Browsing by keyword "Caribbean Region"
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A dietary behaviors measure for use with low-income, Spanish-speaking Caribbean Latinos with type 2 diabetes: the Latino Dietary Behaviors QuestionnaireThis study examines the validity of a Spanish-language dietary behaviors self-report questionnaire (The Latino Dietary Behaviors Questionnaire [LDBQ]) for Latinos with diabetes. The sample (n=252) was Spanish-speaking, female (77%), middle-aged (mean age 55 years), low education (56% <8th grade>education), and low income (50% <$10,000 annual household income). Baseline and 12-month measures were collected as part of a randomized clinical trial. LDBQ reliability, validity, and sensitivity to change over time were evaluated using exploratory factor analysis; internal consistency analysis; and correlation analysis using baseline and change scores for LDBQ, 3-day 24-hour dietary recall nutrient mean, and clinical measures. Cronbach's alphas were moderate. Four factors were identified at both time points. Significant baseline correlations (r) were found for LDBQ total scores; factor scores; and energy intake (r=-0.29 to -0.34), total dietary fiber (r=0.19), sodium (r=-0.24 to -0.30), percent energy from total fat (r=-0.16), fat subtypes (r=-0.16 to 0.15), and percent energy from protein (r=0.17). Twelve-month data produced a similar pattern. T tests of LDBQ change scores showed significantly greater change in dietary behaviors for the intervention group than for the control group, t(135)=-4.17, P<0.01. LDBQ change scores correlated significantly with mean 24-hour nutrient intake and a subset of clinical measures, but were not associated with clinical change scores (except high-density lipoprotein cholesterol). The LDBQ is a useful tool to assess and target behaviors for change and assess intervention effects. Inc. All rights reserved.
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Underreporting of energy intake and associated factors in a Latino population at risk of developing type 2 diabetesThe objective of this study was to examine the extent of underreporting of total energy intake and associated factors in a low-income, low-literacy, predominantly Caribbean Latino community in Lawrence, MA. Two hundred fifteen Latinos participated in a diabetes prevention study, for which eligibility included a >or=30% risk of developing diabetes in 7.5 years. Dietary self-reported energy intake was assessed using three randomly selected days of 24-hour diet recalls. Basal metabolic rate (BMR) was estimated using the Mifflin-St Jeor equation. Underreporting was determined by computing a ratio of energy intake to BMR, with a ratio of 1.55 expected for sedentary populations. Linear regression analyses were used to identify factors associated with underreporting (energy intake:BMR ratio). The population was predominately women (77%), middle-aged (mean 52+/-11 years), obese (78% had a body mass index >or=30); low-literate (62% < high school education), unemployed (57% reported no job), married or living with partner (52%), and some had a family history of diabetes (37% had siblings with diabetes). Reported total daily energy intake was 1,540+/-599 kcal, whereas estimated BMR was 1,495.7+/-245.1 kcal/day. When multiplied by an activity factor (1.20 for sedentariness), expected energy intake was 1,794+/-294.0 per day, indicating underreporting by an average of 254 kcal/day. Mean energy intake:BMR was 1.03+/-0.37, and was lower for participants with higher body mass index, siblings with diabetes, sedentary lifestyle, and those who were unemployed. Energy intake underreporting is prevalent in this low-income, low-literacy Caribbean Latino population. Future studies are needed to develop dietary assessment measures that minimize underreporting in this population.
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Use of cognitive interviewing to adapt measurement instruments for low-literate HispanicsPURPOSE: Cognitive interviewing techniques were used to adapt existing measures for use with a population of low-literate Spanish-speaking people with diabetes. METHODS: Five individuals of Caribbean origin with diabetes participated in cognitive interviews for 4 instruments (measuring diabetes knowledge, quality of life, self-management, and depression) adapted for oral administration to low-literate individuals. Audiotaped interviews and handwritten notes were subjected to content analysis to identify problems across the 4 instruments as well as specific to a given instrument. RESULTS: The following key problems were identified: general instructions were not helpful, items that were not specific enough generated a variety of interpretations, some wording was confusing, abstract concepts were difficult to understand, some terminology was unfamiliar, and interpretation of certain words was incorrect. CONCLUSIONS: The data illustrate the usefulness of cognitive interviewing as a first step in the process of adapting measurement instruments.