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标题：Family History of Diabetes, Awareness of Risk Factors, and Health Behaviors Among African Americans
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作者：Kesha Baptiste-Roberts ; Tiffany L. Gary ; Gloria L.A. Beckles 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2007
卷号：97
期号：5
页码：907-912
DOI：10.2105/AJPH.2005.077032
语种：English
出版社：American Public Health Association
摘要：Objectives. We examined the role of family history of diabetes in awareness of diabetes risk factors and engaging in health behaviors. Methods. We conducted a cross-sectional analysis of 1122 African American adults without diabetes who were participants in Project DIRECT (Diabetes Interventions Reaching and Educating Communities Together). Results. After adjustment for age, gender, income, education, body mass index, and perceived health status, African Americans with a family history of diabetes were more aware than those without such a history of several diabetes risk factors: having a family member with the disease (relative risk [RR]=1.09; 95% confidence interval [CI]=1.03, 1.15), being overweight (RR=1.12; 95% CI=1.05, 1.18), not exercising (RR=1.17; 95% CI=1.07, 1.27), and consuming energy-dense foods (RR=1.10; 95% CI=1.00, 1.17). Also, they were more likely to consume 5 or more servings of fruits and vegetables per day (RR=1.31; 95% CI=1.02, 1.66) and to have been screened for diabetes (RR=1.21; 95% CI=1.12, 1.29). Conclusions. African Americans with a family history of diabetes were more aware of diabetes risk factors and more likely to engage in certain health behaviors than were African Americans without a family history of the disease. Diabetes is a major contributor to morbidity and mortality and generates large direct as well as indirect costs. 1 ^– 3 The prevalence of diabetes among US adults 4 has increased substantially over the past several decades and stood at 8.7% in 2002. 2 ^, 5 The burden of type 2 diabetes disproportionately affects African Americans. For example, data from nationally representative samples show that White men are one half to one fifth as likely as African American men to have or develop diabetes, and African American women are approximately twice as likely as White women to have or develop the disease. 6 ^, 7 It is estimated that 33% to 50% of people with type 2 diabetes are not diagnosed. 8 ^, 9 As a result, many patients may already have early complications of the disease at the time of their clinical diagnosis. In addition to older age and being overweight, family history is a well-known risk factor for type 2 diabetes, with risk estimates (relative risks [RRs]) ranging from 2 to 6 depending on study design and case definition. 10 Family histories reflect both inherited genetic susceptibilities and shared environments, which include cultural factors such as preferences, values, and perceptions and behavioral factors such as diet and physical activity. 11 Thus, family history of diabetes may be a useful tool to identify individuals at increased risk of the disease and target behavior modifications that could potentially delay disease onset and improve health outcomes. For example, individuals with impaired glucose tolerance could be encouraged to make lifestyle changes, given that results from randomized clinical trials indicate that losing weight, reducing fat intake, and increasing physical activity can result in a 58% reduction in the incidence of diabetes. 12 Previous research has focused primarily on examining the role of family history of diabetes in the development of type 2 diabetes, insulin resistance, and obesity. 13 ^– 18 One study examined the impact of family history of diabetes on glycemic control, 19 and a few studies have examined whether family history of diabetes influences perceived susceptibility and protective health behaviors. 20 ^, 21 However, these studies have been conducted among nonminority populations. To our knowledge, the specific role that family history of diabetes plays among African Americans in terms of their being aware of diabetes risk factors and engaging in protective health behaviors has not yet been explored. In this study, we conceptualized our data in the context of the Health Belief Model, 22 a psychological model that attempts to explain and predict health behaviors by focusing on people’s attitudes and beliefs. We hypothesized that individuals with a family history of diabetes would be more aware of risk factors and more likely to engage in healthy behaviors than would individuals without such a family history.