Diabetes Prevention for Hispanics Residing in Rural Communities: A Mobile Web-based Approach

项目摘要/摘要 在美国，拉美裔美国人受到2型糖尿病(T2D)风险、患病率和 结果。超过一半的拉美人会在一生中患上糖尿病，死于糖尿病的可能性要高出50% 它与非西班牙裔白人进行了比较。摄入高脂肪饮食，体力活动不足，以及 超重/肥胖都与T2D有关。与此一致的是，拉美裔更有可能参与到 这些危险行为和超重/肥胖。幸运的是，相对适度的体重减轻可以 显著降低患T2D的风险。具有里程碑意义的糖尿病预防计划(DPP)明确 证明了这一点。接受民进党的参与者体重减轻了5%至7%。此外，还有几个 适应已被证明在种族/民族人口中是成功的。 然而，仍然存在差距。农村拉美裔成年人的糖尿病相关健康状况更差 与以下情况相比，他们更不可能获得糖尿病自我管理和支持计划 他们的同龄人生活在大城市县。此外，农村拉美裔面临着强大的准入和 资源障碍。对于这种高危人群，采用面对面的糖尿病预防计划是不够的 人口。然而，拉美裔拥有很高的智能手机拥有率，农村拉美裔利用 从移动设备上网的速度比高加索人和非裔美国人都高。因此，利用 移动的、基于网络的方法是一种值得称赞的针对高危社区的手段。 这将是第一个同时为两个人定制DPP的mHealth糖尿病预防计划 优先人群：拉美裔和生活在农村社区的人。这是以证据为基础和理论驱动的 干预将为农村拉美裔人提供改善健康的知识、技能和自我效能 并降低患糖尿病的风险。用户将通过以下途径浏览有关健康饮食和体育锻炼的内容 一系列视频、易于理解的图表和简单的导航功能。用户还将获得健康 短信到他们的手机，并可以访问现场计划教练，以获得额外的帮助和动力。 在第一阶段，开发了一个原型STEPS，它是由与 53名农村拉美裔成年人的寿命。第一阶段的结果有力地支持了该项目的可行性和潜力 干预的有效性，远远超过第一阶段提案中确定的基准。 在第二阶段，我们将完成为农村拉美裔成年人制定STEPS计划。在……里面 与南得克萨斯州社区行动公司合作，我们将审查 通过增加体力活动和改善整体饮食习惯来减少体重的步骤干预。 参与者将被随机分配到干预条件或对照条件。次要的 措施将评估糖尿病知识、饮食、客观/自我报告的体力活动、自我效能、压力和 社会支持。

PROJECT SUMMARY/ABSTRACT Hispanics in the U.S. are disproportionately affected by Type 2 diabetes (T2D) risk, prevalence, and outcomes. More than half of Latinos will develop diabetes in their lifetime and are 50% more likely to die from it compared to non-Hispanic whites. Consumption of a high fat diet, insufficient physical activity, and being overweight/obese have all been linked to T2D. Consistent with this, Hispanics are more likely to engage in these risk behaviors and be overweight/obese. Fortunately, a relatively modest reduction in body weight can significantly reduce the risk of developing T2D. The landmark Diabetes Prevention Program (DPP) has clearly demonstrated this. Participants who received the DPP reduced their weight by 5-7%. Additionally, several adaptations have been shown to be successful in racial/ethnic populations. However, there remains a gap. Rural Hispanic adults experience even worse diabetes-related health disparities and are less likely to have access to diabetes self-management and support programs compared to their counterparts living in metropolitan counties. Furthermore, rural Hispanic face formidable access and resource barriers. Employing an in-person diabetes prevention program is not sufficient for this at-risk population. However, Latinos have high rates of ownership of smartphones and rural Hispanics utilize the internet from a mobile device at higher rates than both Caucasians and African Americans. Thus, utilizing a mobile, web-based approach is a laudable means of targeting a high-risk community. This will be the first mHealth diabetes prevention program that will simultaneously tailor the DPP for two priority populations: Hispanics and those living in rural communities. This evidence-based and theory driven intervention will provide rural Hispanics with the knowledge, skills, and self-efficacy to improve health behaviors and reduce diabetes risk. Users will explore content on healthy eating and physical activity through an array of videos, easy to understand diagrams, and simple navigation features. Users will also receive health text messages to their phones and can access to a live program coach for additional assistance and motivation. In Phase I, a prototype STEPS was developed, which was informed by formative research conducted with 53 rural Hispanic adults across the lifespan. The results of Phase I strongly support the feasibility and potential effectiveness of the intervention, far exceeding the benchmarks established in the Phase I proposal. During Phase II we will complete development of the STEPS program for rural Hispanic adults. In partnership with Community Action Corporation of South Texas, we will examine the effectiveness of the STEPS intervention to reduce body weight by increasing physical activity and improving overall eating habits. Participants will be randomly assigned to either the intervention condition or to a control condition. Secondary measures will assess diabetes knowledge, diet, objective/self-report physical activity, self-efficacy, stress, and social support.