Family-Centered Diabetes Project

糖尿病是全国和新墨西哥州印第安人（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危险因素上。年轻的NA女性是糖尿病预防活动的重要接受者，因为她们在家庭环境中扮演着关键角色，因为她们购买和准备食物，照顾孩子和家庭。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文化特异性干预减少NA女性及其家庭的可改变糖尿病危险因素。本研究的具体目的是确定一个健康的生活方式干预计划，“分享智慧”，提供给没有糖尿病的年轻NA女性是否会降低糖尿病的危险因素。采用随机试验设计，分为两个实验组：干预组和对照组，对照组接受延迟干预。测量将在普通临床研究中心（GCRC）完成，在基线、干预后、干预后6个月和12个月由研究小组协助。过程评估将由一个单独的小组进行。目标人群是在印第安人保健服务（IHS）诊所或城市印第安人诊所就诊的18-40岁的北美妇女。以下假设将被检验：i)干预参与者将以大于或等于80%的干预保留率参加分享智慧计划，并将积极评价该计划。ii)与干预后的对照组相比，干预参与者的糖尿病风险因素（主要结果）有所改善：饮食中卡路里的脂肪百分比降低，使用块食物频率问卷测量的蔬菜摄入量增加，使用Kriska可修改活动问卷每周进行30分钟以上中度或剧烈体育活动的参与者百分比增加。iii)干预后，与对照组相比，干预参与者的临床指标（次要结局）将得到改善：通过预测VO2峰值测量的身体素质得到改善，通过皮褶厚度测量的体脂减少，体重下降，使用HOMA模型降低胰岛素抵抗。iv)干预后6个月和12个月，与对照组相比，干预参与者的结果指标将保持改善。

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.