Promotora-Led Intervention to Promote Weight Loss in Latinas at-risk for Diabetes

描述(由申请人提供)：这项K23提案的总体目标是培训Matthew J.O‘Brien，医学博士，理学硕士，作为肥胖和糖尿病预防方面的独立调查员，特别关注拉丁裔--这些相关疾病的高风险人群。虽然有人试图将循证糖尿病预防计划(DPP)转化为社区环境，但很少有研究包括拉丁裔。社区卫生工作者或推动者是受过培训的门外汉，他们提供健康教育，可以担任拉丁语国家减肥和糖尿病预防工作的领导者。以前的研究已经证明，推动者是一种有效的非职业卫生工作人员，但还没有发表的研究将这种干预模式应用于拉丁裔糖尿病的预防。奥布莱恩博士计划通过开发一种由推动者领导的生活方式干预(PLI)来解决这一知识差距，该方法由DPP提供信息，以促进拉丁裔的减肥并降低心脏代谢风险。拟议的研究分三个阶段来解决相应的具体目标：第一阶段使用焦点小组来探索围绕糖尿病高危拉丁裔与体重相关行为的社会和文化背景，并将研究结果应用于PLI；第二阶段涉及在单臂试验中试行PLI，并评估其可行性和可接受性；第三阶段将在随机对照试验中测试PLI对高危拉丁裔体重和心脏代谢标记物变化的影响。为了成功完成拟议的研究计划，O‘Brien博士将在以下3个领域通过正式课程和结构化指导接受额外培训：1)定性方法；2)减肥和糖尿病预防的随机对照试验；3)肥胖、糖尿病和新陈代谢方面的基础。坦普尔大学是上述每个研究领域的国际知名研究人员的大本营，他们将担任奥布莱恩博士的导师。拟议研究的地点是由O‘Brien-Puentes de Salud博士(“健康之桥”)创建的社区健康中心，该中心服务于拉丁裔人口，自2007年以来一直是涉及目标人群的几项基于PROMPOTOR A的研究的地点。

DESCRIPTION (provided by applicant): The overall goal of this K23 proposal is to train Matthew J. O'Brien, MD, MSc for a career as an independent investigator in obesity and diabetes prevention, with a specific focus on Latinas-a demographic group at high risk for these related disorders. While there have been attempts to translate the evidence-based Diabetes Prevention Program (DPP) into community settings, very few of these studies have included Latinas. Community health workers, or promotoras, are trained lay people who provide health education, and could serve as leaders of weight loss and diabetes prevention efforts in Latinas. Previous research has demonstrated that promotoras are an effective lay health workforce, but no published studies have applied this intervention model to diabetes prevention in Latinas. Dr. O'Brien plans to address this gap in knowledge by developing a promotora-led lifestyle intervention (PLI), informed by the DPP, to promote weight loss and reduce cardiometabolic risk in Latinas. There are 3 Phases to the proposed research that will address corresponding specific aims: Phase 1 uses focus groups to explore the social and cultural context surrounding weight-related behaviors in Latinas at-risk for diabetes, applying the findings to develop PLI; Phase 2 involves piloting PLI in a single-arm trial, and assessing its feasibility and acceptabilit; Phase 3 will test the effects of PLI on changing at-risk Latinas' weight and cardiometabolic markers in a randomized controlled trial. In order to successfully complete the proposed research plan, Dr. O'Brien will receive additional training through formal coursework and structured mentorship in the following 3 areas: 1) qualitative methods; 2) randomized controlled trials for weight loss and diabetes prevention; and 3) foundations in obesity, diabetes, and metabolism. Temple University is home to internationally-recognized researchers in each of these areas of study, who will serve as Dr. O'Brien's mentors. The site for the proposed research is a community health center founded by Dr. O'Brien-Puentes de Salud ("Bridges of Health")-which serves a Latino population and has been the site of several promotora-based studies involving the target population since 2007.