Self-Esteem, Self-Efficacy, Hope, Health Promoting Behaviors and Insulin Resistance in Overweight Mexican American Adolescents

Abstract

Insulin resistance (IR) and type 2 diabetes in Mexican American adolescents living along the United States (US)-Mexico border are linked to genetics, poverty, developmental characteristics, and psychological attributes. Understanding relationships among psychological attributes, health promoting behaviors (HPB) and IR markers addresses gaps in health promotion science that test relationships between lifestyle and biological outcomes.Hendricks' Perceptual Health Promotion Determinants Model provided theoretical underpinnings. The aims were to test the predictive ability of HPB and IR using psychological attributes (self-esteem, self-efficacy, and hope). Biological markers for IR included body mass index (BMI), waist circumference (WC), and Homeostasis Mathematical Assessment Model for Insulin Resistance (HOMA-IR).Forty five Mexican American adolescents (62% female; 16.4 [±1.27] mean years) participated. The majority (60%) were obese (BMI ≥ 95th percentile) with 40% overweight (BMI ≥ 85th percentile), 45% with WC ≥ 95th percentile, and 76% with HOMA-IR ≥ 3.16.With self-efficacy for physical activity, 38% (R2 = 0.3771; F = 8.27, df = 3; p < 0.002) of variance in HPB was explained by hope. With self-efficacy for nutrition fats/sodium, 44% (R2 = 0.4382; F = 10.66; df = 3; p < .0001) of variance in HPB was explained by self-efficacy for nutrition fats/sodium and hope. With self-efficacy for nutrition fruits/vegetables, 49% (R2 = 0.4894; F = 13.10; df = 3; p <.0001) of variance in HPB was explained by self-efficacy for nutrition fruits/vegetables and hope.Additionally, with IR reflected as WC, 21% (R2 = 0.2129; F = 2.71; df = 4; p = 0.0437) of variance was explained by self-esteem and self-efficacy for physical activity. With IR reflected as HOMA-IR, 22% (R2 = 0.2214; F = 2.84; df = 4; p = 0.0364) of variance was explained by self-efficacy for physical activity and 23% (R2 = 0.2254; F = 2.91; df = 4; p = 0.0333) of variance was explained by self-efficacy for nutrition fruits/vegetables. Evidence supports using hope and self-efficacy to test interventions to increase HPB and decrease IR in adolescents residing along the US-Mexico border region.