The effects of gender and country of origin on acculturation, psychological factors, lifestyle factors, and diabetes-related physiological outcomes among Mexican Americans: The Starr County diabetes prevention initiative

Abstract

Objectives Examine acculturation and psychological, lifestyle, and physiological factors based on gender and country of origin (U.S. vs. Mexico). Methods Baseline data from the Starr County diabetes prevention study ( N = 300) were analyzed – acculturation ( language), psychological factors ( depression), lifestyle factors ( sedentary behaviors), and diabetes-related physiological outcomes ( insulin resistance). MANOVA and linear regression were used to examine variable relationships based on gender and country of origin and identify predictors of depression and insulin resistance. Results Participants were: predominantly female (73%); 51 years of age, on average; born in Mexico (71%); and Spanish-speaking. Individuals spent 11 of their waking hours (range = 0–18 h) in sedentary activities. Compared to females, more males spoke English and reported fewer hours in sedentary activities. Compared to participants born in Mexico, those born in the U.S. were more likely to: speak English; report depressive symptoms; and exhibit elevated BMI and insulin resistance rates. Two distinct models significantly predicted depression (R2 = 14.5%) and insulin resistance (R2 = 26.8%), with acculturation-language entering into both models. Discussion Significant gender and country-of-origin differences were found. Future research on diabetes prevention should examine other Hispanic subgroups and strategies for addressing individual differences, while employing cost-effective group interventions that incorporate these differences and reach more at-risk individuals.

Transitioning From an In-Person Intervention to Augmented Text Messaging During COVID-19 in Mexican Americans With Prediabetes: The Starr County Diabetes Prevention Randomized Clinical Trial

“…Participants stated they spent most of their waking hours (10 h/d) in sedentary activities, such as watching TV or working on the computer. 11 Selected physiological outcomes, including fasting plasma glucose, A1C, waistto-hip ratio, and BMI, showed varying levels across cohorts at baseline, consistent with the diagnosis of prediabetes.…”

“…Exclusion criteria included a history of using hypoglycemic medications (except during pregnancy), pregnant currently or within the past 3 months, or any medical condition for which changes in diet and/or physical activity would be contraindicated (eg, kidney failure). 11 At baseline of the parent study, participants were assigned to groups, and groups were randomly assigned to an experimental or control condition, a cluster randomized trial. Information presented here reflects analyses of data obtained from a subsample of participants (n = 140) divided into three cohorts: (1) Cohort 1 (n = 50) was constituted by randomly selecting 3 of the 7 groups of participants who had completed the in-person intervention prior to the COVID-19 research pause, (2) Cohort 2 (n = 60) completed all educational and some support group sessions in person but needed additional support sessions to complete the intervention and thus received the RGV TM+ intervention (10 text messages), and (3) Cohort 3 (n = 30) was constituted by selecting the 3 groups randomly assigned (by group) at baseline to serve as controls for the 3 groups in Cohort 2 (received enhanced health guidance offered during data collection appointments; see Figure 1 for further details).…”

Acculturation, Dietary Behaviors, and Macronutrient Intake Among Mexican Americans With Prediabetes: The Starr County Diabetes Prevention Initiative

“…On average, study participants were 51 years old, female, obese, and diagnosed with verified prediabetes. 20 The acculturation variable language preference was significantly associated with dietary intake. Overall dietary quality, as measured by the HEI-2015, was lower than the national average; females had a slightly higher mean dietary quality than males and a higher mean fat avoidance score, although differences were not statistically significant.…”

“…Starr County, the site of this study and previous studies conducted by this research team, has been described in detail in previous publications of these researchers. 14,15,20 Briefly, Starr County is 1 of 14 Texas counties located adjacent to the Rio Grande River that borders northern Mexico. A research field office located in Rio Grande City, the county seat, serves as the center of operations for all research projects.…”

“…Sex differences in behavioral factors and physiological outcomes have been found consistently in previous and current Starr County studies. 20 Accordingly, univariate analysis of covariance (ANCOVA) was used to analyze sex differences (Table 2) and also to examine the effects of the 4 acculturation variables-country of origin, number of years in Starr County, language preference, and food preferences-on psychological factors, diet-related factors, and macronutrient intake while simultaneously controlling for sex differences and additionally controlling for age for the variable, number of years in Starr County (Table 3). ANCOVA, a statistical test that combines analysis of variance and regression, is typically used to remove the influence of 1 or more antecedents, potentially confounding variables.…”