Young Adult African American Men Research Articles

Coping with Community Violence: Perspectives of African American Young Adult Men and Hispanic/Latino Young Adult Men.

Further study is needed regarding the intersection of community violence exposure, coping strategies, and health behaviors among young adult African American men and Hispanic/Latino men. This study did so in Lake County, Indiana, which contains multiple areas with disproportionate prevalence of violence relative to population size. Approximately 22 miles from Chicago, Lake County includes noteworthy mid-sized cities such as Gary, Hammond, and East Chicago. This study explored the perceptions of African American men and Hispanic/Latino men ages 18 to 25 regarding coping strategies and both healthy and health risk behaviors after directly witnessing or indirectly experiencing a violent act or event. We used aspects of social cognitive theory to design this community-based participatory research study. Thirteen males who self-identified as African American, Hispanic/Latino, or both, completed 34- to 80-minute, audio-recorded phone interviews. Audio recordings were transcribed, and NVivo 12 Windows was used by the research team (primary researchers and two coders) to complete transcript analysis. Findings from this study provided insight around African American men and Hispanic/Latino men regarding (a) witnessing violence directly or indirectly experiencing violence; (b) changes in everyday life experiences; (c) coping strategies that involved socio-emotional health, spiritual health, social health, and risky health behaviors; (d) rationales for not asking for help; (e) observations of significant others' coping; (f) what to do differently in the future; (g) beliefs about mentors; and (h) beliefs about mental health providers. Delving into participants' experiences revealed that African American men and Hispanic/Latino men in Lake County, Indiana chose to adopt a range of health risk and health positive strategies after directly witnessing or indirectly experiencing violence. Becoming knowledgeable about African American men's and Hispanic/Latino men's diverse coping strategies and health behaviors may help inform the community about how best to cocreate spaces that aim to alleviate the traumatic experience of having directly or indirectly experienced community violence.

Body dissatisfaction and ethnic identity are associated with loss of control eating among young adult African American men

African American men are rarely the focus of attention in investigations of loss of control (LOC) eating. Theory and extant data support a robust link between body dissatisfaction and LOC eating behaviors in women. Ethnic identity may buffer this association, as the degree to which racially and ethnically diverse women identify with their ethnic group has been shown to decrease the relevancy of the Western culture body ideal, thereby decreasing disordered eating pathology. These associations have not been evaluated in African American men. The current study examined the link between body dissatisfaction and LOC eating frequency in 261 young African American men (1830 years old). Ethnic identity was evaluated as an independent variable and as a putative moderator. After adjusting for income, education, and body mass index, body dissatisfaction was significantly and positively associated with LOC eating frequency (p < .001). Ethnic identity did not function as a significant moderator (p = .84) but was significantly and inversely associated with LOC eating frequency (p < .001). Although longitudinal studies are needed, these data suggest that there may be multiple pathways through which young African American men engage in LOC eating. Similar to extant research with women and other ethnic groups, body dissatisfaction appears to play a role in the LOC eating of African American men. Additional research is needed to clarify the nature of the association between ethnic identity and LOC eating in this population.

Pre-exposure prophylaxis for HIV prevention preferences among young adult African American men who have sex with men.

Pre-exposure prophylaxis (PrEP) is effective in preventing HIV infections among men who have sex with men (MSM). PrEP uptake and adherence remain low and product preferences are unknown, especially among young African American MSM who are most at-risk. We conducted 26 qualitative interviews from 2014–2016 among young adult HIV-negative African American MSM regarding PrEP product preferences in Missouri. While the pill and injectable were most liked of all modalities, about a quarter preferred rectal products or patches. Most participants preferred a long-acting injectable (LAI) to daily oral pills due to better medication adherence and a dislike for taking pills. Many participants preferred daily oral pills to on-demand oral PrEP due to the inability to predict sex and the perception that insufficient time or medication would not achieve HIV protection with on-demand. A fear of needles and the perception that there would not be therapeutic levels for a long duration were concerns with injectable PrEP. Study findings highlight the need for a range of prevention options for African American MSM and can inform PrEP product development as well as dissemination and implementation efforts.

Pathways Linking Adverse Childhood Experiences to Cigarette Smoking Among Young Black Men: a Prospective Analysis of the Role of Sleep Problems and Delayed Reward Discounting.

African American men experience increases in smoking during the young adult transition. Exposure to childhood adversity, a risk factor which disproportionately affects African American men, has been identified as a robust precursor to health risk behavior in general and cigarette smoking in particular. The intermediate mechanisms that transmit the influence of early adversity to smoking behavior are not well understood. We tested a model of the escalation of smoking behaviors among young adult African American men, investigating sleep disturbance and delayed reward discounting as intermediate factors linking adverse childhood experiences with smoking. Hypotheses were tested with three waves of data (M age-T1=20.34, M age-T2=21.92, M age-T3=23.02) from 505 African American men living in rural counties in South Georgia. Men provided self-report data on their adverse childhood experiences, sleep problems, and smoking behavior using audio-assisted computer self-interviews. Men also completed a computer-based delayed reward discounting task. Structural equation modeling analyses supported our hypotheses: Adverse childhood experiences predicted poor sleep adequacy, which forecast increases in delayed reward discounting; discounting, in turn, predicted increased smoking. Significant indirect pathways were detected linking adversity to discounting via sleep adequacy and linking sleep adequacy to smoking via discounting. Prevention and intervention researchers can draw on these findings to develop programs that focus on sleep adequacy to reduce smoking in African American men exposed to childhood adversity.

Measuring Factors Associated with Colorectal Cancer Screening among Young Adult African American Men: A Psychometric Study.

The Male Role Norms, Knowledge, Attitudes, and Perceptions associated with Colorectal Cancer Screening (MKAP-CRCS) survey was developed to assess the attitudes, knowledge, male role norms, perceived barriers, and perceived subjective norms associated with screening for colorectal cancer (CRC) among young adult African American men. There is a critical need for exploring the complex factors that may shape attitudes towards CRC screening among men who are younger (i.e., ages 19-45) than those traditionally assessed by clinicians and health promotion researchers (age 50 and older). Psychometrically sound measures are crucial for eliciting valid and reliable data on these factors. The current study, therefore, assessed the psychometric properties of the MKAP-CRCS instrument using an online sample of young adult African American men (N = 157) across the United States. Exploratory principal component factor analyses revealed that the MKAP-CRCS measure yielded construct valid and reliable scores, suggesting that the scale holds promise as an appropriate tool for assessing factors associated with CRC screening among younger African American men. Strengths and limitations of this study, along with directions for future research are discussed, including the need for more research examining the relationship between masculinity and CRC screening among African American men.

Relationship Between Aerobic Fitness, the Serum IGF-1 Profiles of Healthy Young Adult African American Males, and Growth of Prostate Cancer Cells.

The growth of prostate tumors is mediated by the bioavailability of androgens and insulin-like growth factors. This study tested the hypothesis that healthy young adult African American men exhibiting low aerobic capacity (fitness) have serum insulin-like growth Factor-1 (IGF-1) and testosterone levels that promote growth of prostate cancer cells. A cross-sectional data research design was used to study groups of 18- to 26-year-old healthy men exhibiting low and moderate aerobic fitness, based on their peak oxygen consumption (VO2peak). The individual serum levels of IGF-1, IGF-1 binding protein-3 (IGFBP-3), and testosterone were measured. In vitro growth of androgen-dependent LNCaP prostate tumor cells was measured after incubation in culture medium fortified with each subject's serum. Aerobic capacity was significantly greater in the moderate-fitness group than in the low-fitness group without an intergroup difference in body mass index. The serum IGF-1 concentration was significantly higher in the low-fitness group in the absence of an intergroup difference in serum testosterone. The serum IGFBP-3 concentration was significantly lower in the low-fitness group. Prostate tumor cell growth was significantly greater in the cultures incubated in media containing the sera of the low-fitness group than in the sera of the moderate-fitness group. These findings suggest that moderate aerobic fitness in young adults may decrease the circulating levels of free IGF-1 and lower the potential to support growth of prostate cancer cells.

Cigarette Smoking Among Inmates by Race/Ethnicity: Impact of Excluding African American Young Adult Men From National Prevalence Estimates.

Cigarette smoking prevalence is more than two times greater among incarcerated adults, a population usually excluded from national health surveys. African American young adult (18-25) men are less likely to smoke cigarettes than their white counterparts. However, they are two and a-half-times more likely to be incarcerated. This study estimated smoking prevalence with noninstitutionalized and incarcerated samples combined to determine if excluding incarcerated adults impacts smoking prevalence for certain populations. The Bureau of Justice Statistics last fielded the Survey of Inmates in State and Federal Correction Facilities in 2003-2004. We combined data from Survey of Inmates in State and Federal Correction Facilities (n = 17 910) and the 2003 and 2004 National Health Interview Survey (n = 61 470) to calculate combined cigarette smoking estimates by race/ethnicity, sex, and age. Inmates represented the greatest proportion of smokers among African American men. Among African American young adult men, inmates represented 15.2% of all smokers in the combined population, compared to 2.0% among white young adult men. Cigarette smoking prevalence was 17.6% in the noninstitutionalized population of young adult African American men and 19.7% in the combined population. Among white young adult men, cigarette smoking prevalence was 29.8% in the noninstitutionalized population, and 30.2% in the combined population. There was little difference in estimates among women. The exclusion of incarcerated African American young adult men may result in a small underestimation of cigarette smoking prevalence in this population. Increasing access to smoking cessation support among inmates may reduce smoking prevalence in disproportionately incarcerated segments of the US population. The exclusion of incarcerated adults from national survey data should be considered when examining differences in cigarette smoking prevalence estimates between African American and white young adult men. Approximately one in six African American young adult men who smoke were incarcerated. Increasing access to smoking cessation support among inmates may reduce smoking prevalence among disproportionately incarcerated segments of the population.

Eating behaviors and related cultural attitudes of African American men and women

Cultural groups often participate in traditions and activities surrounding food and eating, which contribute to group differences in maladaptive eating-related patterns and outcomes. This study explored the relationships between cultural attitudes and eating behaviors of young adult African American men and women. Endorsing a strong orientation on various dimensions of African American culture were related to less dieting, bulimic, and anorexic behaviors and attitudes. This study extended our knowledge of the ways in which cultural attitudes were related to the physical and mental health of African Americans and recognized the significance of individual differences within this group.

Male Role Norms, Knowledge, Attitudes, and Perceptions of Colorectal Cancer Screening among Young Adult African American Men.

Racial disparities in health among African American men (AAM) in the United States are extensive. In contrast to their White counterparts, AAM have more illnesses and die younger. AAM have colorectal cancer (CRC) incidence and mortality rates 25% and 50% higher, respectively, than White men. Due to CRC’s younger age at presentation and high incidence among AAM, CRC screening (CRCS) is warranted at the age of 45 rather than 50, but little is known about younger AAM’s views of CRCS. Employing survey design, the purpose of the study was to describe the male role norms (MRN), knowledge, attitudes, perceived subjective norms, and perceived barriers associated with screening for CRC among a non-random sample of 157 young adult AAM (ages 19–45). Sixty-seven percent of the study sample received a passing knowledge score (85% or better), yet no significant differences were found among the three educational levels (i.e., low, medium, high). More negative attitudes toward CRCS correlated with the participants’ strong perceptions of barriers, but no extremely negative or positive MRN and perceived subjective norms were found. The factors significantly associated with attitudes were family history of cancer (unsure), work status, and perceived barriers. Findings from this study provide a solid basis for developing structured health education interventions that address the salient factors shaping young adult AAM’s view of CRC and early detection screening behaviors.

Perceptions of Harm to Health from Cigarettes, Blunts, and Marijuana among Young Adult African American Men

To assess perceptions and knowledge of health effects of smoking tobacco, blunts, and marijuana among adult African American (AA) men aged 19-30 in five Black Belt counties of rural Alabama. Cross-sectional study using interviewer-administered oral surveys. Four hundred and fifteen participants completed surveys. Cigarettes were the most common initial and current product used (40%) and there were more current than initial users of marijuana and blunts. Significantly more cigarette users (80%) felt that smoking cigarettes was harmful to health compared with marijuana (33%) and blunt (53%) users (p < .001). Many marijuana smokers (71%) and blunt smokers (48%) believed smoking their product was safer than cigarettes for reasons including more natural and less addictive. When compared with cigarettes, knowledge of the health-related effects of smoking marijuana-containing products among young African American men is poor. Intervention strategies focusing on the adverse health effects of smoking marijuana are needed.

Disability and health: exploring the disablement experience of young adult African Americans

Purpose: The objective of this study was to examine disablement as experienced by young adult African American men and women with permanent mobility impairment. Method: This study included a sample of 5 male and 5 female participants ranging in age from 22 to 39. An exploratory descriptive design and qualitative methods, including interviews and fieldnotes, were used. Interview data was analyzed using the process of inductive qualitative content analysis. Results: Basic desires for independence, shared intimacy, and psychological and physical health were not diminished by physical limitations. The disablement experience of this group is reflected in the themes of “Cumulative Losses” and “Sustained Desires”. The findings of this study describe the high level of motivation that young adult African American men and women with disabilities have to improve levels of health and well-being within the context of their impairments. Conclusion: This study provides a better understanding of the contextual factors and experiences that may contribute to the development of further disability and subsequent health-related problems over time. Increased knowledge of the disablement experience of these young men and women may assist health care entities and social service providers in improving health care and rehabilitation efforts targeting this group.Implications for RehabilitationDisablement among African American Young AdultsThis study's findings describe the high level of motivation that young adult African American men and women with disabilities have to improve levels of health and well-being.The two primary themes, “Cumulative Losses” and “Sustained Desires”, suggest that despite a number of significant losses, several innate desires remained intact in the context of impairment.Understanding the disablement experience of young African Americans may assist health care entities and social service providers in improving health care targeting this group.

The Concrete Jungle: City Stress and Substance Abuse among Young Adult African American Men

Substance use is prevalent among African American men living in urban communities. The impact of substance use on the social, psychological, and physical health of African American men has important public health implications for families, communities, and society. Given the adverse consequences of alcohol and drug abuse within communities of color, this study evaluated the relationship between city stress, alcohol consumption, and drug use among African American men. Eighty heterosexual, African American men, 18 to 29years old, completed psychosocial risk assessments that assessed substance use and city stress. Multiple logistic regression analyses, controlling for age, indicated that participants reporting high levels of urban stress, relative to low levels of urban stress, were more likely to report a history of marijuana use (AOR = 5.19, p = .05), history of ecstasy and/or GHB use (AOR = 3.34, p = .04), having family/friends expressing strong concerns about their illicit drug use (AOR = 4.06, p = .02), and being unable to remember what happened the night before due to drinking (AOR = 4.98, p = .01). African American men living within the confines of a stressful urban environment are at increased risk for exposure to and utilization of illicit substances. Culturally competent public health interventions for substance use/abuse should address psychological factors, such as stress and neighborhood violence.

Patterns of Blunt Use Among Rural Young Adult African-American Men

Blunts are hollowed-out cigars or leaf tobacco filled with marijuana. Use of blunts has increased since the 1990s and, in 2005, 3.5% of all American youth were estimated to have used blunts in the past month. Blunt smokers may have greater odds of cannabis and tobacco dependency and are at risk of smoking-related diseases. Previous studies have suggested that blunt use is more common among blacks, older teens, and men. However, data pertaining to blunt use in non-adolescent African-American populations are scarce. To assess patterns of blunt use among young adult African-American men aged 19-30 years residing in five rural Black Belt counties in Alabama and to compare these data with those from tobacco cigarette smokers within the same study population. Verbal, face-to-face interviewer-administered survey of 415 participants collected and analyzed between December 2008 and February 2011. 159 respondents (38.3%) smoked cigarettes and 45 smoked blunts (10.8%). Of blunt smokers, 33 also smoked cigarettes (73.3%). Use of blunts was prevalent among unemployed, single men, and occupational blunt use was uncommon. Factors important in the initiation, maintenance, and cessation of product use were similar for blunt and cigarette smokers, especially product use and acceptance by friends. Legal concerns were an important factor facilitating blunt cessation. Blunt use is relatively common among male African Americans aged 19-30 years and is frequently associated with concomitant cigarette use. Tobacco control efforts in this male African-American population should also address blunt usage.

Risk and Protective Factors Among African American Adolescent Males That Predict Adult Involvement in the Criminal Justice System: Evidence From a National Sample

The current study examined risk and protective factors in adolescence that predicted involvement in the criminal justice system among young adult African American men. Participants (n = 2,274) drawn from the National Longitudinal Study of Adolescent Health were adolescents (11–19 years, M = 15) at Wave 1 and young adults (18–27, M = 22) at Wave 3. We examined how racial differences in social environments (e.g., socioeconomic status, parental supervision, parental quality time, religiosity, peer substance use, and academic achievement) during adolescence predict involvement in the criminal justice system in young adulthood. Results revealed peer substance use as a risk factor, and religiosity and academic achievement as both protective factors against later involvement in the criminal justice system. Implication are discussed in regard to understanding the types of preventative services that may prove to decrease the number of African American young adult men involved in the criminal justice system.

The Accuracy of Selected Equations to Predict Maximal Heart Rate in African American Men

Strength and conditioning professionals, exercise physiologists, and coaches have long used maximal heart rate (MHR) as an acceptable method for prescribing aerobic exercise intensity. There have been a large number of age-predicted MHR equations developed. However, some age-predicted MHR equations appear to be more accurate for certain individuals, which seems to depend on various factors such as sex, age range, training status, and the mode of exercise used. While there is limited evidence to suggest a racial difference between African-American (AA) individuals and Caucasians in the kinetics of heart rate during and after exercise, the data regarding age-predicted MHR equations specifically for AA subjects is lacking. PURPOSE: The purpose of this investigation was to compare five of the most commonly used MHR prediction equations to actual MHR in young adult AA men. METHODS: Thirty AA men (mean age = 22.1 +/- 2.2 years, range = 19 to 31 years) volunteered to participate in this study. Each subject performed a maximal graded exercise test on a treadmill. Heart rate was measured continuously throughout the exercise test via electrocardiography. Gas exchange was also assessed to determine maximal oxygen consumption (V̇o2max). The heart rate value that corresponded to V̇o2max was recorded as actual MHR (aMHR). MHR was also predicted by using five commonly used age-predicted MHR equations as follows: 1) 220-age (Fox et al. 1971); 2) 208 - [0.7 × age] (Tanaka et al. 2001); 3) 216 - [0.84 × age] (Åstrand, 1952); 4) 205.8 - [0.685 × age] (Inbar et al. 1994); and 5) 206.9 - [0.67 × age] (Gellish et al. 2007). Repeated measures analysis of variance (ANOVA) with an LSD follow-up was used to determine if there were any differences between the aMHR and the five MHR equations (p < 0.05). RESULTS: The mean aMHR for the entire group was 188.5 +/− 4.7 beats/min. Each equation's predicted MHR mean was as follows: Fox et al. = 196.8 +/− 3.2 beats · min−1; Tanaka et al. = 191.7 +/− 3.2 beats · min−1; Åstrand et al. = 196.5 +/− 2.7 beats · min−1; Inbar et al. = 189.9 +/− 2.2 beats · min−1; and Gellish et al. = 191.4 +/− 2.1 beats · min−1. The mean predicted MHR of Fox et al., Tanaka et al., and Åstrand et al. were significantly higher compared to aMHR (p < 0.05). However, there was no difference between the predicted MHR of Inbar et al. and aMHR. CONCLUSIONS: For predicting MHR in young adult AA men, it appears that the MHR prediction equation of Inbar et al. is the most accurate. The other age-predicted MHR equations (i.e., Fox et al., Tanaka et al., Åstrand, Gellish et al.) significantly over-estimated MHR. PRACTICAL APPLICATIONS: It is very common to use MHR for establishing aerobic exercise intensity in the fitness industry. The results of this present investigation suggest that of the MHR prediction equations analyzed in the study, the equation by Inbar et al. (1993) appears to be the most precise for AA men. Currently, there are no MHR equations available that are race-specific. Therefore, future research is warranted to further explore the possibility of developing predicted MHR equations that are specific for AA individuals.

A comparison of African-American versus Caucasian men screened for an alcohol administration laboratory study: Recruitment and representation implications

African-Americans are under-represented in alcohol research, especially alcohol administration laboratory studies. Specific recruitment of African-Americans into laboratory studies, however, may also inadvertently affect the generalizability of the findings. In the current study, we compared all African-American young adult men ( n = 53) who volunteered and met criteria for an alcohol administration study to a sample ( n = 50) of Caucasian men recruited for the same study. Groups were compared on variables including demographics, quantity and frequency of alcohol consumption and other substance use, consequences of use and psychopathology. Compared to their Caucasian counterparts, African-American men reported less drinking frequency and quantity, less use of other substances and fewer negative consequences, but their alcohol and drug use was more likely to be associated with various measures of psychopathology. Results suggest that even when recruiting participants using criteria that should minimize differences (i.e. all participants were “social drinkers”), differences on key variables were evident. These differences may have important implications for alcohol research.

Self-regulatory Problems Mediate the Association of Contextual Stressors and Unprotected Intercourse among Rural, African American, Young Adult Men

In this brief report, the hypothesis that self-regulatory problems would mediate the association between contextual stressors and unprotected intercourse among rural African American young adult men was investigated. Family support and religiosity were hypothesized to ameliorate the influence of contextual stressors on self-regulatory problems. Hypotheses were tested on 79 sexually active men from a sample recruited with Respondent Driven Sampling; episodes of unprotected intercourse constituted the criterion variable. Analyses supported the mediating role of self-regulatory problems in linking young adult men's contextual stressors with a heightened likelihood of unprotected intercourse. Religious involvement and family support interacted with contextual stressors to predict diminished associations with self-regulatory problems.

Linking parenting and informal mentor processes to depressive symptoms among rural African American young adult men.

Little is known about the rates of depressive symptoms among rural African American men during young adulthood or the processes that predict those rates. Many rural African American men in the deep South confront difficult environments that provide minimal resources and diminishing social support to help them embark on beneficial life paths. A model of protective processes hypothesized to deter depression among this population was tested that included autonomy-promoting parenting, informal mentoring, and protective self-regulatory processes. Data from a Respondent-Driven Sampling study with 116 rural African American men age 18-21 were used to test study hypotheses. The unadjusted prevalence of clinically significant depression was 37.9%. As predicted, self-regulatory processes mediated the influence of autonomy-promoting parenting on depressive symptoms. Leaving the family home was associated negatively and educational attainment was associated positively with self-regulatory processes. Support from an informal mentor moderated the link between autonomy-promoting parenting and self-regulatory processes. Findings suggest malleable targets for intervention development with this population.

Real Men Do…Real Men Don’t: Young Latino and African American Men’s Discourses Regarding Sexual Health Care Utilization

There is growing recognition that men as well as women need sexual health care (SHC) services. Despite this, male friendly sexual health services are not readily available in the United States, and men are underutilizing the services that are available. This situation needs to be rectified to improve sexual health outcomes for men and women. In this study we conducted 10 focus groups with young adult Latino and African American men to examine their perceptions of the factors influencing SHC utilization among the men they know, with an emphasis on how notions of what it means to be a man affects health care seeking. The findings both amplify and complicate the relationship between masculinity and SHC seeking. They suggest new directions for public health efforts to enhance men's SHC utilization.

The utility of fasting glucose for detection of prediabetes

Treatment of prediabetes attenuates progression to type 2 diabetes mellitus. The American Diabetes Association (ADA) previously defined prediabetes as either impaired fasting glucose (IFG) = 6.1 to 6.9 mmol/L (110-125 mg/dL) and/or impaired glucose tolerance (IGT) (2-hour postload glucose of 7.8-11.0 mmol/L [140-199 mg/dL]). For practical reasons, fasting plasma glucose (FPG) is commonly used for diabetes screening. Recently, the ADA lowered the fasting glucose threshold value for IFG from 110 to 100 mg/dL. Our objective was to determine the utility of FPG alone for detecting prediabetes in African Americans. Oral glucose tolerance test (OGTT) data from a cohort of 304 young adult African American men and women were examined. We calculated prediabetes prevalence using the previous ADA criteria and examined the effect of lowering the IFG threshold value for IFG to 100 mg/dL. The prediabetes prevalence in this cohort using the previous ADA criteria was 20.4% (n = 62). Of the 62 cases, 8 had IFG, 45 had IGT, and 9 had IFG together with IGT. Fasting plasma glucose testing alone detected 17 (27.4%) prediabetic cases, whereas a complete OGTT detected 54 (87.1%). Lowering the IFG threshold value to FPG = 100 mg/dL identified 13 of the 45 IGT-only cases. However, this lower IFG threshold increased prediabetes prevalence in the overall cohort from 20.4% to 31.9%. In conclusion, in young adult African Americans, an ethnic group at high risk for developing diabetes, FPG testing alone may be inadequate for diagnosing prediabetes. Until alternative strategies are identified, an OGTT is presently the best method for detecting the prediabetic condition in these high-risk patients.