CHD Lifestyle Modification for Latinas with Diabetes

拉丁裔糖尿病患者的冠心病生活方式改变

• 批准号: 6895068
• 负责人: DEBORAH J TOOBERT
• 金额: $ 77.08万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-25 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6895068
• 关键词: Hispanic Americans; behavior therapy; behavioral /social science research tag; body physical activity; cardiovascular disorder risk; clinical research; clinical trials; coronary disorder; diet; female; health behavior; health care service; health economics; high risk behavior /lifestyle; human subject; human therapy evaluation; interview; medically underserved population; noninsulin dependent diabetes mellitus; patient oriented research; postmenopause; smoking cessation; social support network; stress management; therapy design /development; women' s health

The primary goal of this project is to extend a promising lifestyle change program to an underserved population at high risk for coronary heart disease (CHD). Hispanic Americans, the fastest growing ethnic population in the US, and in particular postmenopausal Hispanic women (Latinas), have an increased prevalence of type 2 diabetes, and a greater incidence of diabetes complications than non-Hispanic Whites. The proposed study, the Latina Lifestyle Program (LLP), will comprehensively evaluate a multiple-risk-factor intervention (diet, physical activity, stress management, social support, and smoking cessation) in a randomized effectiveness trial and will be offered in English and in Spanish. Our research team has shown that this theory-based comprehensive lifestyle change program is effective in improving behavioral, psychosocial, quality of life, and biologic outcomes among heterogeneous postmenopausal Anglo women with type 2 diabetes. Though the results to date are promising, four important research issues must be addressed before such a program is ready for translation to practice. This proposal focuses on these questions'. (1) How should the structure and content of the program be modified to address the cultural characteristics of Latinas? (2) Will the program succeed if offered in a large health plan serving minority populations (i.e., Kaiser Permanente in Denver, CO)? (3) What are the economic implications of the LLP? (4) How generalizable are the program effects across participants, intervention staff, settings and time? The RE-AIM evaluation framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) will be used to assess the impact of this program, when conducted by regular health plan staff, on dimensions important for translation to practice. Primary outcomes will include change on behavioral measures of healthful eating and physical activity; secondary outcomes will include impacts on quality of life, physiologic measures, member satisfaction, and cost-effectiveness. We also will study the relations between cultural variables in Latinas (e.g., family and social support; acculturation) and program participation and outcomes. Substantial public health impacts of this study include (1) intervening with a high-risk, underserved population, (2) the focus on multiple, critically important lifestyle behaviors known to reduce risk for CHD, (3) a test of maintenance of behavioral changes, (4) the methodology employed to estimate the program's readiness for translation, and (5) measuring the robustness, reach, and cost-effectiveness of the program. The program results, materials, and lessons learned will be disseminated via multiple avenues.

该项目的主要目标是将有希望的生活方式改变计划扩展到服务不足的冠心病风险不足的人群（CHD）。西班牙裔美国人，是美国增长最快的族裔，尤其是绝经后西班牙裔妇女（拉丁裔），比非中丙基白人的患病率更高，糖尿病的患病率更高，糖尿病并发症的发生率更高。拟议的研究是拉丁裔生活方式计划（LLP），将在一项随机有效性试验中全面评估多风险因素干预（饮食，体育锻炼，压力管理，社会支持和戒烟），并将在英语和西班牙语中提供。我们的研究团队表明，这项基于理论的综合生活方式改变计划有效地改善了两种糖尿病的绝经后盎格鲁妇女的行为，社会心理，生活质量和生物学结果。尽管迄今为止的结果是有希望的，但是在准备翻译以进行翻译练习之前，必须解决四个重要的研究问题。该提案重点是这些问题。 （1）如何修改程序的结构和内容以解决拉丁裔的文化特征？ （2）如果在为少数民族人口（即丹佛市的Kaiser Permanente）提供的大型健康计划中提供该计划，该计划是否会成功？ （3）LLP的经济影响是什么？ （4）计划对参与者，干预人员，设置和时间的效果有多普遍？ Re-AIM评估框架（涉及，有效性，采用，实施和维护）将用于评估该计划的影响，并在常规卫生计划人员进行时，对对练习的翻译至关重要。主要结果将包括改变健康饮食和体育锻炼的行为度量；次要结果将包括对生活质量，生理指标，成员满意度和成本效益的影响。我们还将研究拉丁裔（例如家庭和社会支持；适应）与计划参与和结果之间的文化变量之间的关系。这项研究的实质性公共卫生影响包括（1）介入高风险，服务不足的人群，（2）关注多种，至关重要的重要生活方式行为已知可降低CHD风险的已知行为，（3）维持行为变化的测试，（4）用于估算平移和（5）估算的计划的方法，以衡量稳健性和成本效果，并衡量成本，并效果，并效果效率，效果，效果，效率，效率。课程的结果，材料和经验教训将通过多种途径传播。