Theoretical Mediators of Diabetes Risk and Quality of Life Following a Diabetes Prevention Program for Latino Youth With Obesity

Authors

Erica G Soltero
Stephanie L Ayers
Marvyn A Avalos
Armando Peña
Allison N Williams
Micah L Olson
Yolanda P Konopken
Felipe G Castro
Kimberly J Arcoleo
Colleen S Keller
Donald L Patrick
Justin Jager
Gabriel Q Shaibi

Publication Date

9-1-2021

Journal

American Journal of Health Promotion

DOI

10.1177/08901171211012951

PMID

33949215

PMCID

PMC8983113

PubMedCentral® Posted Date

9-1-2022

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Adolescent, Diabetes Mellitus, Type 2, Hispanic or Latino, Humans, Life Style, Obesity, Quality of Life, Latino health, adolescents, family, diabetes prevention, theory

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.