Date of Conferral

4-22-2025

Date of Award

April 2025

Degree

Ph.D.

School

Public Health

Advisor

Srikanta Banerjee

Abstract

Prediabetes affects over 4 million people in New York State and increases the risk of Type 2 diabetes. Prior research identified risk factors such as poor diet, inactivity, obesity, hypertension, and smoking; but no studies examined these collectively or assessed their interactions. This quantitative, cross-sectional study analyzed a sample of 289 non-institutionalized adults aged 18 or older with landline or cellular phone, from the Behavioral Risk Factor Surveillance System. The study examined relationships between prediabetes and 16 factors in five categories: demographic (age, race, sex, education), socioeconomic (income, employment), behavioral (fruit intake, vegetable intake, physical activity, smoking), physiological (hypertension, BMI), and health care-related (health education, health care coverage, medical cost, have personal doctor). Guided by Bronfenbrenner’s Social Ecological Model (adapted by McLeroy), complex samples binary logistic regression identified four significant predictors (vegetable intake, hypertension, BMI, race) associated with increased prediabetes risk. Specifically, risk of prediabetes was higher among Black individuals (odds ratio = 5.08, probability = 0.84), obese individuals (odds ratio = 4.79, probability = 0.83), hypertensive individuals (odds ratio = 3.18, probability = 0.76), and vegetable intake less than once per week (odds ratio = 46.09, probability = 0.98). Income and employment were not significant predictors individually. However, income level moderated the influence of BMI and vegetable intake; employment moderated the influence of BMI. Findings underscore the need to address behavior, but also social determinants of health—income, employment, and access to resources. Public health strategies should include community programs, food subsidies, and workplace wellness initiatives.

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