An Adolescent-mediated intervention to improve diabetes prevention and management in Pacific Islander Families

以青少年为媒介的干预措施，以改善太平洋岛民家庭的糖尿病预防和管理

• 批准号: 10713399
• 负责人: Nicola Hawley
• 金额: $ 6.17万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-20 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10713399
• 关键词: Active Learning; Address; Adolescent; Adoption; Adult; American Samoa; Behavior; Blood Pressure; Body mass index; Caring; Chronic Disease; Communication; Diabetes Mellitus; Diabetes prevention; Diagnosis; Educational Curriculum; Exposure to; Face; Family; Family member; Future; Glycosylated hemoglobin A; Goals; Household; Individual; Intervention; Knowledge; Leadership; Life; Maintenance; Measures; Mediating; Minority Groups; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Pacific Islander; Parents; Participant; Phase; Prediabetes syndrome; Prevention; Primary Care; Program Acceptability; Randomized; Randomized, Controlled Trials; Research; Research Personnel; Research Training; Resources; Risk; Risk Factors; Self Care; Testing; Treatment Efficacy; United States; Work; behavior change; beneficiary; cardiovascular risk factor; cost; diabetes management; diabetes prevention program; diabetes self-management; disorder risk; efficacy evaluation; efficacy outcomes; ethnic minority population; feasibility testing; glycemic control; grandparent; health disparity; improved; innovation; intervention effect; intervention refinement; learning strategy; pilot test; programs; scale up; self-management program; skills; therapy design; treatment program; waist circumference

PROJECT SUMMARY The number of individuals diagnosed with Type 2 Diabetes in the United States (US) has more than doubled since 2000 to over 30 million, with an additional 84.1 million living with prediabetes. One minority group at particular risk is Pacific Islanders (PIs), who are at disproportionate risk and face many barriers (structural and cultural) to engaging in prevention or self-care. To address the critical need for diabetes prevention and treatment programs that target PIs, and building on the family-centered culture, our objective is to pilot test and evaluate a randomized controlled trial of an adolescent-mediated intervention designed to improve the glycemic control and self-care practices of a paired, adult family member with diagnosed diabetes. Building on our own prior work we have adapted an efficacious, primary care-based diabetes self-management program for delivery to adolescents. Specifically, we refined intervention content to focus on behaviors that contributed to glycemic control in prior iterations of the program, adapted the content to target adolsecents as agents of change by adding communication and leadership skills, and incorporated experiential learning activities. We will examine the efficacy of the intervention with a pilot randomized controlled trial. We will randomize n=160 dyads (an adolescent (without diabetes) and a parent/grandparent diagnosed with diabetes who share a household). Adolescents will receive either the six-month diabetes intervention or a leadership and life skills- focused control curriculum in groups (n=10 participants in each group). Aside from planned research assessments we will have no contact with the adults in the dyad, who will proceed with their usual diabetes care. To test our hypothesis that adolescents receiving the intervention will be effective conduits of diabetes knowledge and will support their paired adult in the adoption of self-care strategies, our primary efficacy outcomes will be adult glycemic control and cardiovascular risk factors (BMI, blood pressure, waist circumference). Secondarily, since we believe that exposure to the intervention may encourage positive behavior change in the adolescent themselves we will measure similar outcomes in the adolescents. Outcomes will be measured at baseline, at the end of the active intervention phase (six months post- randomization) and at 12-months post-randomization, to examine maintenance of intervention effects in the absence of contact. To determine potential for long-term sustainability and scale up, we will examine program acceptability, feasibility, fidelity, reach, and cost. Successful completion of our aims and proof of efficacy would produce an innovative, scalable program with high potential for replication in other similar, low-resource, family-centered, ethnic minority groups across the US who are the ideal beneficiaries of innovations to reduce chronic disease risk and eliminate health disparities.

项目摘要 美国诊断为2型糖尿病的人数（美国）增加了一倍以上 自2000年以来，超过3000万，越来越多的8410万生活糖尿病。一个少数群体 太平洋岛民（PIS）的特殊风险是不成比例的，面临许多障碍（结构性和 文化）进行预防或自我保健。满足预防糖尿病的关键需求和 针对PI并以家庭为中心文化的治疗计划，我们的目标是试点测试和 评估青少年介导的干预措施的随机对照试验，旨在改善 配对的成年家庭成员患有诊断糖尿病的血糖控制和自我保健实践。建立 我们自己的先前工作，我们改编了一个有效的基于初级保健的糖尿病自我管理计划 向青少年交付。具体而言，我们完善了干预内容，以关注促成贡献的行为 为了在该程序的先前迭代中进行血糖控制 通过添加沟通和领导能力，并纳入体验式学习活动来改变。我们 将通过试验随机对照试验来检查干预措施的功效。我们将随机化n = 160 二元组（青少年（无糖尿病）和父母/祖父母被诊断为糖尿病，共享 家庭）。青少年将接受六个月的糖尿病干预或领导和生活技能 - 组为组中的控制课程（每组n = 10名参与者）。除了计划研究 评估我们将与二元组中的成年人接触，他们将继续进行常规糖尿病 关心。为了测试我们的假设，即接受干预的青少年将是糖尿病的有效管道 知识并将支持他们配对的成年人在采用自我保健策略方面，这是我们的主要功效 结果将是成人血糖控制和心血管危险因素（BMI，血压，腰部 圆周）。其次，因为我们认为暴露于干预可能会鼓励积极 青少年本身的行为改变我们将衡量青少年的相似结果。 在主动干预阶段结束时，将在基线时测量结果（六个月后 - 随机化）和随机后12个月，以检查对干预效应的维持 没有接触。为了确定长期可持续性的潜力并扩大规模，我们将检查计划 可接受性，可行性，忠诚，触及和成本。成功完成我们的目标和功效证明将会 在其他类似的低资源中，产生具有高潜力复制潜力的创新性，可扩展的程序 全美国以家庭为中心的少数民族群体，他们是减少创新的理想受益者 慢性疾病风险并消除健康差异。

项目成果

Protocol: Implementation and evaluation of an adolescent-mediated intervention to improve glycemic control and diabetes self-management among Samoan adults.

• DOI: 10.1371/journal.pone.0279084
• 发表时间: 2023
• 期刊: PLOS ONE
• 影响因子: 3.7
• 作者: Hawley, Nicola L.;Rivara, Anna C.;Naseri, Joshua;Faumuina, Kitiona;Potoa'e-Solaita, Noelle;Iopu, Francine;Faiai, Mata'uitafa;Naveno, Eminoni;Tasele, Susie;Lefale, Temukisa;Lantini, Ryan;Carlson, Jenna C.;Rabin, Tracy L.;Semaia, Penny;Mugadza, Phyllis;Rosen, Rochelle K.
• 通讯作者: Rosen, Rochelle K.