Family-Based, Culturally-Centered Diabetes Intervention with Ojibwe Communities

项目摘要/摘要 对于许多美国印第安人(AI)社区来说，2型糖尿病是一个显著的健康差距。这样做的目的是 竞争更新研究是为了增强、实施和评估文化定制的、 代际糖尿病管理和预防干预，《共同论糖尿病》。该计划 促进家庭和文化习俗，鼓励健康饮食和体育活动，促进压力- 应对资源和反应，并通过人工智能教授的基于家庭的干预重新联系家庭 准职业家庭健康教练。建议的以社区为基础的参与性研究将参加 被诊断为2型糖尿病的成年照顾者及其10-16岁的孩子，目标是 利用两代人之间的激励互惠。这项工作建立在一项现有研究的基础上 与中西部的五个奥吉布韦部落社区合作，实施随机对照研究(N =280个家庭)，轮候名单的设计尊重包容的文化规范。这项研究将评估 干预对成人生理(主要结局为HbA1c)、行为和心理的影响 健康和儿童的心理社会、家庭、行为和生理风险和保护因素 糖尿病。这项研究还将确定调节干预影响的压力应对机制 关于健康。一种新的协作、定性评估技术将绘制出 家庭和社区内部的干预。如果有效，干预将促进传播和 通过部落卫生教练、社区参与和利益相关者(卫生服务提供者、卫生和 人类服务机构)投入。

Project Summary/Abstract Type 2 diabetes is a significant health disparity for many American Indian (AI) communities. The goal of this competitive renewal research is to enhance, implement, and evaluate the effectiveness of a culturally tailored, intergenerational diabetes management and prevention intervention, “Together on Diabetes.” The program activates family and cultural practices that encourage healthy diets and physical activities, promote stress- coping resources and responses, and reconnect families via a home-based intervention taught by AI paraprofessional Family Health Coaches. The proposed Community Based Participatory Research will enroll “target” adult caregivers diagnosed with type 2 diabetes and their children, ages 10-16 years, with the goal of tapping into motivational reciprocity between the two generations. The work builds on an existing research collaboration with five Ojibwe tribal communities in the Midwest to implement a randomized controlled study (N = 280 families) with a wait-list design respectful of cultural norms of inclusion. The study will evaluate effectiveness of the intervention on adult physiological (primary outcome = HbA1c), behavioral, and mental health and children's psychosocial, familial, behavioral and physiological risk and protective factors for diabetes. The research will also identify stress-coping mechanisms that mediate the impact of the intervention on health. A novel collaborative, qualitative evaluation technique will map potential “ripple effects” of the intervention within families and communities. If effective, the intervention will promote dissemination and scaling with tribal health coaches, community involvement, and stakeholder (health providers, health and human service agencies) input.