Developing and Pilot Testing Community and Family-Based Strategies to improve Type 1 Diabetes Management in African American and Latino School-Aged Children

项目摘要和摘要 越来越多的研究表明，患有1型糖尿病(T1D)的非裔美国人和拉丁裔儿童 比非西班牙裔白人儿童的健康状况更差。家长和家长之间强有力的共同参与 儿童糖尿病管理行为对优化青少年血糖控制至关重要，并保护 防止青春期血糖控制迅速恶化和青壮年结局不佳。 非洲裔美国人和拉丁裔家庭不太可能共同参与糖尿病管理， 但还没有研究确定少数族裔家庭面临的障碍。文学上的这一差距严重限制了 制定以共同参与为目标的干预措施，以改善血糖控制和 防止少数族裔家庭在青春期血糖控制恶化。另一个主要限制 预防这种恶化的文献的一部分是缺乏已发表的适应性干预试验 改善学龄期(5-9岁)家庭保健程序前糖尿病结局的干预措施 都是固化的，而且很难修改。对儿童哮喘的研究表明，以社区为基础 由受过训练的父母同伴提供的干预也可能是改善健康的有效方法 患有T1D的学龄儿童的结局。此项目的目的是创建和测试父对等体- 以家庭团队合作为基础的社区提供的家庭干预，以诊所为基础的有效面对面 对患有T1D的青春期前和青春期早期青少年及其父母进行面部干预，重点是 学龄青年(5-9岁)，是非裔美国人或拉丁裔。干预，我们已经命名为 家庭团队合作-同伴分娩(FT-P)，具有防止血糖迅速恶化的潜力 在青春期以家庭健康常规为目标，在其牢固确立之前进行控制。我们将整合 改编的家庭团队合作课程材料最初是为成功的青少年开发的 由家长同行提供的干预计划我们团队实施的重点是提高质量 在资源有限和长期生活压力较大的少数族裔家庭中进行育儿。我们会申请，申请 每个种族/族裔群体分开，社区利益攸关方参与的方法，以适应 以证据为基础的家庭团队合作组成部分，并将其与父母同行的交付形式相结合。这个 这项研究将在休斯敦这个多元化的城市进行，那里大约30%患有T1D糖尿病的儿童 非裔美国人或拉丁裔。我们将测试以下项目的可行性、利益相关者满意度和初步结果 针对非洲裔美国人和拉美裔家庭的改进、调整和整合的FT-P干预措施，获得 关于家庭可接受性和干预有用性的定性数据，并进一步完善干预措施 分别针对每个种族/民族，为更大规模的随机对照试验做准备。

PROJECT SUMMARY AND ABSTRACT Studies have increasingly showed that African American and Latino children with type 1 diabetes (T1D) have poorer health outcomes than Non-Hispanic white children. Strong shared involvement between parents and children in diabetes management behaviors is essential to optimize glycemic control in youth, and protect against rapid deterioration of glycemic control during adolescence and poor outcomes in young adulthood. African American and Latino families are less likely to engage in shared involvement in diabetes management, but no studies have identified the obstacles faced by minority families. This gap in the literature severely limits the development of interventions that target shared involvement in order to improve glycemic control and prevent glycemic control deterioration during adolescence among minority families. Another major limitation of the literature for preventing this deterioration is that lack of published intervention trials of adapted interventions that improve diabetes outcomes during school-age years (5-9 years) before family health routines are solidified and challenging to modify. Studies in pediatric asthma suggest that community-based interventions delivered by trained parent peers may also be an effective approach for improving health outcomes in school-age children with T1D. The purpose of this project is to create and test a parent peer- delivered, community-based family intervention based on Family Teamwork, an effective clinic-based face to face intervention for pre- and early- adolescent youth with T1D and their parents, focusing on families of school-age youth (ages 5-9 years) who are African American or Latino. The intervention, which we have named Family Teamwork-Peer Delivery (FT-P), has the potential to prevent the rapid deterioration of glycemic control in adolescence by targeting family health routines before they are firmly established. We will integrate adapted Family Teamwork curriculum materials originally developed for adolescents with a successful intervention program delivered by parent peers our team has implemented focused on improving quality parenting among minority families with limited resources and high chronic life stressors. We will apply, for each racial/ethnic group separately, participatory approaches involving community stakeholders to adapt the evidence-based Family Teamwork components and integrate them with the parent peer delivery format. The study will occur in the diverse city of Houston, where approximately 30% of children with T1D diabetes are African American or Latino. We will test the feasibility, stakeholder satisfaction, and preliminary outcomes of the refined, adapted, and integrated FT-P intervention with African American and Latino families, obtain qualitative data on family acceptability and usefulness of the intervention, and further refine the intervention for each racial/ethnic group separately to prepare for a larger randomized controlled trial.