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- Genre: Doctoral Dissertation
Description
Obesity in Hispanic youth has reached alarmingly high levels, increasing the risk of type 2 diabetes, hyperlipidemia, hypertension, and cardiovascular disease. In Mexican American children ages 6-11 years, 41.7% are overweight and obese, 24.7% are obese and 19.6% have a Body Mass Index (BMI) greater than the 97th percentile. While personal, behavioral, and environmental factors contribute to these high rates, emerging literature suggests acculturation, self-efficacy and social support are key influences. The one-group, pre- and post-test, quasi-experimental design used a community-based participatory research (CBPR) method to test the feasibility, acceptability, and preliminary efficacy of the 8-week intervention. Social Cognitive Theory (SCT) was used to guide the design. Measurements included an analysis of recruitment, retention, participant satisfaction, observation of intervention sessions, paired t-tests, effect sizes, and bivariate correlations between study variables (acculturation, nutrition and physical activity [PA] knowledge, attitude and behaviors, perceived confidence and social support) and outcome variables (BMI z-score, waist circumference and BP percentile) Findings showed the SSLN program was feasible and acceptable. Participants (n = 16) reported that the curriculum was fun and they learned about nutrition and PA. The retention rate was 94%. The preliminary effects on adolescent nutrition and PA behaviors showed mixed results with small-to-medium effect sizes for nutrition knowledge and attitude, PA and sedentary behavior. Correlation analysis among acculturation and study variables was not significant. Positive associations were found between perceived confidence in eating and nutrition attitude (r = .61, p < .05) and nutrition behavior (r = .62, p < .05), perceived confidence in exercise and nutrition behavior (r = .66, p < .05), social support from family for exercise and PA behavior (r = .67, p < .01) and social support from friends for exercise and PA behavior (r = .56, p < .05). These findings suggest a culturally specific healthy eating and activity program for adolescents was feasible and acceptable and warrants further investigation, since it may fill a gap in existing obesity programs designed for Hispanic youth. The positive correlations suggest further testing of the theoretical model.
ContributorsStevens, Carol (Author) / Gance-Cleveland, Bonnie (Thesis advisor) / Komnenich, Pauline (Committee member) / Shaibi, Gabriel (Committee member) / Arcoleo, Kimberly (Committee member) / Arizona State University (Publisher)
Created2011
Description
Background. Effects of lifestyle interventions on early biomarkers of oxidative stress and CVD risk in youth with prediabetes are unknown. Objective. To evaluate the effects of a lifestyle intervention to prevent type 2 diabetes among obese prediabetic Latino adolescents on oxidized lipoproteins. Design: In a quasi-experimental design, 35 adolescents (51.4% male, age 15.5(1.0) y, body mass index (BMI) percentile 98.5(1.2), and glucose 2 hours after an oral glucose tolerance test-OGTT 141.2(12.2) mg/dL) participated in a 12-week intervention that included weekly exercise (three 60 min-sessions) and nutrition education (one 60 min-session). Outcomes measured at baseline and post-intervention were: fasting oxidized LDL and oxidized HDL (oxLDL and oxHDL) as oxidative stress variables; dietary intake of fresh fruit and vegetable (F&V) and fitness (VO2max) as behavioral variables; weight, BMI, body fat, and waist circumference as anthropometric variables; fasting glucose and insulin, 2hour glucose and insulin after an OGTT, insulin resistance (HOMA-IR), and lipid panel (triglycerides, total cholesterol, VLDL-c, LDL-c, HDL-c, and Non-HDL) as cardiometabolic variables. Results. Comparing baseline to post-intervention, significant decreases in oxLDL concentration were shown (51.0(14.0) and 48.7(12.8) U/L, p=0.022); however, the intervention did not decrease oxHDL (395.2(94.6) and 416.1(98.4) ng/mL, p=0.944). F&V dietary intake (116.4(97.0) and 165.8(91.0) g/d, p=0.025) and VO2max (29.7(5.0) and 31.6(4.7) ml*kg-1*min-1, p<0.001) significantly increased. Within-subjects correlations between changes in F&V intake and oxidized lipoproteins, adjusted for VO2max changes, were non-significant (R=-0.15, p=0.52 for oxLDL; R=0.22, p=0.25 for oxHDL). Anthropometric variables were significantly reduced (weight -1.3% p=0.042; BMI -2.2% and BMI percentile -0.4%, p=0.001; body fat -6.6% and waist circumference -1.8%, p=0.025). Cardiometabolic variables significantly improved, including reductions in glucose 2hour (-19.3% p<0.001), fasting insulin (-12.9% p=0.008), insulin 2hour (-53.5% p<0.001), and HOMA-IR (-12.5% p=0.015), with 23 participants (66%) that reverted toward a normal glucose tolerance status. Most lipid panel significantly changed (triglycerides -10.2% p=0.032; total cholesterol -5.4% p=0.002; VLDL-c -10.4% p=0.029; HDL-c -3.2% p=0.022; and Non-HDL -5.5% p=0.0007). Conclusion. The intervention resulted in differential effects on oxidized lipoproteins and significant improvements in behavioral, anthropometric and cardiometabolic variables, reducing the high metabolic risk of obese prediabetic kids.
ContributorsRenteria Mexia, Ana Maria (Author) / Shaibi, Gabriel Q (Thesis advisor) / Vega-Lopez, Sonia (Committee member) / Swan, Pamela D (Committee member) / Olson, Micah L (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2017
Description
A secondary data analysis was conducted to investigate the direct and indirect effects of family traditionalism, family cohesion, and parent involvement on alcohol, cigarette, and marijuana use in a sample of pre-adolescent youth (N = 635) and their parents (N = 462). Aim one hypothesized that family cohesion and family traditionalism would be indicators of a higher order construct, operationalized as familismo. Aims two and three hypothesized that family traditionalism, family cohesion, and parent involvement would be protective against youth substance use. Finally, aim four hypothesized that acculturation would decrease the protective effects of family traditionalism and family cohesion on substance use.
Using second order confirmatory factor analysis, aim one found that family cohesion and family traditionalism were indicators of a second order structure. Regarding aims two and three, a consistent significant association was found between family cohesion and parent involvement across alcohol, cigarette, and marijuana use outcomes. As well, family cohesion was significantly and inversely associated with past 30-day alcohol use amount ( = -.21, p < 0.05), lifetime alcohol use ( = -.19, p < 0.05), and lifetime marijuana use ( = -.31, p < 0.001). Counter to what was hypothesized, a significant positive relationship between family traditionalism and past 30-day alcohol use amount was found. No significant indirect effects were found. Specific to aim four, significant moderation effects were found between family cohesion and acculturation on alcohol and cigarette use. Higher acculturated youth had greater past 30-day alcohol and cigarette use amount compared to low acculturated youth; as family cohesion increased, alcohol and cigarette use for both low and high-acculturated youth decreased.
This study has important implications for social work and future research specific to culture, family, and youth substance use. This study may assist direct social work practitioners, school personnel, and other professionals that work with Latino youth and families in the tailoring of services that are culturally sensitive and relevant to this population and provides further understanding regarding the impact of culture and family on Latino youth substance use. Findings and limitations are discussed specific to social work practice, policy, and research.
Using second order confirmatory factor analysis, aim one found that family cohesion and family traditionalism were indicators of a second order structure. Regarding aims two and three, a consistent significant association was found between family cohesion and parent involvement across alcohol, cigarette, and marijuana use outcomes. As well, family cohesion was significantly and inversely associated with past 30-day alcohol use amount ( = -.21, p < 0.05), lifetime alcohol use ( = -.19, p < 0.05), and lifetime marijuana use ( = -.31, p < 0.001). Counter to what was hypothesized, a significant positive relationship between family traditionalism and past 30-day alcohol use amount was found. No significant indirect effects were found. Specific to aim four, significant moderation effects were found between family cohesion and acculturation on alcohol and cigarette use. Higher acculturated youth had greater past 30-day alcohol and cigarette use amount compared to low acculturated youth; as family cohesion increased, alcohol and cigarette use for both low and high-acculturated youth decreased.
This study has important implications for social work and future research specific to culture, family, and youth substance use. This study may assist direct social work practitioners, school personnel, and other professionals that work with Latino youth and families in the tailoring of services that are culturally sensitive and relevant to this population and provides further understanding regarding the impact of culture and family on Latino youth substance use. Findings and limitations are discussed specific to social work practice, policy, and research.
ContributorsMartinez, Marcos Jerome (Author) / Marsiglia, Flavio F (Thesis advisor) / Kulis, Stephen (Committee member) / Anthony, Elizabeth (Committee member) / Arizona State University (Publisher)
Created2015