A Culturally Tailored LIfestyle Intervention to Prevent Diabetes in South Asians:

针对南亚人预防糖尿病的文化定制生活方式干预措施：

• 批准号: 7660005
• 负责人: Kabayam M Venkat Narayan
• 金额: $ 23.25万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-08 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7660005
• 关键词: Address; Adherence; Age; American; Applications Grants; Bangladesh; Behavior; Bhutan; Blood Pressure; Body Weight; Body Weight decreased; Body fat; Body mass index; Caloric Restriction; Communities; Counseling; Coupled; Dancing; Data; Development; Diabetes Mellitus; Diabetes prevention; Diet; Dietary Practices; Disease; Drops; Educational Curriculum; Effectiveness; Enrollment; Ensure; Ethnic group; Evaluation; Exercise; Fat Body; Focus Groups; Food; Gender; General Population; Glucose; Goals; Hip region structure; Home environment; Hour; Hypertriglyceridemia; Immigrant; India; Indigenous; Individual; Insulin Resistance; Intervention; Life; Life Style; Lipids; Maintenance; Maldives; Measures; Metabolic; Metabolic Diseases; Modeling; Music; National Institute of Diabetes and Digestive and Kidney Diseases; Nepal; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Pakistan; Participant; Perception; Physical activity; Pilot Projects; Plasma; Population; Population Heterogeneity; Population Study; Prediabetes syndrome; Prevention; Prevention strategy; Program Acceptability; Protocols documentation; Public Health; Qualitative Evaluations; Qualitative Research; Race; Randomized; Randomized Controlled Trials; Records; Recruitment Activity; Reporting; Research; Research Methodology; Research Proposals; Resources; Risk; Risk Factors; Shapes; Skeleton; South Asian; Sri Lanka; Structure; Subgroup; Support Groups; Symptoms; System; Telephone Interviews; Testing; Translating; Translational Research; Translations; United States; Upper arm; Walking; Weight; Woman; Yoga; age group; base; behavior change; community living; cost; design; diabetes prevention program; diet and exercise; disorder risk; experience; fasting glucose; fasting plasma glucose; flexibility; follow-up; high risk; improved; instructor; interest; intervention program; lifestyle intervention; men; metropolitan; nutrition; peer; portion control; post intervention; prevent; primary outcome; programs; public health relevance; secondary outcome; therapy design

DESCRIPTION (provided by applicant): South Asians, a rapidly growing segment of the US population, have significantly higher rates of Type 2 Diabetes Mellitus (T2DM), get T2DM at younger ages, and do worse health-wise once they have T2DM than the general population. Lifestyle interventions effectively prevent T2DM in high-risk populations; there is a need for culturally appropriate, lifestyle interventions to prevent diabetes in the South Asian community. This pilot study aims to: (1) Develop a culturally appropriate lifestyle intervention for South Asians with sensitivity to socio-cultural norms in the South Asian community. The design of the intervention will be developed based on the results of focus group discussions. This proposal describes a preliminary, skeleton lifestyle intervention based on the Diabetes Prevention Program (DPP) lifestyle protocol and including: (a) An exercise intervention component, designed to increase program flexibility and acceptability, which includes both in-class group exercise sessions and at-home exercise using a DVD. Both the exercise classes and the DVD include exercises based on culturally appropriate activities, including traditional folk dances, yoga, and walking, and use South Asian music and instructors. (b) Lifestyle classes will be based on the curricula developed for the DPP, but modified to focus on nutrition information and foods that are pertinent to this population, with a focus on modifying the South Asian diet for weight loss, portion control, and making healthy food choices. (c) Peer support groups will be formed to increase acceptability of and adherence to the program. The intervention will be designed to be low-cost and sustainable. (2) Implement the culturally specific lifestyle intervention in the South Asian community as a randomized controlled pilot study. Sixty South Asian men and women, aged 25 years or more, with prediabetes and a BMI of 22 kg/m2 will be randomized to receive either the intensive lifestyle program or standard lifestyle advice (30 individuals per group). The intervention will last for 16 weeks, followed by an 8-week less intense, maintenance period, and three months of follow-up. (3) Evaluate the intervention. The primary outcome will be change in body weight, with the study participants counseled to lose 7% body weight and maintain the weight loss over the course of the study. Secondary outcomes are changes in percent body fat, body mass index, waist-to-hip ratio, fasting glucose, blood pressure, plasma lipids, activity, and diet. The acceptability of the program to the participants will be assessed in focus group discussions. Final results of the study will be used to develop a larger, definitive study of a culturally appropriate, lifestyle intervention for the prevention of T2DM in the South Asian population to be submitted as a R18 grant proposal. PUBLIC HEALTH RELEVANCE: The South Asian Community, people with origins in India, Pakistan, Bangladesh, Maldives, Nepal, Sri Lanka, or Bhutan, are more likely to get diabetes, get diabetes at younger ages, and do worse health-wise once they have diabetes than the general population. This R34 proposal describes the development, implementation, and evaluation of a culturally appropriate lifestyle intervention for the prevention of diabetes in the South Asian community. The outcomes of this project could be used to plan larger interventions to prevent diabetes in South Asians, a rapidly growing segment of the US population.

描述（由申请人提供）： 南亚人是美国人口中迅速增长的部分，其2型糖尿病（T2DM）的发生率明显高得多，年轻时就获得T2DM，并且一旦T2DM的健康状况比一般人群更差。生活方式干预有效地防止了高危人群中的T2DM；有必要采取适当的生活方式干预措施，以防止南亚社区的糖尿病。这项试点研究的目的是：（1）对南亚人对南亚社区的社会文化规范敏感的南亚人开发适合文化的生活方式干预措施。干预措施的设计将根据焦点小组讨论的结果制定。该提案描述了基于糖尿病预防计划（DPP）生活方式方案的初步，骨架生活方式干预措施，包括：（a）锻炼干预组件，旨在提高计划的灵活性和可接受性，其中包括班级小组锻炼课程和使用DVD进行家庭运动。运动课和DVD都包括基于文化上适当的活动，包括传统的民间舞蹈，瑜伽和步行，并使用南亚音乐和教练。 （b）生活方式课程将基于为DPP开发的课程，但经过修改，以关注与该人群有关的营养信息和食物，重点是修改南亚饮食以减轻体重，份量控制和做出健康食品选择。 （c）将成立同伴支持小组，以提高对计划的可接受性和遵守性。干预措施将设计为低成本和可持续性。 （2）作为一项随机对照的试点研究，在南亚社区实施文化特定的生活方式干预措施。 60岁的南亚男女，年龄在25岁以上，糖尿病前期和22公斤/m2的BMI将被随机地接受密集的生活方式计划或标准生活方式建议（每组30个人）。干预措施将持续16周，然后进行为期8周的严格，维护期和三个月的随访。 （3）评估干预措施。主要结果将是体重的变化，研究参与者建议在整个研究过程中减轻7％的体重并保持体重减轻。次要结果是体内脂肪百分比，体重指数，腰围比，禁食葡萄糖，血压，血浆脂质，活性和饮食的变化。该计划对参与者的可接受性将在焦点小组讨论中进行评估。该研究的最终结果将用于制定一项更大的，确定的研究，以针对预防南亚人口的T2DM进行文化适当的生活方式干预，以作为R18赠款提案提交。 公共卫生相关性：南亚社区，起源于印度，巴基斯坦，孟加拉国，马尔代夫，尼泊尔，斯里兰卡或不丹的人，更有可能患上糖尿病，年轻时患糖尿病，并且一旦患有糖尿病的人就会比一般人群更糟糕。该R34提案描述了对预防南亚社区糖尿病的文化生活方式干预的发展，实施和评估。该项目的结果可用于计划更大的干预措施，以防止南亚人的糖尿病，这是美国人口中迅速增长的一部分。