Matching Items (3)
Description
Latino youth are disproportionately impacted by obesity, prediabetes and type 2 diabetes (T2D). Pediatric obesity is characterized by abnormal increases in pro-inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and monocyte chemoattractant protein-1 (MCP-1) and reductions in anti-inflammatory markers, high molecular weight adiponectin (HMW Adpn) and interleukin-10 (IL-10). Interleukin-1 receptor antagonist (IL-1ra) is an anti-inflammatory that is positively associated with obesity. IL-6, TNF-α, MCP-1 and IL-1ra have been associated with reduced insulin sensitivity and β-cell dysfunction, two central pathophysiologic mediators of glucose intolerance, while HMW Adpn and IL-10 have been associated with increased insulin sensitivity and β-cell function. The United States Diabetes Prevention Program (DPP) supported lifestyle intervention as the cornerstone approach for preventing T2D among adults with prediabetes, yet no studies to date have assessed the efficacy of an adapted DPP among Latino youth with prediabetes. In this dissertation, three studies were conducted. The first cross-sectional study among Latino youth with prediabetes and obesity (n=65) demonstrated that MCP-1 (β=-0.001, p=0.027; β=0.03, p=0.033), HMW Adpn (β=0.2, p<0.001; β=-2.2, p=0.018), and IL-1ra (β=-0.03, p=0.006; β=0.09, p=0.009) significantly predicted insulin sensitivity (measured by whole body insulin sensitivity index, WBISI) and glucose tolerance (measured by 2-hr glucose concentrations from an oral glucose tolerance test), respectively. Only HMW Adpn significantly predicted β-cell function, measured by oral disposition index, or oDI (β=0.6, p<0.001). The second study was a randomized control trial that demonstrated the efficacy of lifestyle intervention (INT, n=79) for improving oDI among Latino youth with prediabetes and obesity, compared to a usual care control (UCC, n=38) group. No differences were found for changes in WBISI (Δ0.1, p=0.899) or 2-hr glucose (Δ-7.2, p=0.260) between groups. The third study was a secondary analysis (INT n=46, UCC n=29) that demonstrated no significant effects on IL-6, TNF-α, MCP-1, HMW Adpn, IL-10, or IL-1ra (all interactions, p>0.05).
ContributorsPena, Armando (Author) / Shaibi, Gabriel Q. (Thesis advisor) / Vega-Lopez, Sonia (Committee member) / Sears, Dorothy D (Committee member) / Ayers, Stephanie L (Committee member) / Olson, Micah L (Committee member) / Arizona State University (Publisher)
Created2022
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
Introduction: The incidence of type 2 diabetes (T2D) in youth is projected to increase through 2060, especially in minority youth. Every Little Step Counts (ELSC) has demonstrated efficacy in reducing T2D risk factors in Latino youth. Documenting the adaptation of ELSC to a family diabetes prevention program (FDPP) could support future adaptation and scaling of FDPPs.Purpose: To describe the process that guided the adaptation of a culturally grounded evidenced-based DPP tailored to Latino families, with the aim of using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) to classify adaptations.
Methods/Design: The approach that guided the adaptation involved community-based participatory research (CBPR) and phases commonly used to adapt health interventions. Inductive and deductive content analysis guided by the FRAME was conducted on data collected throughout the phases to identify and classify adaptations. Data was then triangulated with the entities involved in the adaptation, analyzed to determine the frequency and proportion of adaptations across the FRAME categories and levels, and cross tabulated.
Results: A total of N=66 adaptations were identified. Adaptations occurred with the highest frequency during the grant preparation and after the pilot study. Most adaptations were led by both the academic institution and community partners. Content modifications were most common. Prominent reasons for adaptation included organization/setting time constraints and integrating community partners’ and interventionists’ feedback.
Discussion: Study results align with the CBPR approach that guided the adaptation and the ELSC core tenet of integrating community partnerships throughout all aspects of the intervention. To efficiently track adaptations, consensus as to what constitutes varying levels of adaptation granularity (i.e., macro, meso, micro) is needed. While tracking adaptations can be time and resource intensive, tracking adaptations may support the development of strategies to tie adaptations to outcomes.
Conclusion: It is critical to determine when adaptations are needed to avoid a “culture of adaptation hyperactivity”. There is an opportunity to analyze past and future ELSC adaptations to better understand the intervention’s core tenets and the relationship between adaptations and outcomes. Future ELSC adaptations would benefit from considering how to incorporate feedback from diverse stakeholders and populations in preparation for scaling.
ContributorsDiaz, Monica (Author) / Shaibi, Gabriel Q (Thesis advisor) / Bruening, Meg (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2024