Reducing Diabetes Risk for Rural Appalachian Grandparent Headed Households

降低阿巴拉契亚农村祖父母户主家庭的糖尿病风险

• 批准号: 8680457
• 负责人: Jennifer Hatcher
• 金额: $ 18.75万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8680457
• 关键词: Address; Adult; Advocacy; Affect; Age; American; Appalachian Region; Area; Asthma; Belief; Biological; Caregivers; Caring; Censuses; Centers for Disease Control and Prevention (U.S.); Child; Chronic Disease; Collaborations; Communities; Coronary heart disease; Country; Data; Development; Diabetes Mellitus; Emotional; Employment; Evidence based intervention; Family; Family health status; Family member; Food; Foundations; Goals; Head; Health; Health Services Accessibility; Health behavior; Health behavior outcomes; Household; Household Heads; Household and Family; Hypertension; Intervention; Interview; Kentucky; Life; Life Style; Literature; Measures; Medical; Mental Depression; Methods; Minority; Non-Insulin-Dependent Diabetes Mellitus; Phase; Physical activity; Physical environment; Population; Poverty; Predisposing Factor; Prevalence; Preventive; Public Health; Research; Risk; Risk Factors; Risk Reduction; Rural; Social Environment; Social Health Services; Socioeconomic Status; Stress; Substance abuse problem; Surveys; System; Testing; Vulnerable Populations; Work; base; design; diabetes control; diabetes risk; disability; experience; grandchild; grandparent; health disparity; informant; innovation; member; nutrition; peer; phase 2 study; prevent; public health relevance; rural area; sedentary; therapy design

DESCRIPTION (provided by applicant): Residents of rural Appalachian Kentucky suffer rates of type II diabetes mellitus (DM) that are among the highest and most rapidly increasing in the country. Members of grandparent headed households (GHH), one of the fastest growing family constellations in rural Appalachian Kentucky and the US, may be particularly vulnerable to health threats elevating their risk for DM. While the literature provides a starting point for the examination of this health disparity, little is known about the socioecological factors that influence the risk for DM among GHH. Given the increasing prevalence of GHH, their vulnerability to health threats, and the current lack of information about their DM risk factors, w propose to holistically examine the socio-ecological context of the health of GHH in rural Appalachian Kentucky in order to implement a culturally and contextually appropriate family intervention to reduce diabetes risk. We will conduct a two phase mixed methods study that culminates in a feasibility trial of such an intervention in rural Appalachian Kentucky. Phase I of the proposed study will utilize a simultaneous mixed methods design to assess socioecologic and biological risk of diabetes for GHH family members via surveys, biological measures, in-depth interviews with family members, key informants interviews, and a community assessment. Seventy families that are headed by a grandparent, have one or more family members at risk for diabetes, and include at least one grandchild ages 10 to 14 will be included in this phase of the study, with 20 of those families participating in the in-depth qualitative interviews. Phase II of he study will include selection and refinement of an appropriate intervention to reduce diabetes risk for the families. Based on phase I findings and existing literature we will select an evidence based intervention and refine it to be culturally and contextually appropriate for the rural Appalachian families that are the focus of this project, in collaboration with our strong network o community partners. Finally, we will test he feasibility and acceptability of the refined intervention with 10 GHH. The proposed study will serve as the foundation for interventions for families in other rural areas with notable diabetes disparities.

描述（由申请人提供）：阿巴拉契亚肯塔基州农村居民遭受II型糖尿病（DM）的率，该糖尿病是该国最高，最快增长的居民。祖父母头户（GHH）的成员是阿巴拉契亚肯塔基州农村地区发展最快的家庭星座之一，可能尤其容易受到健康威胁，从而提高了其DM风险。尽管文献为检查这种健康差异提供了一个起点，但对影响GHH中DM风险的社会生态因素知之甚少。鉴于GHH的患病率越来越高，它们对健康威胁的脆弱性以及目前缺乏有关其DM风险因素的信息，W建议整体研究Appalachian Kentucky GHH健康的社会生态环境，以便在文化上和上下文上实施适当的家庭干预措施以降低糖尿病的风险。我们将进行一项两期混合方法研究，该研究最终在阿巴拉契亚肯塔基州农村的这种干预措施中的可行性试验中达到高潮。第一阶段 拟议的研究将利用同时的混合方法设计来评估GHH家庭成员对糖尿病的社会生物学和生物学风险，通过调查，生物学措施，对家庭成员的深入访谈，主要的线人访谈和社区评估。由祖父母领导的七十个家庭，有一个或多个有糖尿病风险的家庭成员，其中至少有一个10至14岁的孙子将包括在这项研究的这一阶段，其中20个家庭参加了深入的定性访谈。 HE研究的第二阶段将包括选择和改进适当的干预措施，以降低家庭的糖尿病风险。根据第一阶段的发现和现有文献，我们将选择基于证据的干预措施，并在文化和上下文上适合于该项目的焦点的农村阿巴拉契亚家庭，并与我们强大的网络O社区合作伙伴合作。最后，我们将测试使用10 GHH的精制干预措施的可行性和可接受性。拟议的研究将为其他农村地区的家庭干预措施的基础。