The role of acculturation in the accuracy of type 2 diabetes risk perception: National Health and Nutrition Examination Survey 2011–2016

Abstract

Objective: High rates of undiagnosed Type 2 diabetes mellitus (T2DM) necessitate additional efforts to increase risk awareness, particularly among marginalized and immigrant populations. We examined the association of acculturation with the likelihood of accurate perception of T2DM risk in a large nationally representative sample of adults at risk for T2DM. Method: Participants were 5,034 adults, M (SD) age: 53 (23) years, 48% female. Acculturation was operationalized as length of time in the United States, and whether participants predominantly spoke English or their native language at home. Adults were considered to have accurate risk perception if they (a) met American Diabetes Criteria for prediabetes, and (b) self-reported their risk. Results: Less than half of the sample (33%) accurately perceived their T2DM risk. Logistic regression models adjusting for age, race, sex, education, insurance status, smoking, alcohol use, waist circumference, and family history of T2DM revealed that adults living in the United States up to 15 years were 1.35–2.33 times (ps< .04) as likely to inaccurately perceive their risk for T2DM compared to adults living in the United States >15 years and United States-born adults. Adults with lower versus higher English proficiency had a 41% (p = .03) increased likelihood of misperceiving their T2DM risk. Conclusions: Findings suggest that acculturation plays an important role in shaping T2DM risk perceptions among both nonimmigrant and immigrant populations. Increased cognizance of acculturation status (e.g., by healthcare providers) may be warranted to promote early T2DM risk detection and prevention at the population level. (PsycInfo Database Record (c) 2024 APA, all rights reserved)