Family-Centered Diabetes Project

糖尿病是全国和新墨西哥州美洲原住民（NA）社区的主要健康问题。 糖尿病预防工作应集中在可改变的风险因素上。年轻的NA妇女是糖尿病预防活动的重要接受者，因为她们在家庭环境中发挥着关键作用，因为她们购买和准备食物，照顾子女和家庭。 他们也是糖尿病预防的重要接受者，因为他们自己患糖尿病的风险很高。因此，本研究的长期目标是通过特定文化的干预措施减少NA妇女及其家庭中可改变的糖尿病风险因素。 本研究的具体目的是确定是否健康的生活方式干预计划，“分享智慧”，提供给年轻的NA妇女没有糖尿病将减少糖尿病的危险因素。 将采用随机试验设计，分为两个实验组：干预组和将接受延迟干预的对照组。 将在研究团队的协助下，在一般临床研究中心（GCRC）完成基线、干预后以及干预后6个月和12个月的测量。 过程评价将由一个单独的团队进行。 目标人群是18-40岁在印度卫生服务处诊所或城市印度诊所就诊的NA妇女。 将对以下假设进行检验：i）干预参与者将以大于或等于80%的干预留存率参加分享智慧计划，并将积极评价该计划。ii）干预参与者将改善糖尿病风险因素（主要结局）与干预后对照组相比：降低了饮食中卡路里的脂肪百分比，增加了使用块状食物频率问卷测量的蔬菜消费量，使用可调整活动问卷调查，每周进行30分钟以上中度或剧烈体力活动的参与者百分比增加，克里斯卡iii）与干预后的对照组相比，干预参与者将改善临床指标（次要结局）：通过预测的VO 2峰值测量的身体健康改善，通过皮褶厚度测量的体脂减少，体重减轻，以及使用HOMA模型降低胰岛素抵抗。iv）与对照组相比，干预后6个月和12个月，干预参与者将维持结局指标的改善。

Diabetes is a major health problem among Native American (NA) communities nationally and in New Mexico. Diabetes prevention efforts should concentrate on modifiable risk factors. Young NA women are important recipients of diabetes prevention activities because of their pivotal role in the family environment as they purchase and prepare food, and care for their children and families. They are also important recipients of diabetes prevention because of their own high risk of diabetes. Therefore, the long-range goal of this study is to reduce modifiable diabetes risk factors in NA women and their families through a culturally specific intervention. The specific aim of this study is to determine whether a healthful lifestyle intervention program, "Sharing Wisdom", delivered to young NA women without diabetes will reduce diabetes risk factors. A randomized trial design will be used with two experimental groups: intervention group, and comparison group who will receive a delayed intervention. Measures will be completed at the General Clinical Research Center (GCRC) with assistance from the research team at baseline, post intervention, and 6 and 12 months post intervention. Process evaluation will be conducted by a separate team. The target population is NA women ages 18-40 who attend the Indian Health Service (IHS) clinics or an urban Indian clinic. The following hypotheses will be tested: i) Intervention participants will attend the Sharing Wisdom program with a greater than or equal to 80 percent retention rate for the intervention and will evaluate the program positively. ii) Intervention participants will have improvement on diabetes risk factors (primary outcomes) when compared to the comparison group post intervention: decreased percent fat from kcal in the diet, increased vegetable consumption measured using the Block Food Frequency Questionnaire, and increased percent of participants who do moderate or strenuous physical activity for 30 minutes greater than 3 times a week using the Modifiable Activity Questionnaire of Kriska. iii) Intervention participants will improve on clinical measures (secondary outcomes) compared to the comparison group post intervention: improved physical fitness measured by predicted VO2 peak, decreased body fat measured by skinfold thickness, decreased body weight, and decreased insulin resistance using the HOMA model. iv) Improvement in outcome measures will be maintained by intervention participants when compared to the comparison group at 6 and 12 months post intervention.