美国印第安人和阿拉斯加原住民青少年和年轻女性中与妊娠期糖尿病风险相关的健康知识和健康信念及其女性照顾者之间的关系：一项横断面对偶分析。

The Associations Between Health-Related Knowledge and Health Beliefs Regarding Risk for Gestational Diabetes in American Indian and Alaska Native Female Adolescents and Young Adults at Risk for Gestational Diabetes and Their Female Caregivers: A Cross-Sectional Dyadic Analysis.

机构信息

Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.

Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

出版信息

J Midwifery Womens Health. 2024 May-Jun;69(3):383-393. doi: 10.1111/jmwh.13643.

DOI:10.1111/jmwh.13643

PMID:38831486

Abstract

INTRODUCTION

Research on associations between knowledge and health beliefs for women at risk for gestational diabetes mellitus (GDM) has focused on adults at risk for or having GDM. Gaps also exist in examining interpersonal associations with family members or peers. We examined dyadic associations between knowledge and health beliefs about the risk for GDM between and within American Indian and Alaska Native (AIAN) female adolescents and young adults (FAYAs) at risk for GDM and their mothers or adult female caregivers (FCs).

METHODS

Grounded in the Expanded Health Belief Model, we employed a cross-sectional design using baseline data from 147 dyads of AIAN FAYAs at risk for GDM and their FCs who participated in the Stopping GDM in Daughters and Mothers trial. FAYAs were 12.0 to 24.5 years of age, and 89.1% were students. FCs had a mean (SD) age of 44.0 (9.3) years, 87.0% were AIAN, 44.9% were college educated, 19.7% had ever had GDM, and 81.0% were the FAYA's mother. FAYAs and FCs completed surveys about knowledge and health beliefs (benefits, barriers, severity, susceptibility) regarding GDM risk and prevention. Bivariate correlational analyses were performed to examine associations between and within dyad members. Dyadic associations were investigated using actor-partner interdependence modeling (APIM) assuming distinguishable dyad members.

RESULTS

Compared with their FCs, FAYAs had lower health-related knowledge and perceived benefits of GDM prevention and susceptibility regarding GDM risk. APIM revealed actor and partner effects of health-related knowledge on health beliefs for dyads. In particular, positive actor effects were found for FAYAs and FCs for GDM-related knowledge with perceived benefits (P < .001), and positive partner effects of GDM-related knowledge for FCs were related to perceived susceptibility and severity for FAYAs (P < .05).

DISCUSSION

As shown in these AIAN dyads, FAYAs and their FCs, as members of one another's social network, may influence each other's health beliefs regarding GDM risk and prevention.

摘要

简介

针对有妊娠糖尿病（GDM）风险或已患有 GDM 的成年人，已有研究关注知识与健康信念之间的关系。但在研究与有 GDM 风险的家庭成员或同龄人之间的人际关联时，仍存在空白。我们研究了处于 GDM 风险中的美国印第安人和阿拉斯加原住民（AIAN）青少年和年轻女性（FAYA）及其母亲或成年女性照顾者（FC）之间以及她们内部的知识和健康信念对 GDM 风险的双向关联。

方法

基于扩展健康信念模型，我们采用了横断面设计，利用 Stopping GDM in Daughters and Mothers 试验中 147 对有 GDM 风险的 AIAN FAYA 及其 FC 的基线数据。FAYA 的年龄为 12.0 至 24.5 岁，89.1%为学生。FC 的平均（SD）年龄为 44.0（9.3）岁，87.0%为 AIAN，44.9%受过大学教育，19.7%曾患有 GDM，81.0%为 FAYA 的母亲。FAYA 和 FC 完成了关于 GDM 风险和预防的知识和健康信念（益处、障碍、严重程度、易感性）的调查。进行了双变量相关分析，以检查个体内和个体间成员之间的关联。使用假定可区分的对成员的行为者-伙伴相互依赖模型（APIM）研究了对关系。

结果

与 FC 相比，FAYA 的健康相关知识较低，对 GDM 预防和易感性的益处感知较低。APIM 揭示了对知识和健康信念的行为者和伙伴影响。特别是，FAYA 和 FC 对 GDM 相关知识的积极作用表现为对 GDM 相关益处的感知（P<0.001），而对 GDM 相关知识的 FC 的积极伙伴效应与 FAYA 对易感性和严重程度的感知有关（P<0.05）。