabetes prevention lifestyle intervention program. Five years post intervention, 41 individuals out of the original cohort of 91 participants
returned for follow-up and answered a 10-question survey assessing ACEs. Diabetes risk (fasting glucose, 2-hour fasting glucose, HbA1c, and BMI) and quality of life were assessed at 5
timepoints (baseline, 3-months, 6-months, 12-months, and 60-months). Utilizing SPSS, T-tests were utilized to assess the relationship between ACEs and T2D risk. Among the 41 participants (age was 20.6 ±0.9), the mean reported ACE score was 1.5 ±1.9, ranging from 0 to 7. The most frequently reported ACEs was emotional abuse (n=12, 30.0%) and the least frequently reported ACEs was sexual abuse (n=3, 7.3%). Individuals who reported 0 ACEs had significantly lower fasting glucose at 12 months and had lower BMI at 60 months compared to those with 1-7 ACEs. In this study, there was a significant relationship between higher ACEs and
increased BMI and fasting glucose among Latinos. Implementing culturally-sensitive
interventions addressing family dynamics along with health behaviors could prove pivotal in
preventing and managing diabetes among Latino youth.
ContributorsChrostowski, Emilia (Author) / Shaibi, Gabriel (Thesis director) / Braxton, Morgan (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2024-05
Description
Background.
Type 2 Diabetes Mellitus (T2DM) is a leading cause of health disparities, among Hispanic populations, which are disproportionately afflicted by T2DM. The growing research strongly argues that diabetes treatment interventions should be culturally sensitive to address the needs of their target populations. Nonetheless, there is little consensus regarding the necessary components of a culturally sensitive intervention. This review will examine the intervention contents and activities, and the strategies that have been implemented into culturally sensitive diabetes treatment interventions. This review will also to observe how interventions handle complex issues such as the heterogeneity of Hispanic populations and communities. The overarching research questions examined in this study were, “What are the core components of the culturally tailored diabetes interventions currently implemented with Hispanic populations in the US, and why are they needed?” and 2) “How are studies evaluating the impact of their interventions, and how can the proposed study designs be improved?”
Method.
A systematic review across 3 databases was used to identify culturally sensitive diabetes treatment interventions (CSDTI) developed for Hispanic populations. Accordingly, we searched for studies designed to treat Hispanic individuals already diagnosed with having T2DM. All identified studies provided information on the core components of these culturally sensitive interventions, while only studies that included a control or comparison group were used to assess how the studies evaluated outcomes.
Results.
First, we examined intervention effects as examined from two study designs. We examined a total of [17] interventions in this section. Our review of one study design (Design #1 Studies) includes 12 studies that developed a culturally sensitive intervention and evaluated it using a one-group pretest posttest design, or did not evaluate their intervention at all. A second study design (Design #2 Studies) includes 5 studies. These consisted of a two-group randomized controlled field study that conducted pre-post analyses of the culturally adapted intervention comparing it against a control or comparison group. The heterogeneity of all studies made a conventional meta-analysis impossible.
Second, another review section focused on examining and describing various culturally sensitive core components, we examined a total of 17 studies to describe the types of culturally sensitive components that were incorporated into the diabetes treatment intervention. This analysis resulted in a list of 11 general types of culturally sensitive components as included within these 17 interventions. Of the articles that used control or comparison groups, the manner in which interventions evaluated different outcome measures and their conclusions regarding success were examined.
Discussion.
The culturally sensitive aspects identified from these articles were used to address diverse issues that included: (a) communication barriers, (b) the inclusion of cultural relevant content, for relevance to Hispanic/Latinx patients’ lives, (c) selecting appropriate channels and settings for interventions, and (d) addressing specific cultural values, traditions, and beliefs that can either help or hinder healthy behaviors. It should be noted that the Hispanic populations are extremely heterogeneous, and so interventions that would be sensitive culturally to some sectors of a Hispanic community may not be sensitive to other Hispanic sectors of that same community. The issue of heterogeneity of Hispanic communities was addressed well by the authors of some articles and ignored by others.
Conclusions.
It was ultimately impossible draw quantitative conclusions regarding the efficacy or effectiveness of these two types of diabetes treatment interventions (CSDTIs) as delivered to their targeted sample of Hispanic participants. An emerging conclusion is that factors including ethics, cost, and lack of community acceptance, may constitute factors contributing to the higher proportion of one-group pre-test post-test designs and lower proportion of rigorous scientific designs. In the latter case, some communities oppose the use of randomized controlled studies within their community, and thus that objection may explain the low numbers of these randomized controlled studies. The use of viable and rigorous alternatives to RCTs have been proposed to address this community concern. In this review, the author sought to conduct comparative studies between culturally adapted interventions and their associated unaltered or minimally altered evidence-based interventions, although there exists various difficulties that are associated with the conduct of these analyses.
Core components of CSDTIs for Hispanic adults were identified, and their purposes were explained. Additionally, suggestions for improvement to studies were made, to aid in improving our knowledge of CSDTIs through future studies.
Type 2 Diabetes Mellitus (T2DM) is a leading cause of health disparities, among Hispanic populations, which are disproportionately afflicted by T2DM. The growing research strongly argues that diabetes treatment interventions should be culturally sensitive to address the needs of their target populations. Nonetheless, there is little consensus regarding the necessary components of a culturally sensitive intervention. This review will examine the intervention contents and activities, and the strategies that have been implemented into culturally sensitive diabetes treatment interventions. This review will also to observe how interventions handle complex issues such as the heterogeneity of Hispanic populations and communities. The overarching research questions examined in this study were, “What are the core components of the culturally tailored diabetes interventions currently implemented with Hispanic populations in the US, and why are they needed?” and 2) “How are studies evaluating the impact of their interventions, and how can the proposed study designs be improved?”
Method.
A systematic review across 3 databases was used to identify culturally sensitive diabetes treatment interventions (CSDTI) developed for Hispanic populations. Accordingly, we searched for studies designed to treat Hispanic individuals already diagnosed with having T2DM. All identified studies provided information on the core components of these culturally sensitive interventions, while only studies that included a control or comparison group were used to assess how the studies evaluated outcomes.
Results.
First, we examined intervention effects as examined from two study designs. We examined a total of [17] interventions in this section. Our review of one study design (Design #1 Studies) includes 12 studies that developed a culturally sensitive intervention and evaluated it using a one-group pretest posttest design, or did not evaluate their intervention at all. A second study design (Design #2 Studies) includes 5 studies. These consisted of a two-group randomized controlled field study that conducted pre-post analyses of the culturally adapted intervention comparing it against a control or comparison group. The heterogeneity of all studies made a conventional meta-analysis impossible.
Second, another review section focused on examining and describing various culturally sensitive core components, we examined a total of 17 studies to describe the types of culturally sensitive components that were incorporated into the diabetes treatment intervention. This analysis resulted in a list of 11 general types of culturally sensitive components as included within these 17 interventions. Of the articles that used control or comparison groups, the manner in which interventions evaluated different outcome measures and their conclusions regarding success were examined.
Discussion.
The culturally sensitive aspects identified from these articles were used to address diverse issues that included: (a) communication barriers, (b) the inclusion of cultural relevant content, for relevance to Hispanic/Latinx patients’ lives, (c) selecting appropriate channels and settings for interventions, and (d) addressing specific cultural values, traditions, and beliefs that can either help or hinder healthy behaviors. It should be noted that the Hispanic populations are extremely heterogeneous, and so interventions that would be sensitive culturally to some sectors of a Hispanic community may not be sensitive to other Hispanic sectors of that same community. The issue of heterogeneity of Hispanic communities was addressed well by the authors of some articles and ignored by others.
Conclusions.
It was ultimately impossible draw quantitative conclusions regarding the efficacy or effectiveness of these two types of diabetes treatment interventions (CSDTIs) as delivered to their targeted sample of Hispanic participants. An emerging conclusion is that factors including ethics, cost, and lack of community acceptance, may constitute factors contributing to the higher proportion of one-group pre-test post-test designs and lower proportion of rigorous scientific designs. In the latter case, some communities oppose the use of randomized controlled studies within their community, and thus that objection may explain the low numbers of these randomized controlled studies. The use of viable and rigorous alternatives to RCTs have been proposed to address this community concern. In this review, the author sought to conduct comparative studies between culturally adapted interventions and their associated unaltered or minimally altered evidence-based interventions, although there exists various difficulties that are associated with the conduct of these analyses.
Core components of CSDTIs for Hispanic adults were identified, and their purposes were explained. Additionally, suggestions for improvement to studies were made, to aid in improving our knowledge of CSDTIs through future studies.
ContributorsDilli, Christopher Joe (Author) / Castro, Felipe Gonzalez (Thesis director) / Shaibi, Gabriel (Committee member) / School of Molecular Sciences (Contributor) / School of International Letters and Cultures (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05