Exploring Health Beliefs Among Hispanic Adults with Prediabetes

Abstract

Diabetes and prediabetes are increasing in prevalence, corresponding to epidemic rates of obesity. Hispanic adults with prediabetes are 1.7 times more likely than non-Hispanic whites to progress to diabetes. We set out to understand health beliefs of Hispanic adults and, with that knowledge, facilitate tailored messaging to promote patient activation and lifestyle change. Using the Risk Perception Survey for Developing Diabetes along with demographic and lifestyle intervention interest questions, a 34-question survey was mailed to a registry of Hispanic adults with a diagnosis of prediabetes and an HbA1c between 5.7 and 6.4% (N = 414). Despite more than three-quarters of respondents (n = 92; 77%) indicating they had prior knowledge of their diagnosis, overall diabetes risk knowledge was low. A significant difference in diabetes risk knowledge was found between groups stratified by education level. High scores in personal control and worry were reported. Respondents overwhelmingly reported interest in exercise (n = 92; 77%) and healthy eating interventions (n = 60; 50%) over technology-based interventions. High levels of worry and personal control, combined with low to intermediate levels of risk knowledge, indicate an opportunity for education and activation in this community. Healthy eating and exercise programs are possible interventions that may slow the progression from prediabetes to diabetes.

Results from brief educational intervention and health screenings: A community health study of Latinos in Southwest Florida

“…[ 7 17 ] Similarly, participants with higher educational attainment had higher baseline knowledge; previous studies have found high educational attainment to be associated with high health-related knowledge and health literacy. [ 26 ] It has to be noted that 43% of our sample reported having no or less than high school education, but there were statistically significant improvements in their knowledge levels after attending the health educational sessions. The significant change in knowledge levels has implications in the provisions of continuous health education in the community that lacks exposure to such activities otherwise.…”

“…Several studies looked at knowledge level among Latinos on gamut of health-related topics such as oral health, ocular health, diabetes risk, and cancer. [ 24 25 26 27 28 ] However, educational interventions to improve knowledge levels were limited and only included patients already seeking healthcare and lacked diversity in sample characteristics. [ 29 30 31 ]…”

Risk perception of developing diabetes: A concept analysis

“…Most publications reviewed for risk perception of developing diabetes did not provide a formal definition for risk perception or reference any theories (Table 3). Studies providing meager definitions for perceived diabetes risk used terminology previously presented in other uses of risk perception but added descriptions of attitudes or beliefs towards diabetes, a “mental model,” 29 p. 1051 or self‐assessed diabetes risk 30‐37 . Only one study provided a robust definition of risk perception as “a complex term with multiple dimensions,” 5 p. 2543 including the vulnerability to (probability of) diabetes, severity of diabetes, level of personal control, comparative risk perceptions of other diseases and environmental factors.…”

Perceived Risk of Developing Diabetes in the General Population and Asian Americans: Systematic Review

“…There were 11 quantitative studies and one mixed-method study (Kullgren et al, 2016). There were three randomized control trial (RCTs; (Dorman et al, 2012; Voils et al, 2015; Wu et al, 2017), and eight cross-sectional descriptive studies (Fukuoka et al, 2015; Joiner, Sternberg, Kennedy, Chen, et al, 2016; Joiner, Sternberg, Kennedy, Fukuoka, et al, 2016; Piccinino et al, 2015; Seaborn et al, 2016; Shaak et al, 2018; Simonds et al, 2017; Yang et al, 2018).…”

“…Asian participants comprised approximately 5% of the sample of two studies (Wu et al, 2017; Yang et al, 2018) and more than 50% of another study (Fukuoka et al, 2015). Five studies did not specify the percentage of Asian participants (Dorman et al, 2012; Kullgren et al, 2016; Piccinino et al, 2015; Shaak et al, 2018; Voils et al, 2015). Four studies had samples of a single racial or ethnic background—none of which were Asian (Joiner, Sternberg, Kennedy, Chen, et al, 2016; Joiner, Sternberg, Kennedy, Fukuoka, et al, 2016; Seaborn et al, 2016; Simonds et al, 2017).…”