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

居住在农村社区的西班牙裔人的糖尿病预防：基于移动网络的方法

• 批准号: 10458755
• 负责人: DEBRA RIOS
• 金额: $ 70.75万
• 依托单位: ISA ASSOCIATES, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-24 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10458755
• 关键词: Address; Adult; Affect; African American population; Age; Area; Attention; Behavior; Behavior Therapy; Benchmarking; Body Weight; Body Weight decreased; Car Phone; Cellular Phone; Communities; Community Actions; Consumption; County; Development; Diabetes Mellitus; Diabetes prevention; Diet; Diet Habits; Eating; Education; Effectiveness; Effectiveness of Interventions; End stage renal failure; Ethnic group; Exercise; Face; Fatty acid glycerol esters; Federally Qualified Health Center; Female; Glycosylated Hemoglobin; Glycosylated hemoglobin A; Guidelines; Health; Health behavior; Healthy Eating; High Fat Diet; Hispanic; Hispanic Populations; Individual; Internet; Intervention; Knowledge; Language; Latino Population; Link; Location; Longevity; Low income; Marketing; Measures; Medicaid; Minority Groups; Morbidity - disease rate; Motivation; Neighborhood Health Center; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Online Systems; Outcome; Overweight; Ownership; Participant; Patient Self-Report; Persons; Phase; Physical activity; Population; Populations at Risk; Prediabetes syndrome; Prevalence; Preventive; Public Health; Randomized; Randomized Controlled Trials; Reduce health disparities; Research; Resources; Risk; Risk Behaviors; Risk Factors; Rural Community; Rural Health Centers; Self Efficacy; Services; Social Network; Social support; South Texas; Stress; Test Result; Text Messaging; Time; Underserved Population; Videoconferencing; Weight; Weight Gain; base; caucasian American; community organizations; cost; cost effective; design; diabetes prevention program; diabetes risk; diabetes self-management; digital; effectiveness testing; ethnic minority; evidence base; experience; field study; group intervention; handheld mobile device; health disparity; high risk; improved; mHealth; metropolitan; mortality; online version; physical conditioning; physical inactivity; post intervention; prevent; preventive intervention; programs; prototype; racial and ethnic; rural Hispanic; rural area; saturated fat; service organization; skills; social cognitive theory; success; sugar; sweetened beverage; theories; treatment as usual

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.

项目摘要/摘要 美国的西班牙裔人受2型糖尿病（T2D）风险，患病率和 结果。一半以上的拉丁裔会在其一生中患糖尿病，死于50％的可能性 与非西班牙裔白人相比。消费高脂饮食，体育锻炼不足和存在 超重/肥胖都与T2D有关。与此一致，西班牙裔更有可能参与 这些风险行为，超重/肥胖。幸运的是，体重相对适量的减轻 显着降低了发展T2D的风险。具有里程碑意义的糖尿病预防计划（DPP）显然 证明了这一点。接受DPP的参与者将体重减少了5-7％。另外，有几个 在种族/族裔人群中，适应已被证明是成功的。 但是，仍然存在差距。乡村西班牙裔成年人经历与糖尿病有关的健康状况更糟 差异，与糖尿病的自我管理和支持计划相比，不太可能获得 他们的同行居住在大都市县。此外，乡村西班牙裔面孔可强大的通道和 资源障碍。采用面对面的糖尿病预防计划不足以满足这种高风险 人口。但是，拉丁美洲人拥有智能手机和农村西班牙裔的拥有率很高 从移动设备上的互联网比高加索人和非洲裔美国人都高。因此，利用一个 基于移动的，基于网络的方法是针对高风险社区的值得称赞的手段。 这将是第一个同时定制DPP的MHealth糖尿病预防计划 优先人群：西班牙裔和居住在农村社区的人。这种循证和理论驱动 干预将为农村西班牙裔提供知识，技能和自我效能，以改善健康 行为并降低糖尿病风险。用户将通过 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 给他们手机的短信，可以访问现场计划教练以获得更多的帮助和动力。 在第一阶段，开发了一个原型步骤，该步骤由与 53个终生的西班牙裔农村成年人。第一阶段的结果强烈支持可行性和潜力 干预的有效性，远远超过了第一阶段提案中建立的基准。 在第二阶段，我们将完成针对西班牙裔农村成年人的步骤计划的开发。在 与南德克萨斯州社区行动公司的合作伙伴关系，我们将研究 通过增加体育锻炼并改善整体饮食习惯来减轻体重的步骤干预。 参与者将被随机分配到干预条件或控制条件。次要 措施将评估糖尿病知识，饮食，客观/自我报告体育锻炼，自我效能感，压力和 社会支持。