Preventing diabetes & its complications: The contribution of traditional healing

预防糖尿病

• 批准号: 7314891
• 负责人: Spero Mansion
• 金额: $ 18.14万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7314891
• 关键词: Accounting; Address; Alaska Native; American Indians; Aortic Diseases; Area; Aspirin; Attitude; Behavior; Belief; Blood Pressure; Body Weight decreased; Cardiovascular Diseases; Caring; Cause of Death; Cerebrum; Characteristics; Cholesterol; Clinical; Cohort Studies; Communities; Complementary and alternative medicine; Complications of Diabetes Mellitus; Congresses; Coronary Arteriosclerosis; Data; Data Collection; Data Element; Data Quality; Data Sources; Diabetes Mellitus; Diabetes prevention; Diet; Effectiveness; Effectiveness of Interventions; Electronic Health Record; Elements; Enrollment; Epidemic; Ethnic group; Evaluation; Event; Exercise; Face Processing; Family; Family member; Fatty acid glycerol esters; Funding; Future; General Population; Grant; Healed; Health; Health system; Heart; Housing; Incidence; Individual; Intervention; Interview; Knowledge; Learning; Life Style; Link; Lipids; Literature; Measurement; Measures; Medical; Medical Records; Metformin; Methods; Minority Groups; Modeling; Modification; Nature; Non-Insulin-Dependent Diabetes Mellitus; Numbers; Outcome; Outcome Measure; Paper; Participant; Peripheral Vascular Diseases; Pharmaceutical Preparations; Physical activity; Population; Prediabetes syndrome; Prevalence; Primary Prevention; Process; Program Development; Program Evaluation; Provider; Public Health; Purpose; Questionnaires; Randomized Clinical Trials; Rate; Recruitment Activity; Reporting; Research; Research Project Grants; Respondent; Risk; Risk Factors; Risk Reduction; Screening procedure; Services; Severities; Site; Smoking; Standards of Weights and Measures; Technology; Testing; Thinking; Time; United States Indian Health Service; United States National Institutes of Health; Vascular Diseases; Weight; base; blood pressure regulation; cardiovascular disorder risk; design; diabetes prevention program; diabetes risk; disorder risk; experience; falls; glycemic control; healing; impaired glucose tolerance; improved; prevent; programs; racial and ethnic; smoking cessation

diabetes in this population is on average 2-3 times greater than the U.S. population. AI/ANs also experience higher rates of complications due to diabetes; it is no surprise, then, that cardiovascular disease is the number one cause of death for this group. As demonstrated by the NIDDK-sponsored Diabetes Prevention Program, the risk of developing diabetes can be reduced dramatically in at-risk individuals through lifestyle changes and medication. Likewise, the risk of cardiovascular disease in individuals with diabetes can be reduced through control of blood pressure, reduction in cholesterol levels, glycemic control, aspirin use, smoking cessation, physical activity, and weight management. Given the epidemic proportion of diabetes in AI/AN communities, in 2004 Congress funded a large, 5-year demonstration project to prevent diabetes and its complications among AI/ANs by extending these intervention technologies to them. The accompanying mandate called for rigorous evaluation of the processes and outcomes. 66 AI/AN communities subsequently were funded to participate in this effort, which has become known as the Special Diabetes Program for Indians' Competitive Grant Program. The AIANP at the UCHDSC serves as the Coordinating Center, responsible for both program development and evaluation. During the 1st year, the Coordinating Center, grantees, and IMS Division of Diabetes Prevention and Treatment jointly designed a comprehensive, longitudinal, multi-level approach to assessing both intervention process and outcomes. The design gathers relevant data at strategic points in time (pre- and multiple post-tests) from the individual participant, a key family member, a provider, the organization housing the grantee program, and community stakeholders. Each Diabetes Prevention grantee program (n=36) is required to enrolling 48 new participants per year for 3 years, totaling 5,184 unique individuals; each Healthy Heart grantee program (n=30) is required to enrolling 50 new participants per year for 3 years, totaling 4,500 unique individuals. Despite the comprehensive nature of the evaluation, the collaborative planning process faced a difficult challenge in selecting from among many factors grantees, IHS staff, and the Coordinating Center felt might account for successful intervention outcomes. The assessment of traditional healing and its contribution to preventing diabetes and complications such as cardiovascular disease fell victim to this process. Grantees' subsequent experience during the first year of implementation has assured them that respondent burdens are not as great as they initially had assumed, allowing for additional measures. Thus, we propose to incorporate a reliable, well established measure of traditional healing into the baseline assessment of the individual participants..

该人群中的糖尿病平均比美国人口高2-3倍。 AI/ANS也经历 糖尿病引起的并发症发生率更高；那么，心血管疾病是 该组的死因第一。正如NIDDK赞助的预防糖尿病所证明的 程序，可以通过生活方式在高危个人中大大降低患糖尿病的风险 变化和药物。同样，患有糖尿病患者心血管疾病的风险也可以 通过控制血压，胆固醇水平降低，血糖控制，使用阿司匹林的使用，减少 戒烟，体育锻炼和体重管理。 鉴于AI/A/A社区中糖尿病的流行比例，2004年国会资助了一项大型，5年 通过将其扩展为预防AI/ANS中糖尿病及其并发症的演示项目 干预技术。随附的授权要求对 过程和结果。 66 AI/A A社区随后被资助参加这项工作，这是 已被称为印第安人竞争赠款计划的特殊糖尿病计划。 Aianp at UCHDSC是负责计划开发和评估的协调中心。 在第一年，糖尿病预防糖尿病和IMS的协调中心和IMS 治疗共同设计了一种全面，纵向的多层次方法来评估两者 干预过程和结果。该设计收集了战略时间点的相关数据（前和 多次测试）来自个人参与者，关键家庭成员，提供商，组织住房 受赠人计划和社区利益相关者。每个糖尿病预防受赠人计划（n = 36）是 需要每年3年招募48名新参与者，总计5,184个独特的人；每个健康 需要每年3年的50名新参与者，需要4,500 独特的人。 尽管评估具有全面的性质，但协作计划过程仍面临困难 从许多因素中选择受赠人，IHS员工和协调中心的挑战认为可能 说明成功的干预结果。评估传统康复及其对 防止糖尿病和并发症（例如心血管疾病）成为这一过程的受害者。受赠人的 在实施的第一年，随后的经验向他们保证了受访者负担 不像最初假设的那样大，可以采取其他措施。因此，我们建议 将传统康复的可靠，完善的衡量标准纳入基线评估 个人参与者