Diabetes Prevention Translation Project: the Healthy LIFESTYLE Project

描述（由申请人提供）：生活方式干预可以预防或延迟2型糖尿病的发展的证据已在多项临床试验中得到证实，包括美国的多中心临床试验，糖尿病预防计划或DPP。公共卫生面临的挑战是将DPP研究工作中使用的这种有前途和经证实的行为干预转化为“真实的世界”，即，如何以较低的成本使其在不同的社区和不同的地方环境中发挥作用，使尽可能多的高危人群受益。本申请的目的是测试DPP的翻译框架，包括：1）社区卫生保健专业人员培训模型的演示，包括在提供糖尿病预防课程和所需行为生活方式材料方面的初始培训、支持和监督; 2）评估一个更紧凑和灵活的DPP干预计划，以他或她选择的版本管理每个参与者（标准的面对面小组形式或相同生活方式干预计划内容的DVD版本）。这些生活方式干预计划将在三个不同的社区环境中进行，即医疗保健实践、工作场所和当地老年社区中心。最后，将对生活方式干预方案在三个社区环境中的成本效益分析进行测试。如果被证明是有效的，这个糖尿病和心血管风险预防翻译框架是一个可以在美国和国外适应。 公共卫生相关性：这一提议是从利用行为、基于目标的生活方式干预来预防2型糖尿病的有希望的随机临床试验到社区有效性努力的合乎逻辑的下一步。我们已经召集了一个调查小组，指导和评估一个以社区为基础的生活方式干预计划的各个方面，包括一个培训模型，以扩大标准化有效干预措施交付的范围。还将对这些努力进行成本分析。

DESCRIPTION (provided by applicant): Evidence that lifestyle intervention can prevent or delay the development of type 2 diabetes has been demonstrated in several clinical trials including a multi center clinical trial in the US, the Diabetes Prevention Program or DPP. The challenge for public health is to translate this promising and proven behavioral intervention utilized in the DPP research effort to the "real world", i.e., how to make it work in diverse communities in a variety of local settings at a reduced cost so that the maximal number of those at risk can benefit. The purpose of this application is to test a framework for translation of the DPP that includes: 1) demonstration of a training model for community health care professionals that includes initial training, support, and supervision in the delivery of a diabetes prevention curriculum and the needed behavioral lifestyle materials; 2) evaluation of a more compact and flexible DPP intervention program administered to each participant in a version of his or her choice (standard face-to-face group format or a DVD version of the same lifestyle intervention program content). These lifestyle intervention programs will be carried out in three different community settings; i.e. a health care practice, a worksite, and local senior community centers. Lastly, the cost- effectiveness analyses of the LIFESTYLE intervention program in each of the three community settings will be tested. If proven to be effective, this framework for diabetes and cardiovascular risk prevention translation is one that could be adapted throughout the United States and abroad. PUBLIC HEALTH RELEVANCE: This proposal is a logical next step in the progression from promising randomized clinical trials utilizing behavioral, goal-based lifestyle interventions to prevent type 2 diabetes to effectiveness efforts in the community. We have convened a team of investigators to guide and evaluate all aspects of a community- based lifestyle intervention program, including a training model, to expand the reach of standardized effective interventions delivery. A cost-analysis of these efforts will be done as well.