Reducing Diabetes Risk for Rural Appalachian Grandparent Headed Households

降低阿巴拉契亚农村祖父母户主家庭的糖尿病风险

• 批准号: 8680457
• 负责人: Jennifer Hatcher
• 金额: $ 18.75万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8680457
• 关键词: Address; Adult; Advocacy; Affect; Age; American; Appalachian Region; Area; Asthma; Belief; Biological; Caregivers; Caring; Censuses; Centers for Disease Control and Prevention (U.S.); Child; Chronic Disease; Collaborations; Communities; Coronary heart disease; Country; Data; Development; Diabetes Mellitus; Emotional; Employment; Evidence based intervention; Family; Family health status; Family member; Food; Foundations; Goals; Head; Health; Health Services Accessibility; Health behavior; Health behavior outcomes; Household; Household Heads; Household and Family; Hypertension; Intervention; Interview; Kentucky; Life; Life Style; Literature; Measures; Medical; Mental Depression; Methods; Minority; Non-Insulin-Dependent Diabetes Mellitus; Phase; Physical activity; Physical environment; Population; Poverty; Predisposing Factor; Prevalence; Preventive; Public Health; Research; Risk; Risk Factors; Risk Reduction; Rural; Social Environment; Social Health Services; Socioeconomic Status; Stress; Substance abuse problem; Surveys; System; Testing; Vulnerable Populations; Work; base; design; diabetes control; diabetes risk; disability; experience; grandchild; grandparent; health disparity; informant; innovation; member; nutrition; peer; phase 2 study; prevent; public health relevance; rural area; sedentary; therapy design

DESCRIPTION (provided by applicant): Residents of rural Appalachian Kentucky suffer rates of type II diabetes mellitus (DM) that are among the highest and most rapidly increasing in the country. Members of grandparent headed households (GHH), one of the fastest growing family constellations in rural Appalachian Kentucky and the US, may be particularly vulnerable to health threats elevating their risk for DM. While the literature provides a starting point for the examination of this health disparity, little is known about the socioecological factors that influence the risk for DM among GHH. Given the increasing prevalence of GHH, their vulnerability to health threats, and the current lack of information about their DM risk factors, w propose to holistically examine the socio-ecological context of the health of GHH in rural Appalachian Kentucky in order to implement a culturally and contextually appropriate family intervention to reduce diabetes risk. We will conduct a two phase mixed methods study that culminates in a feasibility trial of such an intervention in rural Appalachian Kentucky. Phase I of the proposed study will utilize a simultaneous mixed methods design to assess socioecologic and biological risk of diabetes for GHH family members via surveys, biological measures, in-depth interviews with family members, key informants interviews, and a community assessment. Seventy families that are headed by a grandparent, have one or more family members at risk for diabetes, and include at least one grandchild ages 10 to 14 will be included in this phase of the study, with 20 of those families participating in the in-depth qualitative interviews. Phase II of he study will include selection and refinement of an appropriate intervention to reduce diabetes risk for the families. Based on phase I findings and existing literature we will select an evidence based intervention and refine it to be culturally and contextually appropriate for the rural Appalachian families that are the focus of this project, in collaboration with our strong network o community partners. Finally, we will test he feasibility and acceptability of the refined intervention with 10 GHH. The proposed study will serve as the foundation for interventions for families in other rural areas with notable diabetes disparities.

描述（由申请人提供）：肯塔基州阿巴拉契亚农村居民的 II 型糖尿病 (DM) 发病率是全国最高且增长最快的。祖父母户主家庭 (GHH) 是肯塔基州阿巴拉契亚山区和美国农村地区增长最快的家庭群之一，他们可能特别容易受到健康威胁，从而增加患糖尿病的风险。虽然文献为检验这种健康差异提供了起点，但我们对影响 GHH 糖尿病风险的社会生态因素知之甚少。鉴于 GHH 患病率不断增加、其易受健康威胁以及目前缺乏有关其 DM 风险因素的信息，我们建议全面研究阿巴拉契亚肯塔基州农村地区 GHH 健康的社会生态背景，以便实施适合文化和环境的家庭干预措施，以降低糖尿病风险。我们将进行一项两阶段混合方法研究，最终在肯塔基州阿巴拉契亚农村地区进行这种干预措施的可行性试验。第一阶段 拟议的研究将利用同步混合方法设计，通过调查、生物测量、对家庭成员的深入访谈、关键知情人访谈和社区评估，评估 GHH 家庭成员患糖尿病的社会生态和生物学风险。这一阶段的研究将包括 70 个以祖父母为户主、有一名或多名家庭成员有患糖尿病风险、且至少有一名 10 至 14 岁孙辈的家庭，其中 20 个家庭将参与深度定性访谈。研究的第二阶段将包括选择和完善适当的干预措施，以降低家庭患糖尿病的风险。根据第一阶段的研究结果和现有文献，我们将与我们强大的社区合作伙伴网络合作，选择一种基于证据的干预措施，并对其进行完善，使其在文化和背景上适合本项目重点关注的阿巴拉契亚农村家庭。最后，我们将测试 10 GHH 精细干预的可行性和可接受性。拟议的研究将作为对糖尿病差异显着的其他农村地区家庭进行干预的基础。