PREVENTING DIABETES--A MOHAWK COMMUNITY INITIATIVE

非胰岛素依赖型糖尿病(NIDDM)和肥胖(其主要 风险因素)是美洲原住民的流行病比例失调 而且他们的发病年龄也在逐渐提早。这个 这项提案的长期目标是降低#年非胰岛素依赖型糖尿病的患病率 Akwesasne的莫霍克人通过支持发展 社会对健康生活方式的持久承诺，并通过加强 社区促进更多体育活动的能力和更低的 卡路里摄入，尤指从脂肪中摄取。 这项研究的主要干预对象将是儿童 5-8岁居住在Akwesasne，次要目标将是他们的 父母。研究期间寻求的主要成果是：1.a. 减少儿童食用含38%脂肪的饮食的比例， 从全国50%的中位数水平提高到35%；2.增加 报告说玩跑步游戏或运动更多的儿童比例 每周超过3次，从75%降至90%，比例下降 儿童每天看电视超过2小时的比例从65%上升到 50%；3.体重指数儿童比例下降 从目前的43%到30%的第85个百分位数以上，一个 目标与原住民2000年健康人口目标一致 美国人。 基础广泛的社区健康教育方法的有效性， 它将满足广泛的社区需求，将在 准实验设计，使用队列中的前后测量 5-8岁的儿童将被纵向比较超过5岁 年，横截面与第二个5-8岁的队列 5年后的孩子们。此外，随着时间的推移，第一个 队列将与生活在相同年龄的儿童中的人进行比较 在卡恩觉醒(300英里外的一个类似规模的莫霍克社区) 比较社区范围内预防NIDDM的努力的有效性 通过学校健康教育课程的重点方法， 将强调饮食行为、锻炼和体重控制，即 正在卡纳瓦赫省进行。

Non-insulin dependent diabetes mellitus (NIDDM) and obesity (its major risk factor) are disorders of epidemic proportion in Native American communities and they are occurring at progressively earlier ages. The long-term goal of this proposal is to reduce the prevalence of NIDDM in the Mohawk people in Akwesasne by supporting the development of an enduring community commitment to healthy lifestyles and by enhancing the community's capacity to facilitate more physical activity and a lower caloric intake, especially from fats. The primary target of the intervention in this study will be the children aged 5-8 years living in Akwesasne and a secondary target will be their parents. The major outcomes sought during the study period are; 1. a reduction in the proportion of children eating diets containing 38% fat, from the median national level of 50% to 35%; 2. an increase in the proportion of children reporting playing running games or sports more than 3 times per week from 75% to 90% and a reduction in the proportion of children watching more than 2 hours of television per day from 65% to 50%; 3. a reduction int he proportion of children with a body mass index above the 85th percentile from the current level of 43% to 30%, an objective consistent with the Healthy People 2000 goal for Native Americans. The effectiveness of the broad-based community health education approach, which will address a wide range of community needs, will be tested in a quasi-experimental design, using pre- and post-measurements in a cohort of 5-8 year old children who will be compared longitudinally over 5 years, and cross-sectionally with a second cohort of 5-8 year old children 5 years later. In addition changes over time in the first cohort will be compared with those in the children of the same age living in Kahnawake (a similarly sized Mohawk community 300 miles away) to compare the effectiveness of the community-wide effort to prevent NIDDM with the focused approach of a school health education curriculum that will emphasize dietary behavior, exercise and weight control, that is being undertaken in Kahnawake.