Follow-up of a Culturally-Grounded Diabetes Prevention Program for Obese Latino Adolescents

项目摘要/摘要： 肥胖和相关的健康差距是重大的公共卫生挑战，继续 对社会有负面影响。特别是，肥胖拉美裔青年是一个关键和脆弱的群体， 经历不成比例的2型糖尿病发病率。为了解决这些差距，我们的学术团队和 社区合作伙伴通过NIMHD和西南跨学科研究中心的支持 合作了10年，以开发、实施、测试、完善和扩展基于社区的家庭- 针对肥胖的拉丁裔青少年的重点糖尿病预防干预。每一小步都很重要(ELSC)是一个 在生态发展模式框架内的全面生活方式干预，以利用个人， 社会、社区和文化因素，以改善健康行为(营养和体力活动)和 减少肥胖的拉丁裔青少年患2型糖尿病的危险因素。我们目前的初步结果 P20资助的试验支持ELSC干预改善90名肥胖者糖耐量的有效性 拉丁裔青少年(14-16岁)。我们现在建议对完成ELSC的参与者进行长期随访 在过去的四年里，现在是年轻人(18-22岁)，以1)描述个体糖尿病- 生活方式干预后的相关健康状况，以及2)检查文化家庭规范、家庭 食物环境和邻里环境随着时间的推移与健康状况的变化有关。我们 将使用潜在侧写分析来检查以下目标。具体目标1：描述个体糖尿病 一项以文化为基础的糖尿病预防干预措施在5年内的风险分布 肥胖的拉丁裔青少年。具体目标2：审查包括家庭在内的文化家庭规范 凝聚力、家庭主义和支持性父母教养方式与个体糖尿病风险相关。 时间到了。具体目标3：检查家庭食物环境(水果、蔬菜的可获得性、高 随着时间的推移，糖类食品和饮料)与个体的糖尿病风险状况有关。具体目标4： 检查社区的建筑环境(可步行)或社会环境(劣势、凝聚力、 和信任)与个人随时间推移的糖尿病风险状况有关。该项目建立在已建立的 学术-社区合作和来自脆弱和 代表不足的人口。该团队在将研究成果转化为 社区中有意义的健康促进和疾病预防干预措施。该项目的目标是 研究不足的人口经历了与未来相关的关键发展转型 健康结果。最后，没有把语境因素放在长期的语境中进行研究 生活方式干预后的健康变化。该项目的发现将直接为进一步提供信息 改进成功的干预措施，以便在高危人群中产生更大的影响 糖尿病相关的发病率。

Project Summary / Abstract: Obesity and related health disparities represent significant public health challenges that continue to have a negative impact on society. In particular, obese Latino youth are a key and vulnerable population that experience disproportionate rates of type 2 diabetes. To address these disparities, our team of academic and community partners through support from NIMHD and the Southwest Interdisciplinary Research Center has collaborated for 10 years to develop, implement, test, refine, and expand a community based-based, family- focused diabetes prevention intervention for obese Latino adolescents. Every Little Step Counts (ELSC) is a comprehensive lifestyle intervention that is framed within an Ecodevelopmental Model to leverage individual, social, community, and cultural factors in order to improve health behaviors (nutrition and physical activity) and reduce risk factors for type 2 diabetes among obese Latino adolescents. Preliminary results from our current P20-funded trial support the efficacy of the ELSC intervention to improve glucose tolerance among 90 obese Latino adolescents (age 14-16). We now propose a long-term follow-up of participants who completed ELSC over the past four years and are now young adults (age 18-22) in order to 1) describe individual diabetes- related health profiles following the lifestyle intervention and 2) examine how cultural family norms, the home food environment, and neighborhood environment are associated with changes in health profiles over time. We will use latent profile analyses to examine the following aims. Specific Aim 1: To describe individual diabetes risk profiles over a 5-year period in response to a culturally-grounded diabetes prevention intervention for obese Latino adolescents. Specific Aim 2: To examine whether cultural family norms that include family cohesion, familism, and supportive parenting styles are associated with individual diabetes risk profiles over time. Specific Aim 3: To examine whether the home food environment (availability of fruits, vegetables, high- sugar foods and beverages) is associated with individual diabetes risk profiles over time. Specific Aim 4: To examine if the neighborhood built environment (walkability) or social environment (disadvantage, cohesion, and trust) are associated with individual diabetes risk profiles over time. The project builds upon an established academic-community collaboration and a comprehensively characterized cohort from a vulnerable and underrepresented population. The team has an extensive track-record for translating research findings into meaningful health promotion and disease prevention interventions in the community. This project targets an understudied population that has undergone a critical developmental transition that is associated with future health outcomes. Lastly, the contextual factors of interest have not been studied in the context of long-term health changes following lifestyle intervention. The findings from this project will directly inform further refinement of a successful intervention in order to make a greater impact in a population at very high risk for diabetes-related morbidity.