Owing to the fact that diabetes in youth has been cited as an increasing public health concern particularly in specific minority populations (Huang & Goran, 2003), the present paper critically appraises the article titled “A Cross-Sectional of Jamaican Adolescents’ Risk of Type 2 Diabetes and Cardiovascular Diseases” with the view to delineating diabetes risk factors in adolescents. The thesis statement guiding this paper is that life such as lack of physical exercise and obesity restyle variables as the strongest risk factors for diabetes in adolescents. The paper is divided into various sections, as follows: protection of human participants; data collection; data management and analysis; problem statement; interpretation of findings; and conclusion.
Protection of Human Participants
The authors of the study made no mention of the benefits accruing to the participants apart from being provided with a small stipend for their participation. In risks, the participants were screened to establish if they were on any drugs known to alter blood pressure (BP), glucose, or lipid metabolism, and whether they demonstrated any characteristics of known eating disorders (Barrett et al., 2013). Informed consent was obtained through parental written consent as well as students’ assent to take part in the study, implying that the students participated voluntarily in the study. As demonstrated by Barrett et al (2013), the researchers sought approval from “the Florida International University Institutional Review Board, the Division of Standards and Regulations Ministry of Health and Environmental Control, and the Ministry of Education and Youth, Jamaica” (p. 2). Drawing from this appraisal, it is evident that the study fulfilled the mandatory requirements for the protection of human participants.
The authors of the study neither identified nor defined major independent and dependent variables; however, data for the study were collected using a multiplicity of methods, including testing blood by finger pricks to evaluate fasting blood glucose (FBG), total cholesterol (TC), and glycated hemoglobin (HbAlc), conducting an examination to identify the physical signs of Acanthosis Nigricans (AN) and completing demographic and physical activity questionnaires and silhouettes to evaluate the family history of obesity (Barrett et al., 2013). The authors failed to provide any justification for using the stated data collection methods, though all evaluations were completed within 3 hours for each school and all data were collected in October 2007. The sequence of data collection events for each participant is as described above.
Data Management and Analysis
Data for the study were managed as follows: (1) heights and weights were taken and used to calculate body mass index, (2) waist and hip measurements were taken using standard procedures and categorized as risk versus no risk, (3) testing of FBC, TC, and HbAlc was done by professionals and categorized variedly depending on existing codes and standards, (4) blood pressure was measured twice for each patient, (5) the self-administered Physical Activity Questionnaire for Children (PAQ-C) was used to evaluate general physical activity levels during the school year, (6) family history of obesity was determined by students’ selection from nine silhouettes, (7) presence of AN was determined by the detection of a dark line around the neck, and (8) family histories of type 2 diabetes and cardiovascular diseases were determined using the demographic questionnaire (Barrett et al., 2013). Data were analyzed using the statistical software for social sciences (SPSS, version 15.0), which enabled the researchers to undertake various analyses including Spearman’s correlations, logistic regressions and descriptive statistics.
Various measures such as the demographic survey instrument were developed, tested, and validated before being administered to the participants (Barrett et al., 2013). Although the researchers did not reveal how the rigor of the research process was assured, it is assumed that they could have used SPSS to ensure the accuracy of the analysis. Various measures were administered to participants by health professionals in a move that was intended to reduce researcher bias during data collection.
The main research gap which triggered the researchers to undertake the study, it seems, revolved around the fact that it was not yet clear whether known lifestyle variables such as lack of physical exercises and obesity were actually responsible for the noted increase in type 2 diabetes affecting Jamaican adolescents in contemporary times. A gap in knowledge also existed in identifying and internalizing the most appropriate and cost-effective way which could be used by stakeholders within the health care industry to screen for these risk factors in contemporary school settings, hence the need to undertake this particular study.
Interpretations of Findings
Owing to the fact over one-third of the participants were found to be overweight as demonstrated by their waist circumference, waist-to-hip ratio, total cholesterol, familial history as well as blood pressure, the researchers concluded that most Jamaican adolescents are at risk of type 2 diabetes and other known cardiovascular conditions (Barrett et al., 2013). These interpretations of findings are consistent with other research studies which have found a positive correlation between obesity (being overweight) and proliferation of type 2 diabetes among adolescents (Ansari et al., 2014; Huang & Goran, 2003). In addition, the study being critiqued found that most adolescents under risk for type 2 diabetes are less physically active, which in turn leads to a propensity for gaining more weight and subsequent categorization with metabolic syndrome (Barrett et al., 2013). Again, these interpretations of findings are consistent with other research studies which have positively associated lack of physical activity with key diabetes-causing predispositions such as obesity and presence of metabolic syndrome (Fischetti, 2009; Ansari et al., 2014). The research findings are valid as they are consistent with the findings of other research studies on the topic of adolescent risk factors for type 2 diabetes.
In limitations, the authors noted that a more precise and detailed instrument for assessing physical activity is needed as PAQ-C failed to assess the amount of time or energy expended on each activity, resulting in a scenario where findings on the prevalence of overweight and obesity were determined by a surrogate measure rather than actual measures of heights and weights. Overall, it can be argued that there was a coherent logic to the presentation of findings based on the phenomenon under study as well the variables of interest to the study, not mentioning that the study findings can be generalized to a wider population of adolescents due to the various measures undertaken to ensure the validity of findings. The researchers recommended that screening of school children for type 2 diabetes and cardiovascular risk factors should at least be done on an annual basis and that reintroducing and re-emphasizing physical education to all grades in high schools should be prioritized (Barrett et al., 2013).
The study under critique proved that lifestyle variables such as lack of physical exercise and obesity were among the strongest risk factors for type 2 diabetes in adolescents. These findings are of immense importance in assisting nursing professionals to develop strategies and approaches to fight the proliferation of diabetes in adolescents through encouraging healthy eating habits and involvement in physical exercises. The knowledge learned is that being overweight and lack of physical activity are among the strongest risk factors for diabetes in adolescents not only in Jamaica but also globally.
Ansari, S., Samaga, S., Rao, S., Gowda, S., Mohammed, T., Atrolia, S…Kundapur, R. (2014). Awareness of risk factors of diabetes and practices regarding its prevention among the adolescents. Nittle University Journal of Health Science, 4(1), 79-82.
Barrett, S.C., Huffman, F.G., Johnson, P., Campa, A., Magnus, M., & Ragoobirsingh, D. (2013). A cross-sectional of Jamaican adolescents’ risk for type 2 diabetes and cardiovascular diseases. BMJ Open, 3(2), 1-9.
Fischetti, N. (2009). Perceived risk for developing type 2 diabetes in adolescents (Doctoral thesis, State University of New Jersey). Web.
Huang, T.T.K., & Goran, M.I. (2003). Prevention of type 2 diabetes in young people: A theoretical perspective. Pediatric Diabetes, 4(2), 38-56.