The Monthly Cycling of Food Insecurity in Latinas at Risk for Diabetes: Methods, Retention, and Sample Characteristics for a Microlongitudinal Design

Abstract BackgroundFood insecurity (FI) is a risk factor for type 2 diabetes (T2D) that disproportionately affects Latinas. We conducted a microlongitudinal study to examine the relationship of monthly cycling of FI and diabetes risk factors. ObjectiveThis study ai...

Full description

Saved in:
Bibliographic Details
Main Authors: Angela Bermúdez-Millán, Rafael Pérez-Escamilla, Sofia Segura-Pérez, James Grady, Richard S Feinn VI, Hanako Agresta, Dean Kim, Julie Ann Wagner
Format: Article
Language:English
Published: JMIR Publications 2025-03-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2025/1/e66970
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849762852616798208
author Angela Bermúdez-Millán
Rafael Pérez-Escamilla
Sofia Segura-Pérez
James Grady
Richard S Feinn VI
Hanako Agresta
Dean Kim
Julie Ann Wagner
author_facet Angela Bermúdez-Millán
Rafael Pérez-Escamilla
Sofia Segura-Pérez
James Grady
Richard S Feinn VI
Hanako Agresta
Dean Kim
Julie Ann Wagner
author_sort Angela Bermúdez-Millán
collection DOAJ
description Abstract BackgroundFood insecurity (FI) is a risk factor for type 2 diabetes (T2D) that disproportionately affects Latinas. We conducted a microlongitudinal study to examine the relationship of monthly cycling of FI and diabetes risk factors. ObjectiveThis study aimed to determine the quantitative methodology, recruitment and retention strategies, predictors of retention across time, and baseline sample demographics. MethodsParticipants were adult Latinas living in Hartford, Connecticut who were recruited through a community agency, invited to participate if they were receiving Supplementary Nutrition Assistance Program (SNAP) benefits, screened positive for FI using the 2-item Hunger Vital Sign Screener, and had elevated risk factors for T2D using the American Diabetes Association risk factor test. Using a microlongitudinal design, we collected data twice per month for 3 months (week 2, which is a period of food budget adequacy; and week 4, which is a period of food budget inadequacy) to determine if the monthly cycling of FI was associated with near-term diabetes risk (fasting glucose, fructosamine, and glycosylated albumin) and long-term risk (BMI, waist circumference, and glycated hemoglobin) markers. We determined whether household food inventory, psychological distress, and binge eating mediated associations. We examined Health Action Process Approach model constructs. To assess the relationship between monthly cycling of FI with diabetes risk markers, we used repeated measures general linear mixed models. To assess the role of mediators, we performed a causal pathway analysis. ResultsParticipant enrollment was from April 1, 2021 to February 21, 2023. A total of 87 participants completed 420 assessments or a mean of 4.83 (SD 2.02) assessments. About half (47/87, 54%) of the sample self-identified as Puerto Rican, mean age was 35.1 (SD 5.8) years, with 17.1 (SD 11.6) years in the mainland United States. Just under half (41/87, ) spoke Spanish only, 69% (60/87) had no formal schooling, and 31% (27/87) had less than eighth ConclusionsThis study demonstrated how FI cycles over the month and whether and to what degree the cycling itself is related to the risk for T2D development, as well as the evidence for some putative mechanisms of this association that can serve as future intervention targets including SNAP disbursement schedules.
format Article
id doaj-art-0022df6bb1874a948e5c62acda12cfd6
institution DOAJ
issn 2561-326X
language English
publishDate 2025-03-01
publisher JMIR Publications
record_format Article
series JMIR Formative Research
spelling doaj-art-0022df6bb1874a948e5c62acda12cfd62025-08-20T03:05:38ZengJMIR PublicationsJMIR Formative Research2561-326X2025-03-019e66970e6697010.2196/66970The Monthly Cycling of Food Insecurity in Latinas at Risk for Diabetes: Methods, Retention, and Sample Characteristics for a Microlongitudinal DesignAngela Bermúdez-Millánhttp://orcid.org/0000-0002-7905-4575Rafael Pérez-Escamillahttp://orcid.org/0000-0001-9416-8039Sofia Segura-Pérezhttp://orcid.org/0000-0001-8717-3315James Gradyhttp://orcid.org/0000-0003-4783-5964Richard S Feinn VIhttp://orcid.org/0000-0002-4158-7640Hanako Agrestahttp://orcid.org/0000-0002-4286-8954Dean Kimhttp://orcid.org/0000-0003-1237-9022Julie Ann Wagnerhttp://orcid.org/0000-0002-1439-8940 Abstract BackgroundFood insecurity (FI) is a risk factor for type 2 diabetes (T2D) that disproportionately affects Latinas. We conducted a microlongitudinal study to examine the relationship of monthly cycling of FI and diabetes risk factors. ObjectiveThis study aimed to determine the quantitative methodology, recruitment and retention strategies, predictors of retention across time, and baseline sample demographics. MethodsParticipants were adult Latinas living in Hartford, Connecticut who were recruited through a community agency, invited to participate if they were receiving Supplementary Nutrition Assistance Program (SNAP) benefits, screened positive for FI using the 2-item Hunger Vital Sign Screener, and had elevated risk factors for T2D using the American Diabetes Association risk factor test. Using a microlongitudinal design, we collected data twice per month for 3 months (week 2, which is a period of food budget adequacy; and week 4, which is a period of food budget inadequacy) to determine if the monthly cycling of FI was associated with near-term diabetes risk (fasting glucose, fructosamine, and glycosylated albumin) and long-term risk (BMI, waist circumference, and glycated hemoglobin) markers. We determined whether household food inventory, psychological distress, and binge eating mediated associations. We examined Health Action Process Approach model constructs. To assess the relationship between monthly cycling of FI with diabetes risk markers, we used repeated measures general linear mixed models. To assess the role of mediators, we performed a causal pathway analysis. ResultsParticipant enrollment was from April 1, 2021 to February 21, 2023. A total of 87 participants completed 420 assessments or a mean of 4.83 (SD 2.02) assessments. About half (47/87, 54%) of the sample self-identified as Puerto Rican, mean age was 35.1 (SD 5.8) years, with 17.1 (SD 11.6) years in the mainland United States. Just under half (41/87, ) spoke Spanish only, 69% (60/87) had no formal schooling, and 31% (27/87) had less than eighth ConclusionsThis study demonstrated how FI cycles over the month and whether and to what degree the cycling itself is related to the risk for T2D development, as well as the evidence for some putative mechanisms of this association that can serve as future intervention targets including SNAP disbursement schedules.https://formative.jmir.org/2025/1/e66970
spellingShingle Angela Bermúdez-Millán
Rafael Pérez-Escamilla
Sofia Segura-Pérez
James Grady
Richard S Feinn VI
Hanako Agresta
Dean Kim
Julie Ann Wagner
The Monthly Cycling of Food Insecurity in Latinas at Risk for Diabetes: Methods, Retention, and Sample Characteristics for a Microlongitudinal Design
JMIR Formative Research
title The Monthly Cycling of Food Insecurity in Latinas at Risk for Diabetes: Methods, Retention, and Sample Characteristics for a Microlongitudinal Design
title_full The Monthly Cycling of Food Insecurity in Latinas at Risk for Diabetes: Methods, Retention, and Sample Characteristics for a Microlongitudinal Design
title_fullStr The Monthly Cycling of Food Insecurity in Latinas at Risk for Diabetes: Methods, Retention, and Sample Characteristics for a Microlongitudinal Design
title_full_unstemmed The Monthly Cycling of Food Insecurity in Latinas at Risk for Diabetes: Methods, Retention, and Sample Characteristics for a Microlongitudinal Design
title_short The Monthly Cycling of Food Insecurity in Latinas at Risk for Diabetes: Methods, Retention, and Sample Characteristics for a Microlongitudinal Design
title_sort monthly cycling of food insecurity in latinas at risk for diabetes methods retention and sample characteristics for a microlongitudinal design
url https://formative.jmir.org/2025/1/e66970
work_keys_str_mv AT angelabermudezmillan themonthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT rafaelperezescamilla themonthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT sofiaseguraperez themonthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT jamesgrady themonthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT richardsfeinnvi themonthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT hanakoagresta themonthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT deankim themonthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT julieannwagner themonthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT angelabermudezmillan monthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT rafaelperezescamilla monthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT sofiaseguraperez monthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT jamesgrady monthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT richardsfeinnvi monthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT hanakoagresta monthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT deankim monthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign
AT julieannwagner monthlycyclingoffoodinsecurityinlatinasatriskfordiabetesmethodsretentionandsamplecharacteristicsforamicrolongitudinaldesign