Evidence for Long-Term Impact of Pasos Adelante: Using a Community-Wide Survey to Evaluate Chronic Disease Risk Modification in Prior Program Participants
Abstract
:1. Introduction
2. Methods
2.1. Design/Participants and Sampling
2.2. Adjusting for Selection Bias
2.3. Procedure/Measures
Behavioral Variables | Assessment Methods |
Program Exposure | “Yes” to “Have you participated in the Pasos Adelante program?” |
Diabetes-Related Control Beliefs | “Yes” to 2 questions: “Do you think that diabetes can be prevented?” & “If someone develops diabetes, do you think it can be controlled?” |
Activity Level | International Physical Activity Questionnaire (IPAQ; Short Form) [28]. Sedentary behavior: sitting 5 h or more/day [29]. Physical activity: walking 150 min or more/week and whether they met CDC recommended level of exercise (150 min of moderate intensity exercise/week or 75 min of vigorous intensity exercise/wk) [30]. |
Fruit and Vegetable Consumption | Behavioral Risk Factor Surveillance System (BRFSS) [31,32]. Whether respondents ate three or more servings of fruit and vegetables. (Note only 3% ate five or more a day) |
Fatty Milk Consumption | Determined by whether participants answered that they drank “whole milk.” [33] |
High Sugared Drink Consumption | Determined by whether participants drank on average >1 drink a day from soda or other sugared drink (lemonade, iced tea, kool-aide, horchata, Gatorade) [33] |
2.4. Analysis of the Effects of Pasos Adelante
3. Results
Variable | Total sample; N = 708 | All Pasos participants; n = 48 | Natural controls; n = 148 | Pasos matched participants;n = 37 * |
Age (mean ± SD) | 52.8 ± 19.0 | 59.1 ± 14.2 | 57.3 ± 18.2 | 57.0 ± 13.2 |
Gender Male Female | 37.3% 62.7% | 10.6% 89.4% | 10.9% 89.1% | 13.5% 86.5% |
Hispanic (Mexican) Origin (Yes) | 91.7% | 100% | 100% | 100% |
Marital Status(Yes) | 59.6% | 59.6% | 52.4% | 56.8% |
Education in years (mean ± SD) | 11.4 ± 2.6 | 11.5 ± 2.5 | 11.2 ± 2.8 | 11.2 ± 2.5 |
Insurance Status Medicaid Medicare Private | 40.8% 28.2% 25.8% | 38.3% 34.0% 21.3% | 36.7% 35.4% 25.9% | 43.2% 29.7% 21.6% |
US born (Yes) | 43.2% | 19.1% | 21.8% | 21.6% |
Years in the US (Mean ± SD) | 35.9 ± 21.6 | 17.1 ± 5.1 | 17.2 ± 5.6 | 17.3 ± 4.8 |
Years in Douglas (Mean ± SD) | 28.7 ± 20.6 | 29.6 ± 22.6 | 28.6 ± 20.3 | 27.7 ± 20.3 |
English Language Score(score of 2 to 8; mean ± SD) | 5.7 ± 2.7 | 4.8 ± 2.4 | 4.7 ± 2.7 | 4.8 ± 2.4 |
Had diabetes diagnosed ≥7 years ago | 13.4% | 27.7% | 19.7% | 21.6% |
(High) Community empowerment beliefs | 67.1% | 61.7% | 66.0% | 62.2% |
(High) Diabetes control-related beliefs | 65.7% | 76.6% | 70.0% | 78.4% |
Meet CDC recommended Physical Activity per week | 59.3% | 76.6% | 60.5% | 81.1% |
Sit ≥5 h/day | 11.0% | 10.6% | 10.3% | 8.1% |
Walk ≥150 min/day | 38.6% | 42.6% | 35.0% | 40.5% |
Consume ≥3 fruits/vegetables per day | 32.7% | 34.0% | 32.0% | 29.7% |
Consume fatty milk | 23.3% | 8.5% | 23.1% | 8.1% |
Consume >1 sugared drink per day | 64.0% | 51.1% | 63.3% | 54.1% |
Elevated Glucose | 8.1% | 10.6% | 11.6% | 5.4% |
BMI ≥30 | 40.1% | 51.0% | 34.7% | 51.4% |
Elevated WHR | 26.9% | 26.1% | 27.4% | 27.8% |
Variable | COR | AOR a | COR b | |||
---|---|---|---|---|---|---|
COR | 95%CI; n | AOR | 95%CI; n | COR | 95%CI; n | |
Diabetes beliefs | 1.78 | 0.89–3.56; 706 | 1.89 | 0.91–3.91; 706 | 1.55 | 0.66–3.65; 184 |
Sit ≥5 h/day | 0.95 | 0.365–2.48; 704 | 1.03 | 0.37–2.89; 704 | 0.77 | 0.21–2.82; 183 |
Walk ≥150 min/week | 1.19 | 0.653–2.16; 706 | 1.49 | 0.79–2.81; 706 | 1.28 | 0.61–2.69; 184 |
Meet rec. physical activity/week | 2.36 * | 1.18–4.72; 706 | 2.82 *** | 1.33–5.97; 706 | 2.79 * | 1.03–5.60; 184 |
Consume ≥three fruits and vegetables per day | 1.07 | 0.57–2.00; 704 | 1.25 | 0.65–2.40; 704 | 0.90 | 0.41–1.98; 184 |
Consume fatty milk | 0.29 * | 0.10–0.82; 706 | 0.34 * | 0.12–1.00; 706 | 0.29 | 0.09–1.02; 184 |
Consume >1 sugared drink/day | 0.56 | 0.31–1.02; 706 | 0.76 | 0.40–1.46; 706 | 0.73 | 0.68–1.42; 184 |
Elevated Glucose | 1.39 | 0.53–3.66; 706 | 0.76 | 0.25–2.35 | 0.44 | 0.10–1.98; 184 |
BMI ≥30 | 1.54 | 0.85–2.79; 706 | 1.71 | 0.91–3.21; 706 | 1.99 | 0.96–4.12; 182 |
Elevated WHR | 0.96 | 0.49–1.90; 698 | 0.89 | 0.43–1.86; 698 | 1.02 | 0.45–2.30; 182 |
4. Discussion
5. Strengths and Limitations
6. Conclusions
Acknowledgments
Conflicts of Interest
References
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Carvajal, S.C.; Miesfeld, N.; Chang, J.; Reinschmidt, K.M.; De Zapien, J.G.; Fernandez, M.L.; Rosales, C.; Staten, L.K. Evidence for Long-Term Impact of Pasos Adelante: Using a Community-Wide Survey to Evaluate Chronic Disease Risk Modification in Prior Program Participants. Int. J. Environ. Res. Public Health 2013, 10, 4701-4717. https://doi.org/10.3390/ijerph10104701
Carvajal SC, Miesfeld N, Chang J, Reinschmidt KM, De Zapien JG, Fernandez ML, Rosales C, Staten LK. Evidence for Long-Term Impact of Pasos Adelante: Using a Community-Wide Survey to Evaluate Chronic Disease Risk Modification in Prior Program Participants. International Journal of Environmental Research and Public Health. 2013; 10(10):4701-4717. https://doi.org/10.3390/ijerph10104701
Chicago/Turabian StyleCarvajal, Scott C., Noelle Miesfeld, Jean Chang, Kerstin M. Reinschmidt, Jill Guernsey De Zapien, Maria L. Fernandez, Cecilia Rosales, and Lisa K. Staten. 2013. "Evidence for Long-Term Impact of Pasos Adelante: Using a Community-Wide Survey to Evaluate Chronic Disease Risk Modification in Prior Program Participants" International Journal of Environmental Research and Public Health 10, no. 10: 4701-4717. https://doi.org/10.3390/ijerph10104701