HELP PREVENT DIABETES

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 虽然像糖尿病预防计划这样的试验已经证明了通过生活方式干预预防2型糖尿病(DM)的巨大潜力，但一个关键的知识缺口是这种方法是否可以在社区实施。这项研究是一项有300名参与者参加的随机试验，旨在测试这样一种假设，即通过社区糖尿病预防计划实施的生活方式干预将对以下方面产生有益的和临床上有意义的影响：空腹血糖(主要结果)、体力活动、饮食摄入量、体重和腰围(次要结果)和其他第三结果。将进行经济评估，以确定成本效益。其中一项试验将包括以小组为基础的强化生活方式干预，促进健康饮食，增加体力活动，在早期6个月的强化阶段实现适度(5%-7%)的减肥，然后进行18个月的维持阶段。强化干预组将使用非专业健康顾问(LHC)。控制部门将包括个人教育干预，结合现有的社区资源，帮助居民做出更健康的生活方式选择。如果密集干预方法具有成本效益，这种模式可以传播到数千个有DEPS的美国社区。许多慢性病都受运动和饮食的影响。如果我们的生活方式干预成功，应该会转化为2型糖尿病以外的领域的公共健康好处，如肥胖、高血压、心血管健康和癌症预防，从而极大地增加社会的潜在好处，并成为社区健康促进计划的典范。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. While trials such as the Diabetes Prevention Program have demonstrated a significant potential for type 2 diabetes mellitus (DM) prevention through lifestyle interventions, a critical knowledge gap is whether such approaches can be implemented in the community. This study is a 300-participant randomized trial designed to test the hypothesis that a lifestyle intervention administered through a community-based diabetes prevention program will have a beneficial and clinically meaningful impact on: fasting glucose (primary outcome), physical activity, dietary intake, weight, and waist circumference (secondary outcomes), and other tertiary outcomes. An economic evaluation will be conducted to determine cost effectiveness. One trial arm will consist of a group-based intensive lifestyle intervention promoting healthy eating, increased physical activity and modest, yet achievable (5-7%) weight loss delivered in an early 6-month intensive phase followed by an 18-month maintenance phase. Lay Health Counselors (LHCs) will be utilized in the intensive intervention arm. The control arm will consist of an individual educational intervention that incorporates existing community resources that are available to assist residents in making healthier lifestyle choices. If the intensive intervention approach is cost-effective, this model can be disseminated to the thousands of U.S. communities with DEPs. Many chronic diseases are influenced by activity and diet. Our lifestyle intervention, if successful, should translate into public health benefits in areas other than type 2 DM, such as obesity, hypertension, cardiovascular health and cancer prevention, thus greatly multiplying the potential benefits for society and serving as a model for community-based health promotion programs.