Diabetes Prevention in Chinese Americans: Online Adaptation of Diabetes Prevention Program

摘要 亚洲人在美国移民中所占的比例迅速增加， 是增长最快的亚洲人。尽管肥胖患病率相对较低， 显示，亚洲人的糖尿病或空腹血糖受损患病率与 与其他民族。糖尿病预防计划（DPP）的结果表明， 生活方式干预，重点是增加身体活动和减少脂肪摄入量， 与二甲双胍药物组或二甲双胍药物组相比， 对照组因此，民进党的课程已成功地翻译和试点，在不同的 人口和环境。然而，在适应民进党的生活方式方面存在独特的挑战 在中国人群中实施干预。例如，低收入的华裔美国人经常住在 在与主流文化接触有限的孤立社区中。虽然基督教青年会民进党已 虽然该方案在社区得到广泛实施，但没有针对文化和语言问题进行调整， 美国华人的需求。此外，与其他移民群体类似， 经常长时间从事多项工作，没有太多空闲时间参与健康促进 程序.寻找新的策略，如在线提供糖尿病预防计划，可能会 克服移民经常面临的时间障碍。因此，SCORE SC 3项目的目标是：1） 采用形成性评价调整和翻译DPP课程，以完善促进健康的战略 饮食习惯和增加身体活动的高风险的华裔美国人，2）开发一个电子版本的 研究中国DPP课程的可行性和可接受性; 3）制定计划， 过渡到非SCORE支持。拟议的项目具有很高的潜力，可扩展到其他难以达到的 人口。这种翻译模式可以很容易地转移，并随时适用于其他服务不足的地区。 少数民族社区预防或减少糖尿病。此外，有了SCORE SC 3的资金支持，PI 将能够收集所需的初步数据，以生成强大的应用程序，并过渡到非SCORE 支持来源，如NIH R 01资助机制。

ABSTRACT Asians comprise a rapidly increasing proportion of immigrants in the United States with Chinese immigrants comprising the fastest growing Asian subgroup. Despite relatively low obesity prevalence, prior research showed that Asians had comparable, if not higher, diabetes or impaired fasting glucose prevalence compared with other ethnic groups. Results from the Diabetes Prevention Program (DPP) have shown that an intensive lifestyle intervention focusing on increasing physical activity and decreasing fat intake demonstrated a significant reduction in the incidence of type 2 diabetes compared with a metformin medication group or a control group. As a result, the DPP curriculum has been successfully translated and piloted in different populations and settings. However, there are unique challenges inherent in adapting the DPP lifestyle intervention for implementation in Chinese populations. For instance, low-income Chinese Americans often live in insular communities with limited exposure to the dominant mainstream culture. Although the YMCA DPP has widespread community-based implementation, it has not been tailored to address the cultural and linguistic needs of Chinese-speaking Americans. In addition, similar to other immigrant groups, Chinese Americans often work long hours with multiple jobs and do not have much free time to participate in health promotion programs. Finding new strategies, such as delivering diabetes prevention programs online, could potentially overcome the time barrier immigrants often face. Therefore, the aims of the SCORE SC3 project are to: 1) adapt and translate the DPP curriculum using formative evaluation to refine strategies to promote healthy dietary habits and increase physical activity in high-risk Chinese Americans, 2) develop an electronic version of the adapted Chinese DPP curriculum and test its feasibility and acceptability, and 3) develop plans for transition to non-SCORE support. The proposed project has high potential for scalability to other hard-to-reach populations. This translation model can be easily transferred and readily adapted for use in other underserved minority communities to prevent or reduce diabetes. In addition, with this SCORE SC3 funding support, the PI will be able to gather needed preliminary data to generate robust applications and to transition to non-SCORE sources of support such as NIH R01 funding mechanism.