Translating Research into Prevention of Diabetes (TRIP Diabetes)

将研究转化为糖尿病预防（TRIP 糖尿病）

基本信息

批准号：
7663186
负责人：
DAVID C GOFF
金额：
$ 59.23万
依托单位：
WAKE FOREST UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-09-15 至 2010-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7663186
关键词：
Address Affect Age Area Behavior Therapy Behavioral Body Weight decreased Cardiovascular system Caring Characteristics Chronic Disease Clinical Trials Collaborations Communities Community Practice Development Diabetes Mellitus Diabetes prevention Diet Dietary intake Early treatment Eating Educational Intervention Effectiveness Effectiveness of Interventions Epidemic Ethnic Origin Ethnic group Gender Glucose Goals HDL-triglyceride Health Health Benefit Health Policy Health Promotion Home environment Human Human Resources Hypertension Incidence Individual Insulin Intervention Knowledge Life Style Maintenance Mediating Metabolic Metabolic syndrome Metabolism Methods Modeling Monitor Non-Insulin-Dependent Diabetes Mellitus OGTT Obesity Outcome Participant Patients Pattern Persons Phase Physical activity Populations at Risk Prediabetes syndrome Prevention Prevention Research Primary Health Care Professional counselor Public Health Published Comment Quality of Care Randomized Controlled Clinical Trials Research Research Personnel Resource Allocation Resources Role Safety Serious Adverse Event Services Site Societies Standardization Testing Training Translating Translations Underrepresented Minority Upper arm Weight Weights and Measures Work base behavior change cancer prevention case finding case-based community setting cost cost effectiveness diabetes education diabetes prevention program diabetes risk economic evaluation empowered fasting glucose health disparity health related quality of life improved innovation intervention effect lifestyle intervention nutrition primary outcome programs secondary outcome social social cognitive theory tool waist circumference

项目摘要

DESCRIPTION (provided by applicant): While trials such as the Diabetes Prevention Program have demonstrated a significant potential for the prevention of type 2 diabetes mellitus (DM) through lifestyle interventions, a critical knowledge gap is whether such approaches can be implemented in the community. Our goal is to translate DM prevention research into community practice via key translations that have been pilot-tested to enhance logistical and fiscal feasibility and dissemination including 1) finding prediabetes cases based on adiposity and fasting glucose, 2) the use of a group-based lifestyle intervention employing professional and lay health counselors (LHCs) aided by standardized informational videos and other tools, and 3) delivery of the intervention in the community setting via innovative expansion of an existing diabetes education program collaborating with LHCs as empowered community partners. We propose a 480-participant randomized trial to test the hypothesis that a lifestyle intervention administered through a community-based diabetes prevention program will have a beneficial and clinically meaningful impact on: fasting glucose (primary outcome), physical activity, dietary intake, weight, and waist circumference (secondary outcomes), and other tertiary outcomes. An economic evaluation will be conducted to determine cost effectiveness. One trial arm will consist of a group-based intensive lifestyle intervention promoting healthy eating, increased physical activity and modest, yet achievable (5-7%) weight loss delivered in an early 6-month intensive phase followed by an 18-month maintenance phase. LHCs will be utilized in the intensive intervention arm. The control arm will consist of an individual educational intervention that incorporates existing community resources that are available to assist residents in making healthier lifestyle choices. We have revised our plan based on the reviewers' comments and the results of our pilot work. We have described our organizational plan in greater detail and increased our resource allocation for training, monitoring and supporting the LHCs in their roles. We have developed drafts of intervention tools, including videos, that will enhance standardization of intervention delivery and subsequent dissemination. We have piloted our proposed methods of LHC recruitment and training, and participant recruitment, assessment and early intervention. We have improved the description of our analytic plan. We are confident we can conduct this important translational project. If the intensive intervention approach is cost-effective, this model could be disseminated to the thousands of U.S. communities with diabetes education programs. Many chronic diseases are influenced by activity and diet. Our lifestyle intervention, if successful, should translate into public health benefits in areas other than type 2 DM, such as obesity, hypertension, cardiovascular health and cancer prevention, thus greatly multiplying the potential benefits for society.

描述（由申请人提供）：虽然诸如预防糖尿病计划之类的试验证明了通过生活方式干预措施预防2型糖尿病（DM）具有巨大的潜力，但关键的知识差距是是否可以在社区中实施这种方法。我们的目标是通过经过试点测试的主要翻译将DM预防研究转化为社区实践，以增强后勤和财政的可行性和传播，包括1）基于肥胖和禁食性葡萄糖，找到糖尿病前期案例，2）使用群体的生活方式干预措施，通过雇用专业和外行的顾问（LHCS）的工具，并通过标准化的工具进行了互助的工具，并通过标准化的工具进行了互助的工具，并实现了30个工具的设置，并实现了式的工具，并实现了有性的工具，并实现了工具，并使用有性的工具，并使用有性的工具进行了工具，并使用了工具的工具，并使用有性的工具，并使用该工具进行了工具，并使用了工具的工具，并使用该工具的工具，并使用该工具进行了工具，并将其设置为有性化的工具，并使用该工具进行介绍。现有的糖尿病教育计划的创新扩展与LHC作为授权社区合作伙伴合作。我们提出了一项480个参与者的随机试验，以检验以下假设：通过基于社区的糖尿病预防计划进行的生活方式干预措施将对：禁食葡萄糖（主要结果），体育活动，饮食，体重和腰围和腰围（次要的cormenters）和其他遗产对：禁食葡萄糖（主要结果），临床有意义。将进行经济评估以确定成本效益。一个试验部门将包括一个基于团体的强化生活方式干预措施，促进健康饮食，增加体育锻炼和适度但可实现的（5-7％）的体重减轻，以6个月的早期强化阶段进行，然后是18个月的维护阶段。 LHC将用于密集干预部门。控制部门将包括一个个人的教育干预措施，该干预措施结合了现有的社区资源，可帮助居民做出更健康的生活方式选择。我们根据审阅者的评论和试点工作的结果进行了修改。我们已经更详细地描述了我们的组织计划，并增加了我们的资源分配，以培训，监视和支持LHC的角色。我们已经开发了包括视频在内的干预工具草案，以增强干预交付和随后的传播标准化。我们已经试行了提议的LHC招聘和培训方法，以及参与者招聘，评估和早期干预。我们改善了分析计划的描述。我们有信心我们可以进行这个重要的翻译项目。如果强化干预方法具有成本效益，则可以将这种模型传播给成千上万的具有糖尿病教育计划的美国社区。许多慢性疾病受活动和饮食的影响。如果成功的话，我们的生活方式干预应转化为2型DM以外的其他领域，例如肥胖，高血压，心血管健康和预防癌症，从而极大地增加了对社会的潜在利益。