Skip to main content
Log in

Diabetes Risk Factor Knowledge Varies Among Multiracial College Students

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

All racial/ethnic groups are at higher risk for type 2 diabetes compared to whites, but it is unknown if young adults recognize their risk. Risk knowledge and individual risk perception were examined in 1579 multiracial urban college students. Students have little knowledge of diabetes risk factors; identifying less than three of ten. Considerable variation exists in the understanding of risk; only .02 % of Asian, 14.0 % of Hispanic and 22.8 % of black students recognized that their race increased risk. Among those with ≥3 risk factors (n = 541) only 39 % perceived their risk. These under-estimators had lower knowledge scores (p = .03) than those who acknowledged their risk; indicating that the cause of under-estimating risk may be, at least, in part due to a lack of information. There is a pressing need to heighten understanding of type 2 diabetes risk among young adults to decrease the future burden of this disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. National diabetes statistics report: estimates of diabetes and its burden in the United States. Atlanta, GA: U.S. Department of Health and Human Services; 2014.

    Google Scholar 

  2. Centers for Disease Control and Prevention (CDC). Diabetes statistics. https://doi.org/www.cdc.gov/diabetes/statistics/prev/national/figraceethsex.htm. Accessed 12 Jan 2015.

  3. American Diabetes Association. Diabetes statistics. https://doi.org/www.diabetes.org/diabetes-basics/diabetes-statistics/. Accessed 10 Apr 2010.

  4. Kanaya AM, Herrington D, Vittinghoff E, et al. Understanding the high prevalence of diabetes in U.S. South Asians compared with four racial/ethnic groups: the MASALA and MESA studies. Diabetes Care. 2014;37(6):1621–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Lee JWR, Brancati FL, Yeh HC. Trends in the prevalence of type 2 diabetes in Asians versus whites: results from the United States national health interview survey, 1997–2008. Diabetes Care. 2011;34(2):353–7.

    PubMed  PubMed Central  Google Scholar 

  6. Schiller JS, Lucus LJ, Peregoy JA, Summary health statistics for U.S. adults: National Health Interview Survey. National Center for Health Statistics. Vital Health Stat. 2011;10(256):2012.

    Google Scholar 

  7. Karter AJ, Schillinger D, Adams AS, et al. Elevated rates of diabetes in Pacific Islanders and Asian subgroups: The Diabetes Study of Northern California (DISTANCE). Diabetes Care. 2013;36(3):574–9.

    PubMed  PubMed Central  Google Scholar 

  8. Chiu M, Austin PC, Manuel DG, Shah BR, Tu JV. Deriving ethnic-specific BMI cutoff points for assessing diabetes risk. Diabetes Care. 2011;34(8):1741–8.

    PubMed  PubMed Central  Google Scholar 

  9. Tillin T, Hughes AD, Godsland IF, et al. Insulin resistance and truncal obesity as important determinants of the greater incidence of diabetes in Indian Asians and African Caribbeans compared with Europeans: the Southall And Brent REvisited (SABRE) cohort. Diabetes Care. 2013;36(2):383–93.

    PubMed  PubMed Central  Google Scholar 

  10. Rush EC, Freitas I, Plank LD. Body size, body composition and fat distribution: comparative analysis of European, Maori, Pacific Island and Asian Indian adults. Br J Nutr. 2009;102(4):632–41.

    CAS  PubMed  Google Scholar 

  11. Ghouri N, Purves D, McConnachie A, Wilson J, Gill JM, Sattar N. Lower cardiorespiratory fitness contributes to increased insulin resistance and fasting glycaemia in middle-aged South Asian compared with European men living in the UK. Diabetologia. 2013;56(10):2238–49.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Celis-Morales CA, Ghouri N, Bailey ME, Sattar N, Gill JM. Should physical activity recommendations be ethnicity-specific? Evidence from a cross-sectional study of South Asian and European men. PLoS One. 2013;8(12):e82568.

    PubMed  PubMed Central  Google Scholar 

  13. Ortega F, Konstabel K, Pasquali E, Ruiz J, Hurtig-Wennlof A, et al. Objectively measured physical activity and sedentary time during childhood, adolescence and young adulthood: a cohort study. PLoS One. 2013;8(4):e60871.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Reilly J, Kelly J. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes. 2011;35:891–8.

    CAS  Google Scholar 

  15. Jose K, Blizzard L, Dwyeer T, McKercher C, Alison J. Childhood and adolescent predictors of leisure time physical activity during the transition from adolescence to adulthood: a population based cohort study. Int J Behav Nutr Phys Act. 2011;8(1):54–62.

    PubMed  PubMed Central  Google Scholar 

  16. Larson NI, Neumark-Sztainer D, Hannan PJ, Story M. Trends in adolescent fruit and vegetable consumption, 1999–2004: project EAT. Am J Prev Med. 2007;32(2):147–50.

    PubMed  Google Scholar 

  17. Small M, Bailey-Davis L, Morgan N, Maggs J. Changes in eating and physical activity behaviors across seven semesters of college: living on or off campus matters. Health Educ Behav. 2013;40(4):435–41.

    PubMed  Google Scholar 

  18. Gillen MM, Lefkowitz ES. The ‘freshman 15’: trends and predictors in a sample of multiethnic men and women. Eat Behav. 2011;12(4):261–6.

    PubMed  PubMed Central  Google Scholar 

  19. Kvaavik E, Andersen LF, Klepp KI. The stability of soft drinks intake from adolescence to adult age and the association between long-term consumption of soft drinks and lifestyle factors and body weight. Public Health Nutr. 2005;8(2):149–57.

    PubMed  Google Scholar 

  20. Nelson TF, Gortmaker SL, Subramanian SV, Cheung L, Wechsler H. Disparities in overweight and obesity among US college students. Am J Health Behav. 2007;31(4):363–73.

    PubMed  Google Scholar 

  21. Strong KA, Parks SL, Anderson E, Winett R, Davy BM. Weight gain prevention: identifying theory-based targets for health behavior change in young adults. J Am Diet Assoc. 2008;108(10):1708–15.

    PubMed  PubMed Central  Google Scholar 

  22. Nelson TF, Gortmaker SL, Subramanian SV, Wechsler H. Vigorous physical activity among college students in the United States. J Phys Act Health. 2007;4(4):495–508.

    PubMed  Google Scholar 

  23. Patel SR, Hu FB. Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring). 2008;16(3):643–53.

    Google Scholar 

  24. Serlachius A, Hamer M, Wardle J. Stress and weight change in university students in the United Kingdom. Physiol Behav. 2007;92(4):548–53.

    CAS  PubMed  Google Scholar 

  25. Vella-Zarb RA, Elgar FJ. The ‘freshman 5’: a meta-analysis of weight gain in the freshman year of college. J Am Coll Health. 2009;58(2):161–6.

    PubMed  Google Scholar 

  26. Wengreen H, Moncur C. Change in diet, physical activity, and body weight among young-adults during the transition from high school to college. Nutr J. 2009;42:32–8.

    Google Scholar 

  27. Glanz K, National Cancer Institute (U.S.). Theory at a glance: a guide for health promotion practice. 2nd ed. Bethesda, MD: U.S. Dept. of Health and Human Services, National Cancer Institute; 2005.

    Google Scholar 

  28. Smith M, Dickerson J, Sosa E, McKyer E, Ory M. College students’ perceived disease risk versus actual prevalence rates. Am J Health Behav. 2012;36(1):96–106.

    PubMed  Google Scholar 

  29. DeSalvo KB, Gregg J, Kleinpeter M, Pedersen BR, Stepter A, Peabody J. Cardiac risk underestimation in urban, black women. J Gen Intern Med. 2005;20(12):1127–31.

    PubMed  PubMed Central  Google Scholar 

  30. Graham GN, Leath B, Payne K, et al. Perceived versus actual risk for hypertension and diabetes in the African American community. Health Promot Pract. 2006;7(1):34–46.

    PubMed  Google Scholar 

  31. Dearborn JL, McCullough LD. Perception of risk and knowledge of risk factors in women at high risk for stroke. Stroke. 2009;40(4):1181–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Walker EA, Caban A, Schechter CB, et al. Measuring comparative risk perceptions in an urban minority population: the risk perception survey for diabetes. Diabetes Educ. 2007;33(1):103–10.

    PubMed  Google Scholar 

  33. Heikes KE, Eddy DM, Arondekar B, Schlessinger L. Diabetes risk calculator: a simple tool for detecting undiagnosed diabetes and pre-diabetes. Diabetes Care. 2008;31(5):1040–5.

    PubMed  Google Scholar 

  34. Malik VS, Popkin BM, Bray GA, Despres JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010;33(11):2477–83.

    PubMed  PubMed Central  Google Scholar 

  35. American Diabetes Association. Diabetes risk test. https://doi.org/www.diabetes.org/diabetes-basics/prevention/diabetes-risk-test/. Accessed 10 Nov 2011.

  36. Rosal MC, Borg A, Bodenlos JS, Tellez T, Ockene IS. Awareness of diabetes risk factors and prevention strategies among a sample of low-income latinos with no known diagnosis of diabetes. Diabetes Educ. 2011;37(1):47–55.

    PubMed  Google Scholar 

  37. Brezo J, Royal C, Ampy F, Headings V. Ethnic identity and type 2 diabetes health attitudes in Americans of African ancestry. Ethn Dis. 2006;16(3):624–32.

    PubMed  Google Scholar 

  38. Chesla CA, Skaff MM, Bartz RJ, Mullan JT, Fisher L. Differences in personal models among Latinos and European Americans: implications for clinical care. Diabetes Care. 2000;23(12):1780–5.

    CAS  PubMed  Google Scholar 

  39. Mochari-Greenberger H, Mills T, Simpson S, Mosca L. Knowledge, preventive action, and barriers to cardiovascular disease prevention by race and ethnicity in women: an American Heart Association national survey. J Womens Health. 2010;19(7):1243–9.

    Google Scholar 

  40. Sivalingam S, Ashraf J, Vallurupalli N, Friderici J, Cook J, Rothberg M. Ethnic differences in the self-recognition of obesity and obesity-related comorbidities: a cross-sectional analysis. JGIM. 2011;26(6):616–20.

    PubMed  Google Scholar 

  41. Tan AU, Hoffman B, Rosas SE. Patient perception of risk factors associated with chronic kidney disease morbidity and mortality. Ethn Dis. 2010;20(2):106–10.

    PubMed  Google Scholar 

  42. Gupta LS, Wu CC, Young S, Perlman SE. Prevalence of diabetes in New York City, 2002–2008: comparing foreign-born South Asians and other Asians with U.S.-born whites, blacks, and Hispanics. Diabetes Care. 2011;34(8):1791–3.

    PubMed  PubMed Central  Google Scholar 

  43. Kanaya AM, Wassel CL, Mathur D, et al. Prevalence and correlates of diabetes in South asian Indians in the United States: findings from the metabolic syndrome and atherosclerosis in South asians living in America study and the multi-ethnic study of atherosclerosis. Metab Syndr Relat Disord. 2010;8(2):157–64.

    CAS  PubMed  Google Scholar 

  44. Walker EA, Mertz CK, Kalten MR, Flynn J. Risk perception for developing diabetes: comparative risk judgments of physicians. Diabetes Care. 2003;26(9):2543–8.

    PubMed  Google Scholar 

  45. Bates L, Acevedo-Garcia D, Alegría M, Krieger N. Immigration and generational trends in body mass index and obesity in the United States: results of the national Latino and Asian American survey, 2002–2003. AJPH. 2008;98(1):70–7.

    Google Scholar 

  46. Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China. N Engl J Med. 2010;362(12):1090–101.

    CAS  PubMed  Google Scholar 

  47. Pinelli NR, Herman WH, Brown MB, Jaber LA. Perceived risk and the willingness to enroll in a diabetes prevention lifestyle intervention in Arab-Americans. Diabetes Res Clin Pract. 2010;90(2):e27–9.

    PubMed  PubMed Central  Google Scholar 

  48. Baptiste-Roberts K, Gary TL, Beckles GL, et al. Family history of diabetes, awareness of risk factors, and health behaviors among African Americans. AJPH. 2007;97(5):907–12.

    Google Scholar 

  49. Mosca L, Mochari H, Christian A, et al. National study of women’s awareness, preventive action, and barriers to cardiovascular health. Circulation. 2006;113(4):525–34.

    PubMed  Google Scholar 

  50. Kim C, McEwen LN, Piette JD, Goewey J, Ferrara A, Walker EA. Risk perception for diabetes among women with histories of gestational diabetes mellitus. Diabetes Care. 2007;30(9):2281–6.

    PubMed  Google Scholar 

  51. Morrison MK, Lowe JM, Collins CE. Perceived risk of type 2 diabetes in Australian women with a recent history of gestational diabetes mellitus. Diabet Med. 2010;27(8):882–6.

    CAS  PubMed  Google Scholar 

  52. Klein WM, Stefanek ME. Cancer risk elicitation and communication: lessons from the psychology of risk perception. CA J Clin. 2007;57(3):147–67.

    Google Scholar 

  53. Wendt S. Perception of future risk of breast cancer and coronary heart disease in female undergraduates. Psychol Health Med. 2005;10(3):253–62.

    Google Scholar 

  54. Lytle LA, Moe SG, Nanney MS, Laska MN, Linde JA. Designing a weight gain prevention trial for young adults: the CHOICES study. Am J Health Educ. 2014;45(2):67–75.

    PubMed  PubMed Central  Google Scholar 

  55. Dour CA, Horacek TM, Schembre SM, et al. Process evaluation of project WebHealth: a nondieting web-based intervention for obesity prevention in college students. J Nutr Educ Behav. 2013;45(4):288–95.

    PubMed  Google Scholar 

  56. Napolitano MA, Hayes S, Bennett GG, Ives AK, Foster GD. Using Facebook and text messaging to deliver a weight loss program to college students. Obesity (Silver Spring). 2013;21(1):25–31.

    Google Scholar 

  57. Mongiello LL, Freudenberg N, Spark A. Making the healthy choice the easy choice on campus: a qualitative study. Health Behav Policy Rev. 2015;2(2):110–21.

    Google Scholar 

  58. Frieden TR. A framework for public health action: the health impact pyramid. Am J Public Health. 2010;100(4):590–5.

    PubMed  PubMed Central  Google Scholar 

  59. Kandula NR, Lauderdale DS. Leisure time, non-leisure time, and occupational physical activity in Asian Americans. Ann Epidemiol. 2005;15(4):257–65.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lorraine Laccetti Mongiello.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mongiello, L.L., Freudenberg, N. & Jones, H. Diabetes Risk Factor Knowledge Varies Among Multiracial College Students. J Immigrant Minority Health 18, 971–978 (2016). https://doi.org/10.1007/s10903-015-0250-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-015-0250-9

Keywords

Navigation