227046 Latent Class Analysis of Stages of Change for Multiple Health Behaviors: Results from the Special Diabetes Program for Indians

Monday, November 8, 2010 : 2:50 PM - 3:10 PM

Luohua Jiang, PhD , Centers for American Indian and Alaska Native Health, University of Colorado Denver, Aurora, CO
Janette Beals, PhD , Centers for American Indian and Alaska Native Health, University of Colorado Denver, Aurora, CO
Lijing Zhang , Centers for American Indian and Alaska Native Health, University of Colorado Denver, Aurora, CO
Yvette Roubideaux, Md, MPH , Director, Indian Health Services, Rockville, MD
Kelly J. Acton, MD, MPH, FACP , Division Of Diabetes Treatment and Prevention, Indian Health Service, Albuquerque, NM
Spero M. Manson, PhD , Centers for American Indian and Alaska Native Health, University of Colorado Denver, Aurora, CO
     
Objective: This study sought to identify latent subgroups among American Indian and Alaska Native (AI/AN) patients with pre-diabetes based on their stages of change for multiple health behaviors.

Methods: We analyzed baseline data from participants of the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) Program, a lifestyle intervention program to prevent diabetes among AI/ANs. A total of 3,148 participants from 36 participating sites completed baseline questionnaires assessing stages of change for multiple health behaviors, including exercise, healthy eating, and losing weight. Multilevel latent class analysis was used to identify subgroups of participants based on their answers to stages of change questions while accounting for the nested data structure of this multi-site project. Latent class analysis with covariates was used to validate the identified latent classes by investigating how class membership was related to sociodemographic, behavioral, and psychosocial factors.

Results: Three classes were identified based on the distribution of the stages of change variables: a Contemplation, a Preparation, and an Action/Maintenance class. Older and retired participants were more likely to be in more advanced stages. Those in the Action/Maintenance class were more likely to eat healthier, exercise more, and weigh less. They were also more likely to have higher self-efficacy, lower daily distress, stronger family support, and better health-related quality of life.

Conclusions: We find that stages of change for multiple behaviors can be summarized by a three-class model. Designing class-specific lifestyle interventions in the future may lead to more effective delivery of evidence-based intervention.

Learning Areas:
Biostatistics, economics
Epidemiology
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Describe how to use latent class analysis to identify latent subgroups among American Indian and Alaska Natives based on their stages of change for multiple health behaviors. 2. Evaluate the validity of the identified latent classes based the relationships between class membership and sociodemographic, behavioral, and psychosocial factors.

Keywords: Minority Health, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I conceptualized and designed this study and oversaw the statistical analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3350.0: Statistical Applications of Survey Methods