Diabetes Prevention Translation Project: the Healthy LIFESTYLE Project

描述（由申请人提供）：生活方式干预可以预防或延缓2型糖尿病发展的证据已经在多个临床试验中得到证实，包括美国的多中心临床试验，糖尿病预防计划或DPP。公共卫生面临的挑战是，如何将DPP研究工作中使用的这种有前途和经过验证的行为干预措施转化为“现实世界”，即如何以较低的成本使其在不同社区、不同地方环境中发挥作用，从而使最大数量的高危人群受益。本应用程序的目的是测试DPP的翻译框架，其中包括：1)示范社区卫生保健专业人员的培训模式，包括在提供糖尿病预防课程和所需的行为生活方式材料方面的初始培训、支持和监督；2)评估一个更紧凑和灵活的DPP干预计划，每个参与者都可以选择一个版本（标准的面对面小组形式或相同生活方式干预计划内容的DVD版本）。这些生活方式干预项目将在三个不同的社区环境中进行；例如，医疗保健实践，工作场所和当地的老年社区中心。最后，将测试生活方式干预计划在三种社区环境中的成本效益分析。如果被证明是有效的，这个糖尿病和心血管风险预防转换的框架可以在整个美国和国外进行调整。

DESCRIPTION (provided by applicant): Evidence that lifestyle intervention can prevent or delay the development of type 2 diabetes has been demonstrated in several clinical trials including a multi center clinical trial in the US, the Diabetes Prevention Program or DPP. The challenge for public health is to translate this promising and proven behavioral intervention utilized in the DPP research effort to the "real world", i.e., how to make it work in diverse communities in a variety of local settings at a reduced cost so that the maximal number of those at risk can benefit. The purpose of this application is to test a framework for translation of the DPP that includes: 1) demonstration of a training model for community health care professionals that includes initial training, support, and supervision in the delivery of a diabetes prevention curriculum and the needed behavioral lifestyle materials; 2) evaluation of a more compact and flexible DPP intervention program administered to each participant in a version of his or her choice (standard face-to-face group format or a DVD version of the same lifestyle intervention program content). These lifestyle intervention programs will be carried out in three different community settings; i.e. a health care practice, a worksite, and local senior community centers. Lastly, the cost- effectiveness analyses of the LIFESTYLE intervention program in each of the three community settings will be tested. If proven to be effective, this framework for diabetes and cardiovascular risk prevention translation is one that could be adapted throughout the United States and abroad. PUBLIC HEALTH RELEVANCE: This proposal is a logical next step in the progression from promising randomized clinical trials utilizing behavioral, goal-based lifestyle interventions to prevent type 2 diabetes to effectiveness efforts in the community. We have convened a team of investigators to guide and evaluate all aspects of a community- based lifestyle intervention program, including a training model, to expand the reach of standardized effective interventions delivery. A cost-analysis of these efforts will be done as well.