Family-Focused Community Program to Prevent Type 2 Diabetes in Peripubertal Youth

描述（由申请人提供）：超过三分之一的儿童和青少年超重，近五分之一的人肥胖。代谢综合征是2型糖尿病（T2 D）和心血管疾病（CVD）的强预测因子，在高达44%的肥胖青年中发生，预示着T2 D的患病率更高和发病更早。如果没有有效的干预措施，“糖尿病”将恶化，T2 D患病率将增加，成年人将在更年轻的时候面临其后果。鉴于肥胖与青年慢性疾病风险因素之间的密切联系，我们认为T2 D预防（和CVD预防）类似于体重控制和肥胖预防。拟议项目的目标是制定一个以家庭为中心，以社区为基础的计划，预防青春期（9-13岁）青年的T2 D。使用参与式的方法，我们打算适应成功的成人为重点的基督教青年会糖尿病预防计划（YDPP）的青年和家庭，并评估的可行性，参与者接受和遵守YFDPP使用两种交付格式：一个16周的基督教青年会为基础的面对面的程序和16周的组合面对面加移动的设备为基础的程序。拟议的研究将测试我们的前提，即技术交付可以减少参与者的感知负担，提高依从性，并导致人体测量（身高，体重和BMI和腰围），行为（饮食和体力活动）和生理结果（空腹胰岛素，血糖，血脂，血压）的改善。我们将使用得到的数据来设计一个适当的动力全面试验。上述统计数据和最近呼吁将有效的临床干预措施转化为有效的青年社区计划的建议都强调了拟议研究的重要性。拟议的干预措施的潜在影响是巨大的，因为该方案将由社区的辅助专业人员提供，没有大学研究人员;重要的是，它针对儿童的一个重大公共卫生挑战，包括评估客观的行为和临床数据;和创新，因为它侧重于高危人群，发生在一个受欢迎的，方便的社区场所，并利用移动的技术扩大覆盖面，增加青年和家庭对干预内容的参与。长期目标是创建一个可扩展、可复制和可持续的计划，克服现有的障碍，向青年和家庭实施和传播循证、经研究证明的糖尿病预防计划，从而改善人口健康。

DESCRIPTION (provided by applicant): Over one-third of children and adolescents are overweight and nearly 1 in 5 of them are obese. Metabolic syndrome, a strong predictor of Type 2 diabetes (T2D) and cardiovascular disease (CVD), occurs in up to 44% of obese youth, foreshadowing greater prevalence and earlier onset of T2D. Without effective interventions, "diabesity" will worsen, T2D prevalence will increase, and adults will face its consequences at younger ages. Given the strong association between obesity and chronic disease risk factors in youth, we contend T2D prevention (and CVD prevention) is akin to weight control and obesity prevention. The objective of the proposed project is to develop a family-centered, community-based program for T2D prevention in peripubertal (9-13-year-old) youth. Using participatory methods, we intend to adapt the successful adult-focused YMCA Diabetes Prevention Program (YDPP) for youth and families and assess the feasibility, participant acceptance of and adherence to the YFDPP using two delivery formats: a 16-week YMCA-based face-to-face program and a 16-week combined face-to-face plus mobile device-based program. The proposed study will test our premise that delivery with technology can reduce participant perceived burden, improve adherence, and lead to improved anthropometric (height, weight and BMI and waist circumference), behavioral (diet and physical activity) and physiological outcomes (fasting insulin, glucose, lipid, blood pressure). We will use the resulting data to design an appropriately powered full-scale trial. The importance of the proposed study is underscored both by the statistics cited above and the recent call for proposals to translate efficacious clinical interventions into effective community programs for youth. The potential impact of the proposed intervention is great in that the program will be delivered by paraprofessionals from the community without university researchers; significant in that it targets a major public health challenge in children and includes assessment of objective behavioral and clinical data; and innovative in that it focuses on an at-risk population, takes place at a popular, accessible community venue, and uses mobile technologies to extend reach and increase engagement of youth and families with intervention content. The long-term goal is to create a scalable, replicable, and sustainable program that overcomes existing barriers to implementation and dissemination of evidence-based, research-proven diabetes prevention programs to youth and families, thereby improving population health.