Prevention and Control of Diabetes in Families

家庭糖尿病的预防和控制

• 批准号: 7233303
• 负责人: ANNY H XIANG
• 金额: $ 57.59万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2009-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7233303
• 关键词: Prevention; Control; Diabetes; Families

DESCRIPTION (provided by applicant): The prevalence of type 2 diabetes is rapidly increasing, creating a compelling need to develop, evaluate and disseminate effective programs for the prevention and self-management of this disease. Recent research has shown the efficacy of lifestyle changes on dietary and physical activity behavior for the prevention and self-management of diabetes. Programs are needed to translate these findings into effective community interventions. This has led NIDDK to release the program announcement entitled "Translational Research for the Prvention and Control of Diabetes" (PA-02-153). Two of the three objectives of this program announcement call for the evaluation of clinical and behavioral programs to 1) improve methods of diabetes self-management, and 2) promote healthy lifestyles what will reduce the risk of diabetes and obesity. Our proposal addresses the objectives of the translational research program announcement through intervention with married couples where one of the spouses has been diagnosed with type 2 diabetes. These married couples offer several advantages for intervention including 1) self-management and prevention can be addressed through change in the same behaviors, 2) spousal partners can provide support to one another, 3) behaviors are aggregated in families, and 4) these partners may be highly motivated to alter lifestyle behaviors. This intervention will be evaluated using a randomized experimental design in which spousal pairs, with one diabetic spouse, will be recruited from the diabetes registry of Kaiser Permanente Southern California, stratified on type of diabetes medication used and gender of the diabetic spouse, within primary care practice, and randomly assigned to a special intervention (SI) or a usual care (UC) control condition. In the SI condition, spouses will meet with an educator and will complete a 30-minute computer program guiding each spouse to set a goal for behavior change, define barriers to the goal and solutions to the barriers, and will generate an action plan. Each spouse will also complete an assessment of the spousal support activities, home environment change, and wider environmental linkages that can facilitate completion of the action plan. Both spouses will then select one factor from each of these categories that will support completion of the action plans. Tailored newsletters will be mailed three- and six-weeks after the educator visit. Support telephone calls will be made one week and one month after completion of the educator visit. This sequence will be completed for one behavior (e.g., diet) and then repeated for the second behavior (e.g., physical activity). Spousal partners in the UC condition will complete a computerized Health Risk Assessment and receive general health education in a visit with an educator. Assessments will occur at baseline, 4-, and 12-months post baseline. Changes in HbA1c (diabetic spouse only), dietary and physical activity behavior will constitute the primary outcomes. The ratio of total cholesterol to HDL cholesterol, BMI, blood pressure, quality of life and mediational variables (e.g., perceived self-efficacy, spousal support) will also be measured.

描述（由申请人提供）： 2型糖尿病的患病率正在迅速增加，迫切需要开发，评估和传播有效的预防和自我管理这种疾病的计划。最近的研究表明，生活方式的改变对饮食和身体活动行为的预防和自我管理糖尿病的疗效。需要制定方案，将这些发现转化为有效的社区干预措施。这使得NIDDK发布了题为“预防和控制糖尿病的转化研究”（PA-02-153）的项目公告。该计划的三个目标中有两个要求对临床和行为计划进行评估，以1）改善糖尿病自我管理的方法，2）促进健康的生活方式，降低糖尿病和肥胖的风险。我们的提案通过对其中一方配偶被诊断为2型糖尿病的已婚夫妇进行干预来解决转化研究计划公告的目标。这些已婚夫妇为干预提供了几个优势，包括1）自我管理和预防可以通过改变相同的行为来解决，2）配偶伴侣可以相互提供支持，3）行为在家庭中聚集，4）这些伴侣可能有很高的动机改变生活方式行为。将使用随机化实验设计对该干预进行评价，其中将从Kaiser Permanente Southern加州的糖尿病登记处招募配偶对（其中一方为糖尿病配偶），在初级护理实践中根据所用糖尿病药物类型和糖尿病配偶性别进行分层，并随机分配至特殊干预（SI）或常规护理（UC）对照条件。在SI条件下，配偶将与教育者会面，并将完成一个30分钟的计算机程序，指导每个配偶设定行为改变的目标，定义目标的障碍和障碍的解决方案，并将制定一个行动计划。每位配偶还将完成对配偶支助活动、家庭环境变化以及有助于完成行动计划的更广泛的环境联系的评估。然后，配偶双方将从这些类别中选择一个因素，以支持完成行动计划。量身定制的通讯将在教育工作者访问后三周和六周寄出。支持电话将在教育工作者访问结束后一周和一个月内拨打。此序列将针对一个行为完成（例如，饮食）然后重复第二行为（例如，体力活动）。UC条件下的配偶伴侣将完成计算机化的健康风险评估，并在与教育工作者的访问中接受一般健康教育。将在基线、基线后4个月和12个月进行评估。HbA 1c（仅糖尿病配偶）、饮食和体力活动行为的变化将构成主要结局。总胆固醇与HDL胆固醇的比率、BMI、血压、生活质量和中介变量（例如，自我效能感、配偶支持）也将被测量。