Parents and Children Together Preventing Diabetes (PACT PD)

描述（由申请人提供）：2型糖尿病（T2 DM）是一种由于遗传、行为和文化风险因素而在家族中聚集的疾病。1 T2 DM占美国糖尿病的至少90%，另有790万人患有前驱糖尿病（美国糖尿病协会，2011）。非裔美国人在诊断为T2 DM和前驱糖尿病（CDC）的人群中所占比例过高。2 ~3非裔美国人迫切需要有效的、文化相关的、以家庭为基础的糖尿病预防干预措施。糖尿病预防计划（DPP）和过去十年的其他临床试验表明，通过针对饮食和体力活动的强化生活方式干预，可以成功预防或延迟T2 DM。4 -6最近两次有效的基于社区的DPP翻译取得了类似的结果，社区提供的干预强度较小-卫生工作者7和训练有素的基督教青年会生活方式教练。8这两项研究都只关注成年人个体~对于如何从家庭角度最好地翻译DPP知之甚少。预防的力量是一个现有的CDC糖尿病预防计划，基于DPP，专为有T2 DM风险的非洲裔美国家庭设计。据我们所知，该计划尚未在非裔美国人家庭的随机试验中进行评估。我们建议利用基督教青年会生活方式教练在提供糖尿病预防干预措施和培训基督教青年会健身工作人员的有效性的证据，作为“家庭健康教练”，实施权力，以防止计划与超重/肥胖的非洲裔美国人的父母和他们的超重/肥胖8-10岁的孩子。我们提出了父母和孩子一起预防糖尿病（PACT-PD）研究，这是一项以家庭为基础的双条件随机试点研究。我们的小组是理想的定位，以实施和评估以家庭为基础的糖尿病预防干预与非洲裔美国人家庭在进行社区和家庭为基础的干预，特别是与非洲裔美国人的丰富经验。如果我们的研究成功，我们翻译的干预措施可以迅速传播到美国数千个基督教青年会，从而对肥胖、糖尿病和其他与生活方式相关的慢性疾病的公共卫生负担产生重大影响。 公共卫生相关性：与高加索人相比，非裔美国成人和儿童的肥胖和T2 DM发生率更高。21令人担忧的是，预计约50%的AA美国儿童在其一生中会发展为T2 DM。22我们建议进行一项随机试点研究，以评估专门为非裔美国家庭设计的糖尿病预防干预措施的早期疗效。

DESCRIPTION (provided by applicant): Type 2 diabetes (T2DM) is a disease that clusters in families due to genetic, behavioral, and cultural risk factors.1 T2DM accounts for at least 90% of diabetes in the United States and an additional 7.9 million individuals have prediabetes (American Diabetes Association, 2011). African Americans are disproportionately represented among those diagnosed with T2DM and prediabetes (CDC).2~3 Effective, culturally-relevant, family-based diabetes prevention interventions are critically needed for African Americans. The Diabetes Prevention Program (DPP) and other clinical trials over the past decade have demonstrated that T2DM can be successfully prevented or delayed with intensive lifestyle interventions addressing diet and physical activity.4-6 Two recent effective community-based translations of the DPP have achieved similar outcomes with less intensive interventions delivered by community-health workers7 and trained YMCA lifestyle coaches.8 Both of these studies focused solely on individual adults~ little is known about how best to translate DPP from a family perspective. Power to Prevent is an existing CDC diabetes prevention program, based on DPP, and designed specifically for use with African American families at risk for T2DM. To our knowledge, this program has not yet been evaluated in a randomized trial with African American families. We propose to leverage the evidence on the effectiveness of YMCA lifestyle coaches in delivering diabetes prevention interventions and train YMCA fitness staff to serve as "family health coaches" to implement the Power to Prevent program with overweight/obese African American parents and their overweight/obese 8-10 year old children. We propose the Parents and Children Together Preventing Diabetes (PACT-PD) study, a two-condition randomized family-based pilot study translation of DPP. Our group is ideally positioned to implement and evaluate the family-based diabetes prevention intervention with African American families having extensive experience in conducting community- and family-based interventions, particularly with African Americans. If our study is successful, our translated intervention could be disseminated rapidly to thousands of YMCAs in the United States, thereby making a substantial impact on the public health burden of obesity, diabetes, and other lifestyle related chronic diseases. PUBLIC HEALTH RELEVANCE: Narrative African American adults and children experience higher rates of obesity and T2DM, compared to their Caucasian counterparts.21 Alarmingly, about 50% of AA U.S. children are expected to develop T2DM in their lifetime.22 We propose to conduct a randomized pilot study to evaluate the early efficacy of a diabetes prevention intervention specifically designed for African American families.