Computer Assisted Support to Reduce Risks of Diabetes

描述（由申请人提供）：在美国，大约8%的成年人患有2型糖尿病。治疗可以预防一些破坏性的并发症，但通常不能恢复正常的神经功能或消除不良后果。因此，预防是可取的。来自两项大型对照试验的证据表明，通过生活方式干预，2型糖尿病可以推迟，甚至可能预防。营养和锻炼以达到健康的体重是预防糖尿病的关键行为干预措施。然而，这一证据并没有很好地传播到临床实践中。基于诊所的体重管理计划是昂贵的，难以提供人口的基础上，并没有典型的结构，以满足医疗服务不足和西班牙裔人口的独特需求。（西班牙裔成年人的糖尿病患病率尤其高。 本提案的目的是在一项平衡的随机对照试验中测试一种实用且易于实施的体重管理干预措施的有效性，该试验涉及两个研究组（对照组和干预组）各150人，共300例患者。这项研究将针对有糖尿病风险的医疗服务不足的患者。主要结果将是减轻他们的体重和改善葡萄糖代谢。干预将利用基于计算机的交互式软件程序来定制干预以满足每位患者的独特需求。该系统是根据第一阶段SBIR合同（1 R43-DK 066711 - 01 A1）开发的。将应用基于证据的行为模型，这些模型有望帮助个人做出改变，以更好地管理体重。该系统设计用于在诊所的个人计算机上运行，并将向患者提供个人评估和定制的实时反馈报告，以及概述患者改善关键领域的医生报告和从业人员的咨询建议。

DESCRIPTION (provided by applicant): Approximately 8% of adults in the U.S. suffer from type 2 diabetes. Treatment prevents some of its devastating complications, but does not usually restore normal glycemia or eliminate adverse consequences. Hence, prevention is preferable. Evidence from two large, well-controlled trials indicates that type 2 diabetes can be delayed, and possibly prevented, through lifestyle interventions. Nutrition and exercise to achieve a healthy weight are key behavioral interventions in preventing diabetes. However, this evidence has not diffused well into clinical practice. Clinic-based weight management programs are expensive, difficult to deliver on a population basis and are not typically structured to meet the unique needs of medically underserved and Hispanic populations. (Prevalence of diabetes is especially high among Hispanic adults.) The goal of this proposal is to test the efficacy of a practical and easily delivered intervention for weight management in a balanced randomized controlled trial, involving 150 people in each of two study arms (control group and intervention group) for a total of 300 patients. This study will target medically underserved patients with a risk for diabetes. The primary outcomes will be to reduce their weight and improve glucose metabolism. The intervention will utilize an interactive computer-based software program to tailor the intervention to the unique needs of each patient. This system was developed under a Phase I SBIR award (1 R43- DK066711-01A1). Evidence-based behavioral models that hold promise for helping individuals make changes to better manage body weight will be applied. This system is designed to operate on clinic-based personal computers and will provide individual assessment and tailored, real-time and feedback reports to patients and physician reports outlining key areas for patient improvement and counseling suggestions for practitioners.