TEEN HEED: An Adolescent Peer Led Diabetes Prevention Intervention

描述（由申请人提供）：到2050年，美国2型糖尿病青年人数预计将增加49%，其中少数民族青年的发病率更高。糖尿病预防计划（DPP）被认为是一项哨兵研究，证明了生活方式干预对糖尿病前期成人糖尿病预防的有效性， 尚未在青年中复制。此外，在资源有限的高风险社区，这种密集的干预措施往往无法持续。在这些社区的成年人中成功采用的一项战略是基于同伴的健康教育。研究表明，与成年人一样，年轻人更有可能听到和个性化的信息，从而改变他们的态度和行为，如果他们相信信使与他们相似，并面临同样的关注和压力。然而，在少数民族青少年中没有同龄人主导的干预措施，也没有专门针对减肥预防糖尿病的干预措施。最后，在现有的青年健康干预计划中确定的另一个挑战是保持青年参与，以提高计划的参与和影响。一种潜在的策略是使用移动的技术（短信、移动的应用程序、社交媒体）来支持体重管理计划，但迄今为止尚未在青年中研究此类技术的使用。该提案的总体目标是利用基于社区的参与性研究（CBPR），开发和试点测试一种青年同伴主导的糖尿病预防干预措施，为纽约市弱势社区的高危青少年提供新型移动的健康技术。中心假设是，这种干预将导致BMI的维持或降低，改善饮食，身体活动和体重控制行为，并降低糖尿病风险，具体目的：1）探索使用同伴教育者和新型移动的健康技术的策略，作为在-纽约市一个疾病负担很高的社区的少数民族青年。2)设计、试点测试和评估干预措施的初步结果。使用目标1的数据，我们将使用CBPR将一个成熟的成年同伴领导的糖尿病预防干预转化为糖尿病前期少数民族青少年的发展和文化适当的生活方式干预。然后，我们将筛选糖尿病前期和相关生活方式和生物学指标的高危青少年，并比较干预组和等待名单对照组中糖尿病前期青少年的结果，以测试干预的有效性。3)根据干预可行性、可接受性和可持续性的检查，进一步完善更大规模随机对照试验的试点干预措施，

DESCRIPTION (provided by applicant): The number of youth with type 2 diabetes in the U.S. is projected to increase by a staggering 49 percent by 2050, with higher rates among minority youth. The Diabetes Prevention Program (DPP) is recognized as a sentinel study demonstrating the effectiveness of lifestyle interventions for diabetes prevention among pre- diabetic adults but has not yet been replicated in youth. In addition, such intensive interventions are often not sustainable in high risk communities with limited resources. One strategy that has been successfully employed in adults from such communities is peer based health education. Research suggests that like adults, young people are more likely to hear and personalize messages, and thus to change their attitudes and behaviors, if they believe the messenger is similar to them and faces the same concerns and pressures. However, there have been no peer led interventions in ethnic minority teens and no interventions focused specifically on weight loss for diabetes prevention. Finally, another challenge identified in existing youth health intervention programs is keeping youth engaged to enhance program participation and impact. One potential strategy is the use of mobile technologies (text messaging, mobile applications, social media) to support weight management programs, but to date use of such technologies has not been studied in youth. This proposal's overall objective is to use community-based participatory research (CBPR) to develop and pilot test a youth peer-led diabetes prevention intervention incorporating novel mobile health technologies for at-risk adolescents in a vulnerable New York City community. The central hypothesis is that such an intervention will lead to maintenance or decrease in BMI, improved dietary, physical activity and weight control behaviors, and decrease in diabetes risk, Specific Aims: 1) Explore strategies for using peer educators and novel mobile health technologies as part of a group lifestyle change program for diabetes prevention among at-risk ethnic minority youth in a New York City community with high disease burden. 2) Design, pilot test, and evaluate preliminary outcomes for the intervention. Using data from Aim 1, we will use CBPR to translate a proven adult peer led diabetes prevention intervention into a developmentally and culturally appropriate lifestyle intervention for pre-diabetic ethnic minority adolescents. We will then screen at-risk adolescents for pre-diabetes and related lifestyle and biological measures and compare outcomes in pre-diabetic adolescents in intervention and wait list control groups to test intervention effectivenes. 3) Further refine the pilot intervention for a larger RCT based on an examination of intervention feasibility, acceptability, and sustainability,