Family-Centered Diabetes Project

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Diabetes is a major health problem among Native American (NA) communities nationally and in New Mexico. Diabetes prevention efforts should concentrate on modifiable risk factors. Young NA women are important recipients of diabetes prevention activities because of their pivotal role in the family environment as they purchase and prepare food, and care for their children and families. They are also important recipients of diabetes prevention because of their own high risk of diabetes. Therefore, the long-range goal of this study is to reduce modifiable diabetes risk factors in NA women and their families through a culturally specific intervention. The specific aim of this study is to determine whether a healthful lifestyle intervention program, "Sharing Wisdom", delivered to young NA women without diabetes will reduce diabetes risk factors. A randomized trial design will be used with two experimental groups: intervention group, and comparison group who will receive a delayed intervention. Measures will be completed at the General Clinical Research Center (GCRC) with assistance from the research team at baseline, post intervention, and 6 and 12 months post intervention. Process evaluation will be conducted by a separate team. The target population is NA women ages 18-40 who attend the Indian Health Service (IHS) clinics or an urban Indian clinic. The following hypotheses will be tested: i) Intervention participants will attend the Sharing Wisdom program with a greater than or equal to 80 percent retention rate for the intervention and will evaluate the program positively. ii) Intervention participants will have improvement on diabetes risk factors (primary outcomes) when compared to the comparison group post intervention: decreased percent fat from kcal in the diet, increased vegetable consumption measured using the Block Food Frequency Questionnaire, and increased percent of participants who do moderate or strenuous physical activity for 30 minutes greater than 3 times a week using the Modifiable Activity Questionnaire of Kriska. iii) Intervention participants will improve on clinical measures (secondary outcomes) compared to the comparison group post intervention: improved physical fitness measured by predicted VO2 peak, decreased body fat measured by skinfold thickness, decreased body weight, and decreased insulin resistance using the HOMA model. iv) Improvement in outcome measures will be maintained by intervention participants when compared to the comparison group at 6 and 12 months post intervention.