The incidence of type 2 diabetes (T2D) and its long term sequelae are increasing in the US, particularly among Latinos. Latinos are at increased risk for obesity and type 2 diabetes (T2D) and develop T2D at younger ages and at a lower body weight index compared to non-Hispanic whites. For these reasons, Latinos have been identified as a NIDDK priority population with a NIDDK research agenda that includes both biologic, socioeconomic and sociocultural factors that affect T2D prevalence and complications. Acculturation is an important socio-cultural factor that may explain the disproportionate health burden of T2D among Latinos. Acculturation is defined as the process whereby an immigrant culture adopts the beliefs and practices of a host culture. There are limited studies of T2D risk factors and acculturation and how this relationship affects intermediary T2D processes and outcomes such as incident T2D and subclinical cardiovascular disease. The association between acculturation and T2D is inconsistent among Latinos in the published literature. This grant will study the association of acculturation with T2D risk and risk factors using data from multiple well- established epidemiologic NIH cohort studies using validated multidimensional acculturation scales that capture the complex domains of cultural values, beliefs, and behaviors of the acculturation process. The 5 cohorts are: San Antonio Heart Study, Sacramento Latino Study of Aging, Boston Area Community Health Survey, Dallas Heart Study and the Framingham Heart Study Omni Cohort. The simultaneous comparison of findings will maximize the potential for exploring whether the reported heterogeneity of prior study findings is due to differences in underlying Latino cohort characteristics, geographic differences in the process of acculturation in the US and/or differences in the measure of acculturation. Dr. Lopez's long-term goal is to become an independent patient-oriented researcher in diabetes care. Aided by advanced coursework in biostatistics and social epidemiology during the K23 award period, Dr. Lopez will acquire additional research skills and experience under the mentorship of nationally and internationally known researchers in a supportive academic environment. 1

Public Health Relevance

Acculturation is an important socio-cultural factor that may explain the disproportionate health burden of type 2 diabetes (T2D) among Latinos. Understanding how acculturation impacts T2D risk factors and outcomes among Latinos will inform how best to tailor lifestyle and behavioral interventions and reduce health disparities. 2

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DK098280-02
Application #
8710210
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Hyde, James F
Project Start
2013-09-01
Project End
2017-06-30
Budget Start
2014-07-01
Budget End
2015-06-30
Support Year
2
Fiscal Year
2014
Total Cost
$185,977
Indirect Cost
$13,776
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02199
Dinwiddie, Gniesha Y; Zambrana, Ruth E; Doamekpor, Lauren A et al. (2016) The Impact of Educational Attainment on Observed Race/Ethnic Disparities in Inflammatory Risk in the 2001-2008 National Health and Nutrition Examination Survey. Int J Environ Res Public Health 13:ijerph13010042
López, Lenny; Tan-McGrory, Aswita; Horner, Gabrielle et al. (2016) Eliminating disparities among Latinos with type 2 diabetes: Effective eHealth strategies. J Diabetes Complications 30:554-60
Agboola, Stephen; Jethwani, Kamal; Lopez, Lenny et al. (2016) Text to Move: A Randomized Controlled Trial of a Text-Messaging Program to Improve Physical Activity Behaviors in Patients With Type 2 Diabetes Mellitus. J Med Internet Res 18:e307
López, Lenny; Grant, Richard W; Marceau, Lisa et al. (2016) Association of Acculturation and Health Literacy with Prevalent Dysglycemia and Diabetes Control Among Latinos in the Boston Area Community Health (BACH) Survey. J Immigr Minor Health 18:1266-1273
Rodriguez, Fátima; Foody, JoAnne M; Wang, Yun et al. (2015) Young Hispanic Women Experience Higher In-Hospital Mortality Following an Acute Myocardial Infarction. J Am Heart Assoc 4:e002089
López, Lenny; Rodriguez, Fátima; Huerta, Diego et al. (2015) Use of interpreters by physicians for hospitalized limited English proficient patients and its impact on patient outcomes. J Gen Intern Med 30:783-9
Hernandez, Roland A; Hevelone, Nathanael D; Lopez, Lenny et al. (2015) Racial variation in the use of life-sustaining treatments among patients who die after major elective surgery. Am J Surg 210:52-8
Meigs, James B; Grant, Richard W; Piccolo, Rebecca et al. (2014) Association of African genetic ancestry with fasting glucose and HbA1c levels in non-diabetic individuals: the Boston Area Community Health (BACH) Prediabetes Study. Diabetologia 57:1850-8
López, Lenny; Peralta, Carmen A; Lee, Anne et al. (2014) Impact of acculturation on cardiovascular risk factors among elderly Mexican Americans. Ann Epidemiol 24:714-9
López, Lenny; Golden, Sherita Hill (2014) A new era in understanding diabetes disparities among U.S. Latinos--all are not equal. Diabetes Care 37:2081-3