Collaborations for Health Improvement in East Harlem - Project HEED

描述（由申请人提供）：没有一种慢性疾病比糖尿病对消除健康差异的挑战更大。东哈莱姆区是纽约市肥胖和糖尿病交织流行的中心。以低收入为主的黑人和拉丁裔居民没有足够的资源来应对助长这些流行病的各种力量。研究项目证明，适度减肥和增加体育活动可以预防或延缓糖尿病，但这些项目过于繁琐，无法在东哈莱姆这样的社区推广。许多倡议没有体现出社区的声音、支持和参与，这是长期可持续的结果。另一方面，包括真正的社区伙伴关系在内的创新方法往往没有纳入严格的研究设计和衡量影响的方法。

DESCRIPTION (provided by applicant): No chronic illness presents greater challenges to eliminating disparities in health than diabetes. East Harlem is the epicenter in New York City of the intertwined epidemics of obesity and diabetes. Its predominantly low income, Black and Latino residents have insufficient resources to cope with the myriad forces that fuel these epidemics. Research programs proving that modest weight loss and increased physical activity prevent or delay diabetes are too cumbersome to be put to use in communities like East Harlem. Many initiatives do not embody the kind of community voice, support, and participation that is sustainable for long term results. On the other hand, innovative approaches that include true community partnerships often do not incorporate rigorous research designs and methods that measure impact. In the last two years, East Harlem residents and researchers conducted assessments, decided to focus on pre-diabetes in an effort to develop a community-based diabetes prevention intervention. A Community Action Board, supported by researchers, developed and piloted a trial to determine the impact of a peer-led community-based course in achieving weight loss and ultimately in preventing diabetes. Project HEED (Help Educate to Eliminate Diabetes) offers information about pre-diabetes, while motivating and supporting people to find ways to change their lifestyles that are consonant with their social, economic and environmental realities. In just three months, we enrolled 99 overweight, primarily Latino, uninsured, low income East Harlem adults whom we found to be pre-diabetic through numerous community screenings, and HEED classes are underway. Researchers learned that sharing vision, power and control with people directly impacted by the problem they are studying, can lead to novel interventions and very successful recruitment strategies. Community leaders learned research skills, became published authors and gave workshops on community-based participatory research. Based on this successful and informative pilot phase, we are now prepared to conduct a full-scale effectiveness trial. Our partnership now aims to analyze and revise the HEED pilot and our study design. We will then recruit and enroll 400 overweight adults with pre-diabetes into a randomized-controlled trial to test the effectiveness of Project HEED, primarily on weight loss and secondarily on physical activity, quality of life and development of diabetes, and disseminate our findings locally, regionally and nationally. If successful, this community-led and based, low-cost program could spread through East Harlem and other minority communities across the nation.