Partnership for a Hispanic Diabetes Prevention Program

描述（由申请人提供）：西班牙裔服务不足，不太可能利用健康教育活动比他们的非西班牙裔白色同行。我们建议继续我们与社区合作伙伴在社区参与性研究（CBPR）项目中所做的工作，以减少西班牙裔农村地区糖尿病健康差异。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，以确定本研究可行的最佳试点项目。它协助为试点项目和研究的CBPR方面制定了评价计划。CAB一直在努力准备这个干预研究阶段的项目，计划进行一项更大的随机研究来测试干预措施。为此，本提案的具体目的是测试干预措施对糖尿病患者和糖尿病前期患者进行糖尿病管理教育的有效性。在这个项目中，我们将继续我们的CBPR项目与下亚基马谷的华盛顿。我们将与我们的CAB密切合作，测试一种干预措施，在这种干预措施中，患有糖尿病或糖尿病前期的西班牙裔人接受家庭干预，与家人和/或亲戚朋友一起管理他们的糖尿病。糖尿病信息将通过“家庭健康聚会”提供，在个人家中进行指导性讨论。一个训练有素的推广者，或外行健康教育家，被邀请到家里，并提出了四个会议的指导讨论糖尿病。讨论通过在该赠款的规划阶段开发和修订的活动挂图来促进。研究中的个体被给予关于糖尿病因素，饮食行为，身体活动，家族史和社会人口因素的基线问卷，然后随机接受立即干预，或等待接受三个月后的干预;这种延迟干预作为对照。干预的主要结果是随机分组后三个月A1 c水平的变化。次要结果是糖尿病知识的变化。将进行过程评价，以确定干预的真实性。还将在整个试验期间的两个时间点对CBPR过程进行评价：干预中途和数据收集结束时。

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.