Psychosocial Factors Among U.S. South Asians at Risk for Diabetes: A Cross-Sectional Analysis of the South Asian Health and Prevention Education (SHAPE) Trial Open Access

Abstract

Purpose: Research clearly indicates there is an increased risk of diabetes in South Asians, yet there is a lack of knowledge on what psychosocial factors are important to consider for tailored prevention efforts in South Asian communities. This study is intended to address this gap by describing patterns and exploring what, if any, differences exist among a cohort of South Asian Americans at risk of type 2 diabetes regarding: (1) weight loss self-efficacy, (2) perceived stress, (3) risk perception, and (4) social support.

Methods: This cross-sectional study analyzed baseline survey data from the South Asian Health and Prevention Education (SHAPE) trial screenings. The sample included 55 primarily male, middle-aged, well-educated South Asians. Student t tests and analysis of variance were used to compare continuous psychosocial variable means by sex, education level, annual household income, and BMI group.

Results: Weight loss self-efficacy scores were moderately high across all participant subgroups, (overall mean 120.08 ± 39.61, scale of 0-180) with significantly increased self-efficacy in higher BMI groups (p=0.0001). Perceived stress levels were low across the cohort (mean 0.36 ± 0.15, scale of 0-1). Participants reported a high perceived control over preventing diabetes (mean 3.21 ± 0.53, scale of 1-4), while a slight optimistic bias was observed (mean 2.35 ± 0.71, scale of 1-4), reflecting a lower perceived risk of developing diabetes. Socially supportive behaviors for weight management were experienced infrequently among participants (mean overall frequency score 1.97 ± 0.58, scale of 1-5). Those with four-year degrees or less experienced informational social support more frequently than those with higher levels of education (p=0.002); however, low levels of social support were consistently observed across the cohort.

Conclusion: This study suggests that South Asian Americans have higher weight loss self- efficacy and perceived control over developing diabetes and a lower perceived risk of developing diabetes. Poor social support for weight management is also of concern. These psychosocial factors should be prioritized in the design and delivery of future diabetes prevention efforts for South Asian Americans.

Table of Contents

INTRODUCTION ....................................................................................................................................................1

LITERATURE REVIEW ............................................................................................................................... ...........3

STUDY PURPOSE AND RESEARCH QUESTION .....................................................................................................9

METHODS............................................................................................................................................................ 10

RESULTS ..............................................................................................................................................................15

DISCUSSION ........................................................................................................................................................23

REFERENCES .......................................................................................................................................................31

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Psychosocial Diabetes Prevention South Asians
Committee Chair / Thesis Advisor	Mary Beth Weber, PhD, MPH, Emory University

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