Parents and Children Together Preventing Diabetes (PACT PD)

描述(申请人提供)：2型糖尿病(T2 DM)是一种由于遗传、行为和文化风险因素而聚集在家庭中的疾病。1 T2 DM至少占美国糖尿病的90%，另外还有790万人患有前驱糖尿病(美国糖尿病协会，2011年)。非洲裔美国人在被诊断为T2 DM和糖尿病前期(CDC)的患者中所占比例不成比例。2~3非洲裔美国人迫切需要有效的、与文化相关的、以家庭为基础的糖尿病预防干预措施。糖尿病预防方案(DPP)和过去十年的其他临床试验表明，通过针对饮食和体力活动的强化生活方式干预，可以成功地预防或延迟T2 DM。4-6最近两种有效的社区DPP翻译取得了类似的结果，但社区卫生工作者7和受过培训的基督教青年会生活方式教练提供的干预强度较小。8这两项研究都只针对个别成年人~关于如何从家庭角度最好地翻译DPP，人们知之甚少。Power to Prepect是疾控中心现有的一项糖尿病预防计划，基于DPP，专门为有T2 DM风险的非裔美国家庭设计。据我们所知，这项计划尚未在非洲裔美国家庭的随机试验中进行评估。我们建议利用基督教青年会生活方式教练在提供糖尿病预防干预措施方面的有效性的证据，并培训基督教青年会健身工作人员担任“家庭健康教练”，以实施与超重/肥胖的非裔美国父母及其超重/肥胖的8-10岁儿童一起实施的力量预防计划。我们提出了父母和孩子一起预防糖尿病(PACT-PD)研究，这是一项DPP的两条件随机、基于家庭的试点研究翻译。我们小组处于实施和评估以家庭为基础的糖尿病预防干预措施的理想位置，非裔美国家庭在开展基于社区和家庭的干预方面拥有丰富的经验，特别是对非裔美国人。如果我们的研究成功，我们翻译的干预措施可能会迅速传播到美国数以千计的基督教青年会，从而对肥胖、糖尿病和其他与生活方式相关的慢性疾病造成的公共健康负担产生重大影响。 公共卫生相关性：叙事非裔美国成年人和儿童的肥胖率和T2 DM发生率高于高加索儿童。21令人担忧的是，大约50%的AA美国儿童预计会在一生中患上T2 DM。22我们建议进行一项随机试点研究，以评估专门为非裔美国家庭设计的糖尿病预防干预措施的早期效果。

DESCRIPTION (provided by applicant): Type 2 diabetes (T2DM) is a disease that clusters in families due to genetic, behavioral, and cultural risk factors.1 T2DM accounts for at least 90% of diabetes in the United States and an additional 7.9 million individuals have prediabetes (American Diabetes Association, 2011). African Americans are disproportionately represented among those diagnosed with T2DM and prediabetes (CDC).2~3 Effective, culturally-relevant, family-based diabetes prevention interventions are critically needed for African Americans. The Diabetes Prevention Program (DPP) and other clinical trials over the past decade have demonstrated that T2DM can be successfully prevented or delayed with intensive lifestyle interventions addressing diet and physical activity.4-6 Two recent effective community-based translations of the DPP have achieved similar outcomes with less intensive interventions delivered by community-health workers7 and trained YMCA lifestyle coaches.8 Both of these studies focused solely on individual adults~ little is known about how best to translate DPP from a family perspective. Power to Prevent is an existing CDC diabetes prevention program, based on DPP, and designed specifically for use with African American families at risk for T2DM. To our knowledge, this program has not yet been evaluated in a randomized trial with African American families. We propose to leverage the evidence on the effectiveness of YMCA lifestyle coaches in delivering diabetes prevention interventions and train YMCA fitness staff to serve as "family health coaches" to implement the Power to Prevent program with overweight/obese African American parents and their overweight/obese 8-10 year old children. We propose the Parents and Children Together Preventing Diabetes (PACT-PD) study, a two-condition randomized family-based pilot study translation of DPP. Our group is ideally positioned to implement and evaluate the family-based diabetes prevention intervention with African American families having extensive experience in conducting community- and family-based interventions, particularly with African Americans. If our study is successful, our translated intervention could be disseminated rapidly to thousands of YMCAs in the United States, thereby making a substantial impact on the public health burden of obesity, diabetes, and other lifestyle related chronic diseases. PUBLIC HEALTH RELEVANCE: Narrative African American adults and children experience higher rates of obesity and T2DM, compared to their Caucasian counterparts.21 Alarmingly, about 50% of AA U.S. children are expected to develop T2DM in their lifetime.22 We propose to conduct a randomized pilot study to evaluate the early efficacy of a diabetes prevention intervention specifically designed for African American families.