Novel Intervention Linking Public Housing with Primary Care to Prevent Diabetes

将公共住房与初级保健联系起来预防糖尿病的新颖干预措施

• 批准号: 8815540
• 负责人: Gayenell Smith Magwood
• 金额: $ 23.59万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8815540
• 关键词: 20 year old; Address; Adult; African American; Am 80; Behavior; Body Weight decreased; Caring; Church; Clinic; Communities; Community Outreach; Counseling; Data; Diabetes Mellitus; Diabetes prevention; Dyslipidemias; Effectiveness of Interventions; Equilibrium; Ethics; Evaluation; Federally Qualified Health Center; Glucose; Goals; Health; Health Care Reform; Health Services; Healthcare; Heart Diseases; Housing; Hypertension; Individual; Intervention; Life; Life Style; Link; Lipids; Location; Mails; Maintenance; Malignant Neoplasms; Measures; Modification; National Institute of Diabetes and Digestive and Kidney Diseases; Neighborhoods; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Outcome; Overweight; Participant; Patient Education; Patients; Peer Group; Physical activity; Physiological; Pilot Projects; Prediabetes syndrome; Prevention education; Primary Health Care; Process; Program Effectiveness; Public Health; Public Housing; Qualifying; Randomized; Randomized Controlled Trials; Recording of previous events; Recreation; Research Infrastructure; Resources; Risk; Rural; Sample Size; Self Management; Services; Sister; Testing; Translating; United States; Waiting Lists; Woman; Work; Writing; arm; authority; base; behavior measurement; design; diabetes prevention program; diabetes risk; experience; high risk; inner city; lifestyle intervention; member; novel; nutrition; obesity risk; patient assistance; prevent; primary care setting; primary outcome; programs; public health relevance; socioeconomics; treatment as usual

DESCRIPTION (provided by applicant): African American (AA) women, who are 80% more likely to be obese than their non-Hispanic white counterparts. AA women are also at disproportionate risk for negative obesity related health outcomes, including type 2 diabetes, hypertension, dyslipidemia, heart disease, and cancer. Further, AA women living in racially segregated, impoverished inner city neighborhoods are at even higher risk for obesity and associated sequalae, a set of problems exacerbated by the fact that they lack access to primary care and community related resources. To address barriers to primary care among these high-risk groups, Federally Qualified Health Center (FQHC) Primary Care Networks were formed, and now offer services to low SES patients who would otherwise go without care. However, DPP adaptation to this type of setting (that is, exporting DPP interventions to public housing) has not been thoroughly evaluated. Thus, there is a prime opportunity to examine whether novel partnerships linking FQHC networks with Public Housing infrastructure to deliver modified DPP programs directly into high risk communities are effective in reducing obesity and diabetes risk The goal of this R34 two-year planning project is to develop, implement, and evaluate a pilot multi-level DPP intervention. In this pilot study, we will use a randomized wait list control desig to allocate 60 participants to pilot test a translational community based DPP intervention or FHCN/FQHC usual care. The specific aims are to: 1) Evaluate the feasibility, acceptability and implementation of the SHAPE UP intervention in Public Housing settings in the context of FHCN/FQHC infrastructure, using RE-AIM process and outcome indicators. 2) Conduct a preliminary evaluation of this intervention's effectiveness including weight loss at 24 weeks (primary outcome), secondary impact physiological measures (e.g., glucose, A1C, BP, lipids) and behavioral measures (e.g., physical activity (PA), nutrition) in intervention vs. control arms to estimate variability of measures for subsequent sample size calculation. This highly significant and novel study by an experienced team with an extensive partnership history will provide preliminary data to inform an adequately powered, larger randomized controlled trial.

描述（由申请人提供）：非裔美国人（AA）女性，比非西班牙裔白色女性肥胖的可能性高80%。AA女性也处于与肥胖相关的负面健康结果的不成比例的风险中，包括2型糖尿病，高血压，血脂异常，心脏病和癌症。此外，生活在种族隔离、贫困的内城社区的AA妇女患肥胖症和相关后遗症的风险更高，这一系列问题因她们缺乏初级保健和社区相关资源而加剧。为了解决这些高风险群体在初级保健方面的障碍，成立了联邦合格卫生中心初级保健网络，现在为低SES患者提供服务，否则他们将得不到护理。然而，对DPP适应这类环境（即将DPP干预措施输出到公共住房）的情况尚未进行彻底评估。因此，有一个主要的机会，以检查是否新的伙伴关系，将CNOHC网络与公共住房基础设施，以提供修改后的DPP计划直接进入高风险社区是有效的，在减少肥胖和糖尿病的风险这个R34两年规划项目的目标是开发，实施和评估试点多层次的DPP干预。在这项初步研究中，我们将使用随机等待名单对照设计，分配60名参与者进行初步测试，以翻译社区为基础的DPP干预或FHCN/FHCHC常规护理。具体目标是：1）在FHCN/CNOHC基础设施的背景下，使用RE-AIM过程和结果指标，评估公共住房环境中SHAPE UP干预措施的可行性、可接受性和实施情况。2)对该干预措施的有效性进行初步评估，包括24周时的体重减轻（主要结局）、次要影响生理指标（例如，葡萄糖、A1 C、BP、脂质）和行为测量（例如，体力活动（PA）、营养），以估计后续样本量计算的测量变异性。由一个经验丰富的团队进行的这项具有高度重要性和新颖性的研究，具有广泛的合作历史，将提供初步数据，为充分的动力，更大的随机对照试验提供信息。