Every Little Step Counts

项目总结（见说明）： 与肥胖相关的健康差距是我们社会面临的最重大的公共卫生挑战之一。特别是，肥胖的拉丁裔青少年不成比例地受到胰岛素抵抗，心理社会后果和2型糖尿病的影响，但在这个脆弱和服务不足的群体中很少进行预防干预。因此，我们提出了一项随机对照试验，以测试一个基于文化的，以社区为基础的糖尿病预防计划，以增加胰岛素敏感性和特定体重的生活质量在160肥胖的拉丁美洲青少年的疗效。我们也会发掘潜力 介导者和调节者的干预的影响，并估计初始增量成本效益的干预措施，增加胰岛素敏感性。干预是由社会认知理论指导，并在多层次的生态发展模型框架内，以解决周围的背景因素，被认为是影响健康行为和健康结果的肥胖拉丁美洲青年在一个关键的生命周期。 该项目建立在一个跨学科的调查小组与社区现有的合作，以解决如何为肥胖的拉丁美洲青年预防干预措施的开发，实施和评估的关键差距。这种创新的方法是一个具有成本效益的，解决方案为导向的方案，以改善拉丁美洲青年的健康发展的重要一步。

PROJECT SUMMARY (See instructions): Obesity-related health disparities represent one of the most significant public health challenges facing our society. In particular, obese Latino adolescents are disproportionately impacted by insulin resistance, psychosocial consequences, and type 2 diabetes but few prevention interventions have been conducted in this vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the efficacy of a culturally-grounded, community-based diabetes prevention program to increase insulin sensitivity and weight-specific quality of life in 160 obese Latino adolescents. We will also explore potential mediators and moderators of the intervention's effects and estimate the initial incremental cost-effectiveness of the intervention for increasing insulin sensitivity. The intervention is guided by Social Cognitive Theory and framed within a multilevel ecodevelopmental model to address surrounding contextual factors that are thought to influence health behaviors and health outcomes in obese Latino youth during a critical life period. The project builds upon extant collaborations of a transdisciplinary team of investigators with the community to address critical gaps in how prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of cost-effective, solution oriented programs to improve the health of Latino youth.