Influences of Acculturation, Traditionalism and Health Motivation As Predictors of HbA1c in Latinos at Risk of Type 2 Diabetes

Prevention of type 2 diabetes is critical because it is the 7th leading cause of death in the United States (CDC, 2013). Latinos are twice as likely to develop type 2 diabetes when compared to non-Hispanic Caucasians (WHO, 2013). Glycosylated hemoglobin (HbA1c), a popular indicator of glycemic control, was found to be higher for Latino patients in comparison to Caucasian patients even though each group was provided equal healthcare (Brown et al., 2003). Psychological and cultural mechanisms can promote exercise and dietary modifications capable of reducing the risk of developing type 2 diabetes. One such mechanism, acculturation, has both positive and negative effects on health (Lara et al., 2006). Traditionalism, a mechanism that is closely related to acculturation, may predict a patient’s success in disease management (Chesla et al., 2003). Another factor to consider for predicting disease prevention behavior is health motivation. Mexican-Americans value health motivation, but they may be unable to enact lifestyle changes due to economic constraints (Schwab, 1994). In the present study, 34 Latinos at risk for developing type 2 diabetes were recruited from the Maricopa County Diabetes registry. We hypothesized that traditionalism levels, adult acculturation levels, and health motivation levels would predict HbA1c levels in Latino males and females at risk for developing type 2 diabetes. We also predicted that traditionalism would be negatively associated with HbA1c, that acculturation would be positively associated with HbA1c, and health motivation would be negatively associated with HbA1c. After controlling for age in our regression model, acculturation and health motivation were statistically significant predictors of HbA1c levels. Traditionalism was not found to be a significant predictor in our model. Step 1 of our model was not statistically significant, F(1, 32)= 2.204, p = .147; Model R^2= .064. Step 2 of our model was statistically significant, F(4, 29)= 6.319, p = .002; Model R^2= .434. Higher levels of HbA1c were associated with greater levels of traditionalism, and higher levels of health motivation. Less acculturated persons exhibited higher glucose levels. Persons with higher health motivation also exhibited higher glucose levels. The latter effect is not clear but may suggest that those who may know that they have higher glucose values appear more motivated to take health actions. Overall, these results may aid in the design of culturally-sensitive diabetes prevention interventions for Latino populations, especially as related to those adults who are at risk for the development of type 2 diabetes.