Document Type : Original Article
Authors
Abstract
BACKGROUND: Latinos in the U.S., one of the fastest growing minority population, have low
health‑related knowledge and higher rates of diabetes and obesity.
AIM: The study aims (1) to assess health‑related knowledge levels and change in knowledge levels
after brief educational intervention and (2) to assess undiagnosed diabetes, hypertension, and
hypercholesterolemia in adult Latinos residing in Immokalee, Florida. A total of 164 participants
completed pre–posttests while 161 participants took part in health screenings comprising blood
pressure (BP), total cholesterol (TC), blood glucose (BG), and body mass index (BMI).
METHODS: Health‑related knowledge levels were assessed using 10 questions before and
after the educational intervention via face‑to face interviews. BP was measured using automated
sphygmomanometer, BG and TC were measured using lipid and glucose analyzer, waist
circumference using inch tape and BMI using digital scale. T test and Chi square were used to
examine the differences in knowledge levels and distribution of screening results across demographic
characteristics and self‑reports respectively.
RESULTS: Mean age was 40.1 ± 13.3 years; there were 77 males and 87 females. The knowledge
levels based on 10 questions increased by 1.43 (0.42) after educational sessions (P < 0.001).
Participants with college degree had statistically significantly higher pre–posttest scores than those
with no formal or less than high school education (P = 0.041). More males than females had high BP
in the age groups of 18–44 and ≥45 years (P < 0.001). More males in the age group of 18–44 years
had high TC (P = 0.024). Differences between screening results and self‑reports for diabetes and BP
were statistically significant (P < 0.001 and P = 0.01, respectively). Mean BMI was 28.5 ± 5.1 and
waist circumference was 38.6 ± 4.8 inch. Mean random and fasting BG levels and TC were higher
in females than in males (P = 0.003, P = 0.022, and P = 0.004, respectively).
CONCLUSIONS: The study highlights undiagnosed diabetes and hypertension in Latinos and more
Latino males than females to have hypertension and hypercholesterolemia. Latinos’ vulnerability to
chronic diseases and associated complications is further confounded by limited health knowledge.
However, the results of the brief educational program were encouraging and have implications in
setting up structured educational interventions in health clinics and migrant education programs.
Keywords
U.S. Population: 2014‑60; 2015. Available from: https://statistical.
proquest.com/statistic alinsight/result/pqpresultpage.previewt
itle?docType=PQSI & titleUri=/content/2015/2546‑3.194.xml.
[Last accessed on 2019 Nov 09].
2. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity
among adults and youth: United States, 2015‑2016. NCHS Data
Brief 2017;288:1-8.
3. Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of
obesity among adults and youth: United States, 2011‑2014. NCHS
Data Brief 2015;219:1‑8.
4. Diabetes and Hispanic Americans; 2016. Available from:
https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4 &
lvlid=63. [Last updated on 2019 Dec 19. Last accessed on 2020
Mar 13].
5. Heart Disease and Hispanic Americans; 2016. Available from:
https://minorityhealth.hhs.gov/om h/browse.aspx?lvl=4 and
lvlid=64.[Last updated on 2020 Feb 14. Last accessed 2020 Mar 13].
6. Velasco‑Mondragon E, Jimenez A, Palladino‑Davis AG, Davis D,
Escamilla‑Cejudo JA. Hispanic health in the USA: A scoping review of the literature. Public Health Rev 2016;37:31.
7. Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM
occurs at least 4‑7 yr before clinical diagnosis. Diabetes Care
1992;15:815‑9.
8. Schneiderman N, Llabre M, Cowie CC, Barnhart J, Carnethon M,
Gallo LC, et al. Prevalence of diabetes among Hispanics/
Latinos from diverse backgrounds: The Hispanic Community
Health Study/Study Of Latinos (HCHS/SOL). Diabetes Care
2014;37:2233‑9.
9. Roger VL, Go AS, Lloyd‑Jones DM, Benjamin EJ, Berry JD,
Borden WB, et al. Executive summary: Heart disease and stroke
statistics‑2012 update: A report from the American Heart
Association. Circulation 2012;125:188‑97.
10. Stewart SH, Silverstein MD. Racial and ethnic disparity in
blood pressure and cholesterol measurement. J Gen Intern Med
2002;17:405‑11.
11. Chilton L, Hu J, Wallace DC. Health‑promoting lifestyle and
diabetes knowledge in Hispanic American adults. Home Health
Care Manag Pract 2006;18:378‑85.
12. Harmon MP, Castro FG, Coe K. Acculturation and cervical cancer:
Knowledge, beliefs, and behaviors of Hispanic women. Women
Health 1996;24:37‑57.
13. Marin BV, Marin G. Effects of acculturation on knowledge
of AIDS and HIV among Hispanics. Hispanic J Behav Sci
1990;12:110‑21.
14. Fitzgerald N, Damio G, Segura‑Pérez S, Pérez‑Escamilla R.
Nutrition knowledge, food label use, and food intake patterns
among Latinas with and without type 2 diabetes. J Am Diet Assoc
2008;108:960‑7. Available from: https://www.clinicalkey.es/playc
ontent/1‑s2.0‑S0002822308003258. [Last accessed on 2019 Sep 09].
15. Nutbeam D. Health literacy as a public health goal: A challenge
for contemporary health education and communication strategies
into the 21st century. Health Promot Int 2000;15:259‑67. Available
from: https://search.proquest.com/doc view/200046563. [Last
accessed on 2019 Nov 09].
16. Misra R, Mcbride M, Xiang P, Lambert L, Kahar P, Sen CK.
Learning preference and motivation to learn by age and gender
in patients with chronic wound. J Community Med Health Educ
2012;2:127. doi: 10.4172/jcmhe. 1000127.
17. Fitzgerald N, Damio G, Segura‑Pérez S, Pérez‑Escamilla R.
Nutrition knowledge, food label use, and food intake patterns
among Latinas with and without type 2 diabetes. J Am Diet Assoc
2007;107:A83. Available from: https://www.clinicalkey.es/playco
ntent/1‑s2.0‑S0002822307011091. [Last accessed on 2019 Dec 11].
18. Lirio NK, Kahar P. Sociodemographic and health indicators of
foreign‑born and U.S.‑born Latino/as in Immokalee. Florida:
A comparative study. 2020. Under review in Social Work in Public
Health.
19. Menke A, Casagrande S, Avilés‑Santa ML, Cowie CC. Factors
associated with being unaware of having diabetes. Diabetes Care
2017;40:e55‑6.
20. Werch CC, Grenard JL, Burnett J, Watkins JA, Ames S, Jobli E.
Translation as a function of modality: The potential of brief
interventions. Eval Health Prof 2006;29:89‑125.
21. Sacerdote C, Fiorini L, Rosato R, Audenino M, Valpreda M,
Vineis P. Randomized controlled trial: Effect of nutritional
counselling in general practice. Int J Epidemiol 2006;35:409‑15.
22. Whatnall MC, Patterson AJ, Ashton LM, Hutchesson MJ.
Effectiveness of brief nutrition interventions on dietary behaviours
in adults: A systematic review. Appetite 2018;120:335‑47.
23. Dotson KB, Dunn ME, Bowers CA. Stand‑alone personalized
normative feedback for college student drinkers: A meta‑analytic
review, 2004. PLoS One 2015;10:e0139518.
24. McClure LA, Tannenbaum SL, Zheng DD, Joslin CE, Perera MJ,
Gellman MD, et al. Eye health knowledge and eye health
information exposure among Hispanic/Latino individuals:
Results from the Hispanic community health study/study of
Latinos. JAMA Ophthalmol 2017;135:878‑82.
25. Patino D, McQuistan MR, Qian F, Hernandez M,
Weber‑Gasparoni K, Macek MD. Oral health knowledge levels
of Hispanics in Iowa. J Am Dent Assoc 2018;149:1038‑48.
26. Shaak K, Johnson MB, Marsh JK, Hansen SE, Banerjee ES,
Stello B, et al. Exploring health beliefs among hispanic adults with
prediabetes. J Community Health 2018;43:962‑8.
27. Furgurson KF, Sandberg JC, Hsu FC, Mora DC, Quandt SA,
Arcury TA. Cancer knowledge among Mexican immigrant
farmworkers in North Carolina. J Immigr Minor Health
2019;21:515‑21.
28. Sanderson M, Khabele D, Brown CL, Harbi K, Alexander LR,
Coker AL, et al. Results of a health education message intervention
on HPV knowledge and receipt of follow‑up care among Latinas
infected with high‑risk human papillomavirus. J Health Care Poor
Underserved 2015;26:1440‑55.
29. Molokwu J, Penaranda E, Flores S, Shokar NK. Evaluation
of the effect of a promotora‑led educational intervention on
cervical cancer and human papillomavirus knowledge among
predominantly Hispanic primary care patients on the US‑Mexico
border. J Cancer Educ 2016;31:742‑8.
30. Peña‑Purcell NC, Boggess MM. An application of a diabetes
knowledge scale for low‑literate Hispanic/Latinos. Health Promot
Pract 2014;15:252‑62.
31. Valdez A, Napoles AM, Stewart SL, Garza A. A randomized
controlled trial of a cervical cancer education intervention for
Latinas delivered through interactive, multimedia kiosks. J Cancer
Educ 2018;33:222‑30.
32. Healthy weight: Assessing your weight. Centers for Disease
Control and Prevention; 2017. Available from: https://www.cdc.
gov/healthy weight/assessing/bmi/adult_bmi/index.html.Last
updated 29.8.2017. [Last accessed on 2019 Nov 09].
33. Summary Health Statistics: National Health Interview Survey;
2017. Available from: https://ftp.cdc.gov/pub/Health_Stati
stics/NCHS/NHIS/SHS/2017_SHS_Table_A‑4.pdf.[Last
accessed on 2019 Nov 09].
34. Casagrande SS, McEwen LN, Herman WH. Changes in health
insurance coverage under the affordable care act: A national
sample of U.S. Adults with diabetes, 2009 and 2016. Diabetes
Care 2018;41:956‑62.
35. Summary Health Statistics: National Health Interview Survey;
2017. Available from: https://ftp.cdc.gov/pub/Health_Statis
tics/NCHS/NHIS/SHS/2017_SHS_Table_A‑1.pdf. [Last
accessed on 2019 Nov 09].
36. Seidell JC, Cigolini M, Charzewska J, Ellsinger BM, Björntorp P,
Hautvast JG, et al. Fat distribution and gender differences in serum
lipids in men and women from four European communities.
Atherosclerosis 1991;87:203‑10.
37. Shohaimi S, Boekholdt MS, Luben R, Wareham NJ, Khaw KT.
Distribution of lipid parameters according to different
socio‑economic indicators‑ the EPIC‑Norfolk prospective
population study. BMC Public Health 2014;14:782.
38. Health, United States 2016. Centers for Disease Control and
Prevention, National Center for Health Statistics; 2017. 2017‑1232
Available from: https://www.cdc.gov/nc hs/data/hus/hus16.
pdf.[Last accessed on 2020 Jan 02].
39. National Health Interview Survey: National Center for Health
Statistics. https://ftp.cdc.gov/pub/Health_Statistics/NC HS/
NHIS/SHS/2017_SHS_Table_A‑15.pdf. [Last updated on 2017.
Last accessed 2019 Dec 11].
40. Noar SM, ZimmermanRS. Health behavior theory and cumulative
knowledge regarding health behaviors: Are we moving in the
right direction? Health Educ Res 2005;20:275‑90.
)