Total Glucose Intolerance, Hypertension, and Metabolic Syndrome in a Multi-ethnic Community in Rural Hawai‘i: The Kōhala Health Research Project
Total Glucose Intolerance, Hypertension, and Metabolic Syndrome in a Multi-ethnic Community in Rural Hawai‘i: The Kōhala Health Research Project
Date
2020
Authors
CUNANAN, VANESSA LLENARIZAS
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Grandinetti, Andrew
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Public Health
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Using cross-sectional data from the Kōhala Health Research Project, this dissertation examined the prevalence of, and risk factors for, chronic diseases and conditions that may disproportionately affect underserved and understudied ethnic groups. Studies 1 and 2 analyzed prevalence differences and prevalence ratios for total glucose intolerance (TGI) and hypertension among Filipino Americans (FAs) in the study. TGI includes type 2 diabetes and its precursor states of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) (1, 2). Study 3 utilized confirmatory factor analysis (CFA) and multi-group CFA to determine the best fitting metabolic syndrome (MetS) model structure for the study sample; configural invariance across different ethnic groups in the study; and, how the measured risk variables manifested or clustered according to ethnic group. Findings demonstrated disproportionately high prevalence of TGI and hypertension in the FA group. The CFA revealed an acceptable fit for a 4-factor model possibly underlying the MetS structure. High factor loadings for the obesity and hypertension factors emphasized the importance of preventing and/or mitigating the effects of these MetS components across all ethnic groups. Configural invariance from the multi-group CFA indicated acceptable fit, suggesting that the pattern of fixed and free parameters in the 4-factor model was equivalent or stable across all five ethnic groups. By analyzing TGI and hypertension prevalence with ethnicity, place of birth, and acculturation mode in addition to CFA and multi-group CFA, the overarching objective of this dissertation was to add to existing knowledge on prevention, screening, and intervention practices for chronic diseases and conditions with enormous impact on vulnerable populations – all crucial, timely, and fair given public health’s mandate and mission of optimal and equitable health for all.
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Epidemiology,
Diabetes,
Filipino,
Hypertension,
Metabolic Syndrome,
Multi-ethnic,
Total Glucose Intolerance
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112 pages
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