BIENESTAR: A SCHOOL BASED DIABETES PREVENTION PROGRAM

第三次(1988-1994年)全国健康和营养检查调查报告说，墨西哥裔美国成年人的确诊和未确诊糖尿病和其他美国种族/民族人口的年龄和性别标准化患病率较高。最近，研究人员报告说，墨西哥裔美国年轻人患2型糖尿病的频率越来越高。在非糖尿病的墨西哥裔美国青年中也发现了糖尿病的危险因素。由于糖尿病在墨西哥裔美国成年人中高度流行，糖尿病在墨西哥裔美国青年中的发病率正在上升，糖尿病风险因素在墨西哥裔美国儿童中更为常见，因此，谨慎的措施是探索旨在预防这一高危人群糖尿病的健康教育计划。我们提出了一项干预措施，Bienestar健康计划，这是一个以学校为基础的风险因素预防计划，目标是居住在贫困社区的四年级墨西哥裔美国儿童。Bienestar健康计划的学习活动以社会认知理论为基础。学习活动是为四个社会系统制定的，从概念上讲，这四个系统应该对儿童的健康行为产生最大影响--父母、学校教室、学校食堂和课后照料。圣安东尼奥独立学区将是干预措施的东道主，德克萨斯大学圣安东尼奥分校教育部和位于圣安东尼奥的德克萨斯大学健康科学中心(儿科、内分泌科和南德克萨斯健康研究中心)将在实施和评估干预措施方面发挥协作者作用。对于这项研究，假设是，与尚未接受干预的学校的儿童相比，接受比尼司他干预的儿童将显着降低他们患糖尿病的风险因素。如果存在差异，这项研究将检查糖尿病危险因素的差异是否随着时间的推移而保持差异(干预后3年)。研究结果将是行为和生物学的终点。行为结果将是身体脂肪百分比、膳食脂肪摄入量、水果和蔬菜摄入量以及身体健康。生物结果将禁食毛细血管血糖水平。最终，我们希望延迟或预防2型糖尿病的发病。

The Third (1988-1994) National Health and Nutrition Examination Survey reported that Mexican-American adults had higher age- and sex- standardized prevalence of diagnosed and undiagnosed diabetes and other U.S. racial/ethnic populations. Recently investigators have reported the increasing frequency of type 2 diabetes in Mexican-American youth. Diabetes risk factors also have been identified in non-diabetic Mexican- American youth. Since diabetes is highly prevalent in Mexican-American adults, diabetes is increasing in Mexican-American youth and diabetes risk factors are more common in Mexican-American children, a prudent measure would be to explore health education programs aimed at preventing diabetes in this population at risk. We propose an intervention, the Bienestar health program, a school-based risk factor prevention program that targets 4th grade Mexican-American children residing in poor neighborhoods. The Bienestar health program's learning activities are based on Social Cognitive Theory. Learning activities were developed for the four social systems that conceptually should have the most influence on children's health behaviors-parents, school classroom, school cafeteria and after school care. The San Antonio Independent School District will be the host for the intervention and the University of Texas at San Antonio division of education, and the University of Texas Health Science Center at San Antonio (Department of Pediatrics, Division of Endocrinology and South Texas Health Research Center) will be collaborators in the implementation and evaluation of the intervention. For this study the hypothesis is that children exposed to Bienestar intervention will significantly reduce their risk factors for developing diabetes compared to children in schools not yet receiving the intervention. If differences exist, the study will examine if diabetes risk factors differences are maintained over time (3 years post-intervention). Study outcomes will be behavioral and biological endpoints. Behavioral outcomes will be percent body fat, dietary fat intake, fruit and vegetable intake and physical fitness. Biological outcomes will fasting capillary glucose levels. Ultimately, we would like to delay or prevent the onset of type 2 diabetes.