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受到胰岛素抵抗、心理社会后果和2型糖尿病的不成比例的影响，但很少对这一脆弱和服务不足的群体进行预防干预。因此，我们提出了一项随机对照试验，以测试以文化为基础、以社区为基础的糖尿病预防计划的有效性，该计划可以提高160名肥胖拉丁裔青少年的胰岛素敏感性和特定体重的生活质量。我们还将发掘潜力 评估干预效果的中介者和调节者，并估计干预提高胰岛素敏感性的初始增量成本效益。这项干预措施以社会认知理论为指导，并在多层次生态发展模型的框架内，以解决被认为影响肥胖拉丁裔青年在关键人生时期的健康行为和健康结果的周围背景因素。 该项目建立在一个跨学科调查小组与社区现有合作的基础上，以解决在如何制定、实施和评估针对拉美裔肥胖青年的预防干预措施方面存在的严重差距。这一创新方法是制定具有成本效益、以解决方案为导向的方案以改善拉美裔青年健康的关键一步。

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.