Erica G Soltero1, Stephanie L Ayers2, Marvyn A Avalos2, Armando Peña3, Allison N Williams3, Micah L Olson3,4, Yolanda P Konopken5, Felipe G Castro3, Kimberly J Arcoleo6, Colleen S Keller3, Donald L Patrick7, Justin Jager2,8, Gabriel Q Shaibi3. 1. Children's Nutrition Research Center, Department of Pediatrics, 3989Baylor College of Medicine, Houston, TX, USA. 2. Southwest Interdisciplinary Research Center, 7864Arizona State University, Phoenix, AZ, USA. 3. Center for Health Promotion and Disease Prevention, 7864Arizona State University, Phoenix, AZ, USA. 4. Department of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA. 5. Family Wellness Program, St. Vincent De Paul Medical and Dental Clinic, Phoenix, AZ, USA. 6. School of Nursing, 6927University of Rochester, Rochester, NY, USA. 7. Department of Health Services, 49462School of Public Health, University of Washington, Seattle, WA, USA. 8. T. Denny Sanford School of Social and Family Dynamics, 7864Arizona State University, Tempe, AZ, USA.
Abstract
PURPOSE: This study tested self-efficacy and social support for activity and dietary changes as mediators of changes in type 2 diabetes related outcomes following a lifestyle intervention among Latino youth. SETTING AND INTERVENTION: Latino adolescents (14-16 years) with obesity (BMI% = 98.1 ± 1.4) were randomized to a 3-month intervention (n = 67) that fostered self-efficacy and social support through weekly, family-centered sessions or a comparison condition (n = 69). MEASURES: Primary outcomes included insulin sensitivity and weight specific quality of life. Mediators included self-efficacy, friend, and family social support for health behaviors. Data was collected at baseline, 3-months, 6-months, and 12-months. ANALYSIS: Sequential path analysis was used to examine mediators as mechanisms by which the intervention influenced primary outcomes. RESULTS: The intervention had a direct effect on family (β = 0.33, P < .01) and friend social support (β = 0.22, P < .001) immediately following the intervention (3-months). Increased family social support mediated the intervention's effect on self-efficacy at 6-months (β = 0.09, P < .01). However, social support and self-efficacy did not mediate long-term changes in primary outcomes (P > .05) at 12-months. CONCLUSIONS: Family social support may improve self-efficacy for health behaviors in high-risk Latino youth, highlighting the important role of family diabetes prevention. Fostering family social support is a critical intervention target and more research is needed to understand family-level factors that have the potential to lead to long-term metabolic and psychosocial outcome in vulnerable youth.
PURPOSE: This study tested self-efficacy and social support for activity and dietary changes as mediators of changes in type 2 diabetes related outcomes following a lifestyle intervention among Latino youth. SETTING AND INTERVENTION: Latino adolescents (14-16 years) with obesity (BMI% = 98.1 ± 1.4) were randomized to a 3-month intervention (n = 67) that fostered self-efficacy and social support through weekly, family-centered sessions or a comparison condition (n = 69). MEASURES: Primary outcomes included insulin sensitivity and weight specific quality of life. Mediators included self-efficacy, friend, and family social support for health behaviors. Data was collected at baseline, 3-months, 6-months, and 12-months. ANALYSIS: Sequential path analysis was used to examine mediators as mechanisms by which the intervention influenced primary outcomes. RESULTS: The intervention had a direct effect on family (β = 0.33, P < .01) and friend social support (β = 0.22, P < .001) immediately following the intervention (3-months). Increased family social support mediated the intervention's effect on self-efficacy at 6-months (β = 0.09, P < .01). However, social support and self-efficacy did not mediate long-term changes in primary outcomes (P > .05) at 12-months. CONCLUSIONS: Family social support may improve self-efficacy for health behaviors in high-risk Latino youth, highlighting the important role of family diabetes prevention. Fostering family social support is a critical intervention target and more research is needed to understand family-level factors that have the potential to lead to long-term metabolic and psychosocial outcome in vulnerable youth.
Entities:
Keywords:
Latino health; adolescents; diabetes prevention; family; theory
Authors: Mohammad Bagherniya; Ali Taghipour; Manoj Sharma; Amirhossein Sahebkar; Isobel R Contento; Seyed Ali Keshavarz; Firoozeh Mostafavi Darani; Mohammad Safarian Journal: Health Educ Res Date: 2018-02-01
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