Family-Focused Community Program to Prevent Type 2 Diabetes in Peripubertal Youth

预防青春期前后青少年 2 型糖尿病的以家庭为中心的社区计划

• 批准号: 8769389
• 负责人: Melanie Daniela Hingle
• 金额: $ 18.55万
• 依托单位: UNIVERSITY OF ARIZONA
• 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 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8769389
• 关键词: 13 year old; Address; Adherence; Adolescent; Adult; Age; Age of Onset; Amputation; Behavioral; Blood Pressure; Body Weight; Body Weight decreased; Cardiovascular Diseases; Child; Chronic Disease; Clinical; Clinical Data; Clinical Research; Communities; Control Groups; Data; Development; Devices; Diabesity; Diabetes prevention; Diet; Environment; Epidemic; Face; Family; Family member; Fasting; Glucose; Goals; Health; Height; Home environment; Insulin; Intervention; Lead; Life; Lipids; Metabolic Diseases; Metabolic syndrome; Methods; Modeling; Neuropathy; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Overweight; Parents; Participant; Physical activity; Physiological; Populations at Risk; Prevalence; Prevention program; Program Evaluation; Public Health; Records; Research; Research Personnel; Retinal Diseases; Risk; Risk Factors; Technology; Testing; Translating; Universities; Weight; Weight maintenance regimen; Work; Youth; base; behavior change; cardiovascular disorder prevention; community setting; cost; design; diabetes prevention program; diabetes risk; disorder risk; early onset; effective intervention; evidence base; handheld mobile device; high risk; improved; innovation; lifestyle intervention; obesity in children; obesity prevention; population health; prevent; programs; public health relevance; research to practice; statistics; success; waist circumference

DESCRIPTION (provided by applicant): Over one-third of children and adolescents are overweight and nearly 1 in 5 of them are obese. Metabolic syndrome, a strong predictor of Type 2 diabetes (T2D) and cardiovascular disease (CVD), occurs in up to 44% of obese youth, foreshadowing greater prevalence and earlier onset of T2D. Without effective interventions, "diabesity" will worsen, T2D prevalence will increase, and adults will face its consequences at younger ages. Given the strong association between obesity and chronic disease risk factors in youth, we contend T2D prevention (and CVD prevention) is akin to weight control and obesity prevention. The objective of the proposed project is to develop a family-centered, community-based program for T2D prevention in peripubertal (9-13-year-old) youth. Using participatory methods, we intend to adapt the successful adult-focused YMCA Diabetes Prevention Program (YDPP) for youth and families and assess the feasibility, participant acceptance of and adherence to the YFDPP using two delivery formats: a 16-week YMCA-based face-to-face program and a 16-week combined face-to-face plus mobile device-based program. The proposed study will test our premise that delivery with technology can reduce participant perceived burden, improve adherence, and lead to improved anthropometric (height, weight and BMI and waist circumference), behavioral (diet and physical activity) and physiological outcomes (fasting insulin, glucose, lipid, blood pressure). We will use the resulting data to design an appropriately powered full-scale trial. The importance of the proposed study is underscored both by the statistics cited above and the recent call for proposals to translate efficacious clinical interventions into effective community programs for youth. The potential impact of the proposed intervention is great in that the program will be delivered by paraprofessionals from the community without university researchers; significant in that it targets a major public health challenge in children and includes assessment of objective behavioral and clinical data; and innovative in that it focuses on an at-risk population, takes place at a popular, accessible community venue, and uses mobile technologies to extend reach and increase engagement of youth and families with intervention content. The long-term goal is to create a scalable, replicable, and sustainable program that overcomes existing barriers to implementation and dissemination of evidence-based, research-proven diabetes prevention programs to youth and families, thereby improving population health.

描述（由申请人提供）：超过三分之一的儿童和青少年超重，近五分之一的儿童和青少年肥胖。代谢综合征是2型糖尿病（T2D）和心血管疾病（CVD）的一个强有力的预测因子，高达44%的肥胖青年发生代谢综合征，预示着T2D的更高患病率和更早发病。如果没有有效的干预措施，“糖尿病”将恶化，T2D患病率将增加，成年人将在更年轻的时候面临其后果。鉴于肥胖与青少年慢性疾病风险因素之间的密切联系，我们认为预防T2D（和预防CVD）类似于控制体重和预防肥胖。拟议项目的目标是制定一个以家庭为中心、以社区为基础的方案，以预防青春期（9-13岁）青少年患T2D。采用参与式方法，我们打算将成功的以成人为中心的YMCA糖尿病预防计划（YDPP）调整为青少年和家庭，并评估可行性，参与者对YFDPP的接受度和依从性，采用两种交付形式：一个16周的YMCA面对面项目和一个16周的面对面+移动设备结合项目。该研究将验证我们的假设，即技术交付可以减轻参与者的感知负担，提高依从性，并改善人体测量（身高、体重、BMI和腰围）、行为（饮食和身体活动）和生理结果（空腹胰岛素、血糖、血脂、血压）。我们将使用得到的数据来设计一个适当的全尺寸试验。上述统计数据和最近呼吁将有效的临床干预措施转化为有效的青少年社区计划的建议，都强调了拟议研究的重要性。拟议的干预措施的潜在影响是巨大的，因为该计划将由来自社区的辅助专业人员提供，而没有大学研究人员；重要的是，它针对儿童面临的重大公共卫生挑战，并包括对客观行为和临床数据的评估；它的创新之处在于，它关注高危人群，在一个受欢迎的、可访问的社区场所举行，并利用移动技术扩大影响范围，增加青少年和家庭对干预内容的参与。长期目标是创建一个可扩展、可复制和可持续的项目，克服现有的障碍，以实施和传播以证据为基础、经研究证实的糖尿病预防项目给年轻人和家庭，从而改善人口健康。