Date of Award

May 2017

Degree Type


Degree Name

Doctor of Philosophy



First Advisor

Julia Snethen

Committee Members

Aaron Buseh, Reinhold Hutz, Julie Ellis


Acculturation, Health Promotion, Latino, Physical Activity, Pre-Diabetes, Self-efficacy


Latinos immigrants may experience stress during acculturation to the U. S., which can influence their ability to engage in health-promoting behaviors, such as dietary intake and physical activity. Dietary intake and physical activity influence the prevention or development of pre-diabetes/Type 2 Diabetes (T2DM). The immigrant’s ability to perform health-promoting behaviors can also be influenced by their perceptions of self-efficacy to engage in health-promoting behaviors. Limited information is available in the literature on effective strategies for decreasing stress during the acculturation process of Latino immigrants, while also increasing self-efficacy on health-promoting behaviors. The purpose of this study was to explore the associations between stress, acculturation, self-efficacy and the health-promoting behaviors of Latino adults. An adapted theoretical model based on the Health Promotion Model by Pender will guide this study. Participants were adults (N = 195), 18 years or older, who were Latino immigrants. Participants completed 4 surveys with all questions in both Spanish and English, exploring perceptions of self-efficacy, exercise behavior, acculturation, and stress. Participants also completed pre-diabetes and demographic questionnaires. 61% of the respondents reported having at least one family member with T2DM. Having a family member with T2DM did not influence physical activity of the participants. Examination of physical activity levels by gender suggested that Latino men reported engaging in significantly more vigorous physical activity when compared to Latino women (p = 0.017). There were significant correlations between walking behaviors and vigorous physical activity (χ2 (137) = .380, p = .05). Significant correlations were also found between walking and moderate physical activity (χ2 (137) = .278, p = .01). Among Latinos without prediabetes/T2DM, self-efficacy level and stress predicted physical activity. Among Latinos with pre-diabetes/T2DM, only age predicted physical activity. When the sample was stratified by pre-diabetes/T2DM status, self-efficacy remained a significant predictor of physical activity among Latinos without pre-diabetes/T2DM. However, among Latinos with pre-diabetes/T2DM, gender was the only significant predictor of physical activity, and age no longer predicted physical activity. Assessing self-efficacy level may help recognize Latinos at risk for chronic illnesses, such as type 2 diabetes. Stress level can impact health-promoting behaviors among Latino immigrants and assessing stress is important for nurses to consider during interactions with Latinos in order to support health-promoting behaviors and lower risk for T2DM.