Diabetes Prevention Program in American Indian Youth

描述(申请人提供)：尽管年龄调整后的糖尿病患病率在美国印第安人中为16.3%，居住在北部平原地区的20岁或以上，但在蒙大拿州20岁或20岁以下的印度青年中，年龄调整后的糖尿病患病率仅为0.23%。这些数据表明，针对美国印第安人青年的糖尿病预防计划可能对降低未来几代美国印第安人成年人患糖尿病的风险最有希望。糖尿病预防计划(DPP)在资源密集型环境中对成年人进行时显示出有效性。因此，对美国印第安人儿童和青少年实施未经修改的民进党干预活动可能是无效的，并且不适合这个年龄段和文化群体。利用基于社区的参与性研究(CBPR)方法，该项目将为10-14岁的美国印第安人青年翻译和测试基于证据的DPP课程模块。该项目的形成阶段包括由项目调查人员和课程专家对DPP材料进行改编，由北平原印第安人社区焦点小组讨论(n=40名参与者)以进一步完善改编的材料，以及由项目专家对材料进行最终修订。形成阶段为调整后的民进党课程的试点研究做准备。该项目的量化阶段将是一项为期32周的试点研究，以确定接受治疗(适应DPP模块)或对照课程的10-14岁的美国印第安人青年在饮食摄入量、体力活动、体重指数、血压、皮褶厚度、腰围、棘皮病、空腹血糖、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总胆固醇和甘油三酯等方面的干预保真度和测试前后变化的幅度。这个R34项目将开发初步数据，以证明进行干预的长期随机试验(未来的R18试验)的可行性，以测试适应的DPP在美国印第安人青年中预防2型糖尿病的风险。如果证明有效，这些研究将为全国各地的美国印第安人青年提供潜在的有价值和可翻译的糖尿病预防策略。7.项目简介这个项目可以为全国各地的美国印第安人青年提供一个有效的、可翻译的糖尿病预防计划。如果这些策略在随后的全面干预试验中被证明是有效的，这些方法可以通过减少与早期糖尿病风险相关的风险因素来预防糖尿病的高死亡率。这些长期的健康影响将通过减少糖尿病、心血管疾病和肥胖相关的医疗费用来节省资金，并将缩小美洲原住民人口的健康差距。

DESCRIPTION (provided by applicant): Although age-adjusted prevalence of diagnosed diabetes is 16.3% in American Indians, 20 years or older living in the Northern Plains Region, age-adjusted prevalence of diabetes is only 0.23% in Montana Indian youth, age 20 years or less. These data suggest that diabetes prevention programs for American Indian youth may hold the most promise for decreasing diabetes risk in future generations of American Indian adults. The Diabetes Prevention Program (DPP) showed efficacy when conducted with adults in resource intensive settings. Therefore, implementing unmodified DPP intervention activities with American Indian children and adolescents is likely to be ineffective and inappropriate for this age and cultural group. Using a community based participatory research (CBPR) approach, this project will translate and test the evidence based DPP curriculum modules for American Indian youth, age 10-14. The formative phase of the project includes DPP material adaptations by project investigators and curriculum experts, Northern Plains Indian community focus group discussions (n=40 participants) that further refine the adapted materials, and final material revisions by project experts. The formative phase prepares for a pilot study of the adapted-DPP curriculum. The quantitative phase of the project will be a 32-week pilot study that determines intervention fidelity and magnitude of pre- to posttest changes on dietary intake, physical activity, body mass index (BMI), blood pressure, skinfold thickness, waist circumference, acanthosis, fasting plasma glucose, LDL-C, HDL-C, TC and triglycerides in 64 American Indian youth, age 10-14 years, receiving the treatment (adapted-DPP modules) or control curriculum. This R34 project will develop preliminary data that will demonstrate the feasibility of conducting a longer term randomized trial of the intervention (future R18 trial) to test the adapted DPP for preventing risk for type-2 diabetes in American Indian youth. If proven effective, these studies will provide potentially valuable and translatable diabetes prevention strategies for American Indian youth across the nation. 7. Project Narrative This project could provide an effective and translatable diabetes prevention program for American Indian youth across the nation. If the strategies are proven effective in the subsequent, full-scale trial of the intervention, the methods could prevent high rates of death from diabetes by reducing risk factors associated with diabetes risk at an early age. These long-term health effects will save dollars by reducing diabetes, cardiovascular and obesity-related health care costs and will reduce health disparities in Native American populations.