Abstract
This study sought to identify latent subgroups among American Indian and Alaska Native (AI/AN) patients with pre-diabetes
based on their stages of change for multiple health behaviors. We analyzed baseline data from participants of the Special
Diabetes Program for Indians Diabetes Prevention (SDPI-DP) Program, a lifestyle intervention program to prevent diabetes among
AI/ANs. A total of 3,135 participants completed baseline questionnaires assessing stages of change for multiple health behaviors,
specifically exercise, healthy eating, and weight loss. Latent class analysis was used to identify subgroups of people based
on their answers to stages of change questions. Covariates were added to the latent class analyses to investigate how class
membership was related to sociodemographic, behavioral, and psychosocial factors. Three classes were identified based on the
distributions of the stages of change variables: Contemplation, Preparation, and Action/Maintenance classes. Male and retired
participants were more likely to be in more advanced stages. Those who exercised more, ate healthier diets, and weighed less
were significantly more likely to be in the Action/Maintenance class. Further, the participants who had higher self-efficacy,
stronger family support, and better health-related quality of life had higher odds of being in the Action/Maintenance class.
In conclusion, we found that stages of change for multiple behaviors can be summarized by a three-class model in this sample.
Investigating the relationships between latent classes and intervention outcomes represents important next steps to extend
the findings of the current study.
based on their stages of change for multiple health behaviors. We analyzed baseline data from participants of the Special
Diabetes Program for Indians Diabetes Prevention (SDPI-DP) Program, a lifestyle intervention program to prevent diabetes among
AI/ANs. A total of 3,135 participants completed baseline questionnaires assessing stages of change for multiple health behaviors,
specifically exercise, healthy eating, and weight loss. Latent class analysis was used to identify subgroups of people based
on their answers to stages of change questions. Covariates were added to the latent class analyses to investigate how class
membership was related to sociodemographic, behavioral, and psychosocial factors. Three classes were identified based on the
distributions of the stages of change variables: Contemplation, Preparation, and Action/Maintenance classes. Male and retired
participants were more likely to be in more advanced stages. Those who exercised more, ate healthier diets, and weighed less
were significantly more likely to be in the Action/Maintenance class. Further, the participants who had higher self-efficacy,
stronger family support, and better health-related quality of life had higher odds of being in the Action/Maintenance class.
In conclusion, we found that stages of change for multiple behaviors can be summarized by a three-class model in this sample.
Investigating the relationships between latent classes and intervention outcomes represents important next steps to extend
the findings of the current study.
- Content Type Journal Article
- Pages 1-13
- DOI 10.1007/s11121-011-0272-z
- Authors
- Luohua Jiang, Department of Epidemiology and Biostatistics, Texas A&M Health Science Center, 219 SRPH Administration Building, TAMU 1266, College Station, TX 77843-1266, USA
- Janette Beals, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA
- Lijing Zhang, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA
- Christina M. Mitchell, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA
- Spero M. Manson, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA
- Kelly J. Acton, Office of the Assistant Secretary for Health, US Department of Health & Human Services, San Francisco, CA, USA
- Yvette Roubideaux, Office of the Director, Indian Health Service, Rockville, MD, USA
- and the Special Diabetes Program for Indians Demonstration Projects
- Journal Prevention Science
- Online ISSN 1573-6695
- Print ISSN 1389-4986