Diabetes Prevention Culturally Tailored for Mexican Americans

为墨西哥裔美国人量身定制的糖尿病预防文化

• 批准号: 9310918
• 负责人: SHARON A BROWN
• 金额: $ 62.82万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-04-15 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9310918
• 关键词: Acculturation; Address; Adherence; Adopted; Adverse effects; Area; Behavior; Behavior Therapy; Behavioral; Blood Pressure; Candidate Disease Gene; Caring; Clinical; Communities; Community Health Aides; Control Groups; County; Death Rate; Diabetes Mellitus; Diabetes prevention; Diagnosis; Dietary intake; Dietitian; Eating; Education; Educational Intervention; Effectiveness; Effectiveness of Interventions; Enrollment; Ethnic group; Family member; Focus Groups; Food; Genetic Variation; Genetic study; Growth; Guidelines; Health; Health Services Accessibility; Health behavior; Healthy Eating; Hispanics; Hour; Hypertension; Impaired fasting glycaemia; Individual; Intervention; Laboratories; Left Ventricular Hypertrophy; Life Style; Lipids; Maintenance; Measures; Medical; Mexican Americans; Mexico; Minority; Modeling; Monitor; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Nurses; OGTT; Obesity; Outcome; Participant; Pharmaceutical Preparations; Pharmacology; Physical activity; Physicians; Pollution; Population; Population Programs; Poverty; Prediabetes syndrome; Prevalence; Preventive Intervention; Primary Prevention; Problem Solving; Public Health; Randomized; Resources; Rest; Risk; Rural; Self Management; Side; Sleep Apnea Syndromes; Support Groups; Testing; Texas; Time; Translational Research; Unemployment; Ursidae Family; arm; authority; base; bilingualism; blood glucose regulation; cost; demographics; deprivation; design; diabetes management; diabetes prevention program; diabetes risk; diabetic; endothelial dysfunction; exome sequencing; good diet; health belief; healthy lifestyle; high risk; impaired glucose tolerance; improved; improved outcome; innovation; intervention effect; lifestyle intervention; medically underserved; motivational enhancement therapy; multilevel analysis; non-diabetic; prevent; programs; response; success; treatment as usual; urban area; waist circumference; whole genome

ABSTRACT Starr County is a poor Texas-Mexico border community that is 98% Mexican American and has the highest diabetes-related death rate in Texas. In previous Starr County studies, we tested interventions culturally tailored for Spanish-speaking Mexican Americans diagnosed with type 2 diabetes (T2DM). Each study participant was supported by a family member who also received program benefits; 70% of these supporters did not have diabetes. Compared to the control group, fewer non-diabetic supporters in the experimental group converted to diabetes by 12 months post study entry. The primary purpose of the proposed study is to test the effectiveness of our culturally tailored DSME intervention that will be adapted for preventing, or at least delaying, diabetes onset in Mexican Americans with prediabetes. The intervention will involve: 1) 12 2- hour weekly group educational sessions that emphasize eating and preparing healthy Mexican-American foods and increasing physical activity; 2) 15 2-hour bi-weekly/monthly support group sessions on problem solving the barriers to adopting healthier lifestyles; and 3) 3 booster sessions held at 6-month intervals. We will integrate aspects of the Diabetes Prevention Program, as well as motivational interviewing, and prior to intervention testing, we will conduct focus groups with key individuals in Starr County to confirm the strategy and obtain community support. Intervention effectiveness will be examined using a randomized, repeated measures, pretest/posttest control group design, with an “enhanced” usual care control group. We will enroll 300 Mexican Americans with verified prediabetes from rosters of ongoing Starr County genetic studies. Groups of 10 will be constituted according to the area of the county in which people live; each group will be randomly assigned to experimental or control conditions. Growth curve analysis, using multilevel models, will be used to compare intervention effects on health outcomes over time. We hypothesize that participants in the experimental group, compared to the control group, will have better health outcomes (A1C, FBG, lipids, BP, physical activity, dietary intake, and anthropometric variables [BMI, waist circumference]) at 3, 6, 12, 24, and 36 months post baseline, as well as lower rates of converting to T2DM (OGTT) by 36 months. This study is a significant step in our plan to develop effective culturally tailored health programs for populations at high risk for T2DM.

抽象的 斯塔尔县（Starr County）是一个贫穷的德克萨斯 - 墨西哥边境社区，墨西哥裔美国人98％，拥有最高 德克萨斯州与糖尿病有关的死亡率。在以前的斯塔尔县研究中，我们在文化上测试了干预措施 专为讲西班牙语的墨西哥裔美国人量身定制，被诊断出患有2型糖尿病（T2DM）。每个研究 参与得到了一位获得计划福利的家庭成员的支持；这些支持者中有70％ 没有糖尿病。与对照组相比，实验中的非糖尿病支持者较少 研究入门后12个月，小组转化为糖尿病。拟议研究的主要目的是 测试我们的文化量身定制的DSME干​​预措施的有效性，该干预措施将用于预防或 墨西哥裔美国人的糖尿病发作最少，患有糖尿病前期。干预措施将涉及：1）12 2- 每周一次的小组教育课程，强调饮食和准备健康的墨西哥裔美国人 食物和增加体育锻炼； 2）15 2小时每两周/每月的支持小组会议问题 解决采用健康生活方式的障碍； 3）3个助推器会议以6个月的间隔举行。我们 将整合糖尿病预防计划的各个方面，以及动机面试，然后 干预测试，我们将与斯塔尔县的关键个人进行焦点小组以确认该战略 并获得社区支持。将使用随机重复进行干预效果 措施，预测试对照组设计，具有“增强”的常规​​护理对照组。我们将注册 300名来自正在进行的Starr县基因研究的名册中验证前糖尿病的墨西哥裔美国人。 10人将根据人们居住的县地区组成；每个小组将是 随机分配给实验或对照条件。使用多级模型的增长曲线分析将 随着时间的流逝，用于比较干预对健康结果的影响。我们假设参与者 与对照组相比，实验组将具有更好的健康结果（A1C，FBG，脂质，， BP，体育锻炼，饮食摄入和人体测量变量[BMI，腰围]）在3、6、12、24， 基线后36个月，以及较低的转换为T2DM（OGTT）36个月。这项研究 是我们计划开发有效的文化量身定制的健康计划的重要一步 T2DM的风险。