Partnership for a Hispanic Diabetes Prevention Program

描述(由申请者提供)：拉美裔美国人服务不足，与非拉美裔白人相比，他们更不可能利用健康教育活动。我们建议继续与社区合作伙伴开展一项基于社区的参与性研究(CBPR)项目，以减少农村地区拉美裔人经历的糖尿病健康差距。我们的社区咨询委员会(CAB)与研究机构(FHCRC)密切合作，计划和实施一项糖尿病试点项目。在项目早期，CAB资助了小型社区发起的研究项目，以确定对这项研究可行的最佳试点项目。它协助制定了一项评价计划，既用于试点项目，也用于研究的CBPR方面。CAB一直在努力为这一干预研究阶段的项目做准备，计划在这一阶段进行一项更大规模的随机研究来测试干预。为此，这项提议的具体目的是测试一项干预措施的有效性，教育糖尿病患者和糖尿病前期患者有关糖尿病管理的知识。在这个项目中，我们将继续我们与华盛顿州下亚基马山谷的CBPR项目。我们将与我们的CAB密切合作，测试一项干预措施，即患有糖尿病或糖尿病前期的西班牙裔患者与家人和/或亲戚朋友一起接受家庭干预，以管理他们的糖尿病。糖尿病信息将通过“家庭健康聚会”传递，这是在个人家中进行的有指导的讨论。一位训练有素的推动者或非专业健康教育者被邀请走进家里，介绍一个为期四节的关于糖尿病的有指导的讨论。在这笔赠款的规划阶段，开发和修订了一套活动挂图，促进了讨论。研究中的个体被给予关于糖尿病因素、饮食行为、体力活动、家族史和社会人口学因素的基线问卷，然后随机接受立即干预，或者被列入等待接受三个月后干预的名单；这种延迟干预作为对照。干预的主要结果是随机化三个月后A1c水平的变化。第二个结果是糖尿病知识的改变。将进行程序评估，以确定干预的忠诚度。在整个试验过程中，还将在两个点对CBPR进程进行评价：干预过程中的中期和数据收集结束时。

DESCRIPTION (provided by applicant): Hispanics are underserved and less likely to take advantage of health education activities than their non-Hispanic White counterparts. We propose to continue the work we have done with community partners in a community-based participatory research (CBPR) project to reduce the diabetes health disparities experienced by Hispanics in a rural area. Our Community Advisory Board (CAB) has worked closely with the research institution (FHCRC) to plan and implement a pilot project on diabetes. Early in the project, the CAB funded small community-initiated research projects to identify the best pilot project that was feasible for this study. It has assisted in developing an evaluation plan, both for the pilot project, and for the CBPR aspect of the study. The CAB has worked diligently on preparing the project for this intervention research phase, where it plans to conduct a larger, randomized study to test the intervention. Toward that end, the specific aim of this proposal is to test the efficacy of an intervention to educate diabetics and pre-diabetics about the management of diabetes. In this project, we will continue our CBPR project with the Lower Yakima Valley of Washington. We will work closely with our CAB to test an intervention where Hispanic individuals with diabetes or pre-diabetes receive in-home intervention for managing their diabetes with their family members and/or relatives and friends. Diabetes information will be delivered through "home health parties," guided discussions in the individual's home. A trained promotora, or lay health educator, is invited to go into the home and present a four-session guided discussion on diabetes. The discussion is facilitated by sets of flip charts that were developed and revised in the planning phase of this grant. Individuals in the the study are given a baseline questionnaire on diabetes factors, eating behavior, physical activity, family history, and sociodemographic factors, then randomized to receive an immediate intervention, or are waitlisted to receive an intervention three months hence; this delayed intervention serves as control. The primary outcome of the intervention is changes in A1c levels three months after randomization. A secondary outcome is change in knowledge of diabetes. A process evaluation will be conducted to ascertain fidelity of the intervention. An evaluation of the CBPR process will also be conducted at two points throughout the trial: midway through intervention and at the end of data collection.