Strong Men, Strong Communities: Cultural Tradition to Improve Native Men's Health

坚强的男人，强大的社区：改善土著男性健康的文化传统

基本信息

批准号：
8885585
负责人：
KA'IMI ALOHILANI SINCLAIR
金额：
$ 55.26万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-05-01 至 2016-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8885585
关键词：
21 year old Address Age Age-Years American Indians Animals Bison Blood Pressure Body Weight decreased Caring Climate Clinic Clinical Communities Community Participation Complications of Diabetes Mellitus Control Groups Data Death Rate Diabetes Mellitus Diabetes prevention Diagnosis Diet Drops Economics Elements Employee Strikes Enrollment Epidemic Ethnic group Evaluation Feedback Fishes Focus Groups Gender Gender Role Habits Health Health Status Health behavior High Prevalence Incidence Indian reservation Indigenous Individual Intervention Life Style Measures Methods Mille Lacs Band Minnesota Minority Minority Groups Native Americans Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino Obesity Ojibwe Outcome Overweight Participant Perception Phase Physical activity Population Prevalence Proteins Public Health Race Randomized Randomized Controlled Trials Recruitment Activity Resources Risk Factors Risk Reduction Site Universities Waiting Lists Washington Woman base clinical care community intervention community setting cost cost effective design diabetes prevention program diabetes risk experience fruits and vegetables good diet group intervention health disparity healthy lifestyle high risk improved lifestyle intervention male male health men men&apos s group mortality prevent primary outcome programs public health relevance racial and ethnic response secondary outcome tribal community waist circumference

项目摘要

DESCRIPTION (provided by applicant): American Indian (AI) males experience profound health disparities compared to their counterparts in all other U.S. racial and ethnic groups. For example, AI men have the highest age-adjusted prevalence of type 2 diabetes (~18 percent) among U.S. men, while non-Hispanic White men have the lowest (~7 percent). In recent decades, AIs have seen a disproportionate increase in diabetes-related complications and mortality compared to all other groups, such that age-adjusted diabetes death rates in AI men are now almost twice those in White men. Several large randomized, controlled trials in non-AIs confirm that type 2 diabetes can be prevented or delayed by interventions that promote healthy lifestyles, but little empirical data exist on interventions to prevent diabetes in AI men. In the clinic-based U.S. Diabetes Prevention Program (DPP), only 55 out of 3,234 participants were AI men. Similarly, in the diabetes prevention programs in Native communities, participation by AI males is low, ranging from 33 percent to 74 percent. Many explanations have been posited for the low participation rates among men of all races in lifestyle interventions. Recruiting AI men in clinic-based programs is difficult because they tend to seek clinical care less often than women. AI men's perceptions of normative health behaviors and gender roles may also discourage participation, particularly in mixed-gender groups. Therefore, an urgent need exists for diabetes risk reduction programs tailored to the unique values and habits of AI men, with a particular focus on recruitment and retention. We are collaborating with the Mille Lacs Band of Ojibwe (Minnesota), the Indian Health Board of Minneapolis (Minnesota), and Yakama Nation and Heritage University Center for Native American Health and Culture (Washington) to develop the Strong Men, Strong Communities (SMSC) program. This is a culturally appropriate approach for AI men that targets modifiable diabetes risk factors. It uses methods adapted from successful, non-clinic based programs for other high-risk minority populations, and it incorporates elements of DPP and SDPI-DP. Our Specific Aims are to: 1) Refine the SMSC intervention with feedback from focus groups in our 3 partner communities. 2) Compare change in diabetes risk score (primary outcome) and modifiable diabetes risk factors (secondary outcomes) in the SMSC intervention and wait-list control groups. 3) Evaluate the ability of SMSC to retain 80 percent of 240 AI male participants, 21-65 years of age with no previous diagnosis of diabetes. The proposed study fills a striking gap in approaches to increase recruitment and participation in lifestyle programs that reduce diabetes risk in AI men. The proposed study will have broad implications for the ongoing epidemic of AI obesity and diabetes. Given the need to increase AI men's participation in lifestyle interventions, our findings might have substantial public health impact on tribal communities across the U.S.

描述（由适用提供）：与美国所有其他种族和族裔群体相比，美洲印第安人（AI）男性与其同行相比，其健康差异很大。例如，AI男性的年龄调整后，美国男性的2型糖尿病患病率最高（约18％），而非西班牙裔白人男性的患病率最低（约7％）。与所有其他群体相比，近几十年来，AIS与糖尿病相关的并发症和死亡率的增加不成比例，因此AI男性的年龄调整后的糖尿病死亡率现在几乎是白人男性的两倍。非AIS中的几项大型随机对照试验证实，可以通过促进健康生活方式的干预措施来预防或延迟2型糖尿病，但在干预措施上几乎没有经验数据以防止AI男性的糖尿病。在总部位于诊所的美国糖尿病预防计划（DPP）中，3234名参与者中只有55名是AI男性。同样，在本地社区的糖尿病预防计划中，AI男性的参与度较低，范围从33％到74％。在所有种族中，在生活方式干预中的男性中，已经分配了许多解释。在基于诊所的计划很困难，因为它们往往比女性更少寻求临床护理。人工智能男性对正常健康行为和性别角色的看法也可能会阻止参与，尤其是在混合性别群体中。因此，迫切需要量身定制的糖尿病风险降低风险计划，该计划是针对AI男性独特价值和习惯的，特别关注招募和保留。我们正在与Ojibwe（明尼苏达州）的Mille Lacs乐队，明尼阿波利斯印度卫生委员会（明尼苏达州）以及Yakama Nation和Heritage University University for American Americal Health and Cultion（华盛顿）开发强大的男人，强大社区（SMSC）计划。对于针对可修改的糖尿病风险因素的AI男性，这是一种适合文化的方法。它使用针对其他高风险少数群体的成功，非临床的程序改编的方法，并结合了DPP和SDPI-DP的元素。我们的具体目的是：1）通过三个合作伙伴社区的焦点小组的反馈来完善SMSC干预。 2）比较SMSC干预和候补名单对照组中糖尿病风险评分（主要结果）和可修改的糖尿病风险因素（次要结果）的变化。 3）评估SMSC保留80％的能力 240名AI男性参与者，21-65岁，没有先前诊断为糖尿病。拟议的研究填补了增加招聘和参与生活方式计划的方法的明显差距，从而降低了AI男性糖尿病风险。拟议的研究将对AI肥胖症和糖尿病的持续流行有广泛的影响。鉴于需要增加AI男子参与生活方式干预措施，我们的发现可能会对美国各地的部落社区产生重大影响