Collaborations for Health Improvement in East Harlem - Project HEED

描述(由申请人提供)：没有慢性病对消除健康差距的挑战比糖尿病更大。东哈莱姆区是纽约市肥胖症和糖尿病交织流行的震中。其主要是低收入的黑人和拉丁裔居民没有足够的资源来应对助长这些流行病的无数力量。证明适度减肥和增加体力活动可以预防或延缓糖尿病的研究项目过于繁琐，无法在东哈莱姆这样的社区投入使用。许多倡议没有体现社区的声音、支持和参与，这种声音、支持和参与是可持续的长期结果。另一方面，包括真正的社区伙伴关系在内的创新方法往往不包括衡量影响的严格研究设计和方法。 在过去的两年里，东哈莱姆区的居民和研究人员进行了评估，决定将重点放在糖尿病前期，努力开发以社区为基础的糖尿病预防干预措施。社区行动委员会在研究人员的支持下，开发并试行了一项试验，以确定同伴主导的社区课程在实现减肥并最终预防糖尿病方面的影响。HEED(帮助教育消除糖尿病)项目提供有关糖尿病前期的信息，同时激励和支持人们找到方法改变他们的生活方式，使其符合他们的社会、经济和环境现实。在短短三个月的时间里，我们招募了99名超重患者，他们主要是拉丁裔、没有保险、低收入的东哈莱姆区成年人，我们通过大量的社区筛查发现他们是糖尿病前期，Heed课程正在进行中。研究人员了解到，与受他们正在研究的问题直接影响的人分享愿景、权力和控制力，可以带来新的干预措施和非常成功的招聘策略。社区领导人学习研究技能，成为出版作家，并举办以社区为基础的参与性研究讲习班。在这一成功和信息丰富的试验阶段的基础上，我们现在准备进行一次全面的有效性试验。 我们现在的合作伙伴关系旨在分析和修改HEED试验和我们的研究设计。然后，我们将招募400名患有糖尿病前期的超重成年人参加随机对照试验，以测试项目HEED的有效性，主要是在减肥方面，其次是在体力活动、生活质量和糖尿病的发展方面，并在当地、地区和全国范围内传播我们的发现。如果成功，这个由社区主导、以低成本为基础的项目可能会在东哈莱姆区和全国其他少数族裔社区传播。

DESCRIPTION (provided by applicant): No chronic illness presents greater challenges to eliminating disparities in health than diabetes. East Harlem is the epicenter in New York City of the intertwined epidemics of obesity and diabetes. Its predominantly low income, Black and Latino residents have insufficient resources to cope with the myriad forces that fuel these epidemics. Research programs proving that modest weight loss and increased physical activity prevent or delay diabetes are too cumbersome to be put to use in communities like East Harlem. Many initiatives do not embody the kind of community voice, support, and participation that is sustainable for long term results. On the other hand, innovative approaches that include true community partnerships often do not incorporate rigorous research designs and methods that measure impact. In the last two years, East Harlem residents and researchers conducted assessments, decided to focus on pre-diabetes in an effort to develop a community-based diabetes prevention intervention. A Community Action Board, supported by researchers, developed and piloted a trial to determine the impact of a peer-led community-based course in achieving weight loss and ultimately in preventing diabetes. Project HEED (Help Educate to Eliminate Diabetes) offers information about pre-diabetes, while motivating and supporting people to find ways to change their lifestyles that are consonant with their social, economic and environmental realities. In just three months, we enrolled 99 overweight, primarily Latino, uninsured, low income East Harlem adults whom we found to be pre-diabetic through numerous community screenings, and HEED classes are underway. Researchers learned that sharing vision, power and control with people directly impacted by the problem they are studying, can lead to novel interventions and very successful recruitment strategies. Community leaders learned research skills, became published authors and gave workshops on community-based participatory research. Based on this successful and informative pilot phase, we are now prepared to conduct a full-scale effectiveness trial. Our partnership now aims to analyze and revise the HEED pilot and our study design. We will then recruit and enroll 400 overweight adults with pre-diabetes into a randomized-controlled trial to test the effectiveness of Project HEED, primarily on weight loss and secondarily on physical activity, quality of life and development of diabetes, and disseminate our findings locally, regionally and nationally. If successful, this community-led and based, low-cost program could spread through East Harlem and other minority communities across the nation.