Family-Based, Culturally-Centered Diabetes Intervention with Ojibwe Communities

与奥及布威社区一起进行以家庭为基础、以文化为中心的糖尿病干预

• 批准号: 10570891
• 负责人: Melissa L. Walls
• 金额: $ 53.64万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-10 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10570891
• 关键词: Acceleration; Address; Adult; Age; American Indians; Behavior; Behavioral; Blood Pressure; Body mass index; Buffers; Caregivers; Child; Chippewa; Chronic Disease; Collaborations; Communities; Community Participation; Coping Skills; Data; Diabetes Mellitus; Diabetes prevention; Diagnosis; Disparity; Educational Curriculum; Educational process of instructing; Effectiveness of Interventions; Elements; Enrollment; Epidemic; Ethnic Population; Evaluation; Family; Family health status; Foundations; Fracture; Generations; Glycosylated hemoglobin A; Goals; Grant; Health; Health Personnel; Healthcare Systems; Healthy Eating; Home; Human; Intake; Intervention; Knowledge; Life; Life Style; Lipids; Maps; Measures; Mediating; Mental Depression; Mental Health; Midwestern United States; Modeling; Morbidity - disease rate; Motivation; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Parents; Pattern; Persons; Pharmaceutical Preparations; Physical activity; Physiological; Pilot Projects; Prevention; Process; Program Effectiveness; Psyche structure; Qualitative Evaluations; Randomized; Randomized, Controlled Trials; Research; Resources; Risk Factors; Role; Services; Stress and Coping; Techniques; Trauma; Waiting Lists; Work; Youth; aged; behavioral health; commune; community based participatory research; community involvement; comparison control; coping; coping mechanism; depressive symptoms; design; diabetes management; diabetes risk; dietary adherence; effectiveness evaluation; empowerment; experience; family support; follow-up; good diet; health disparity; health equity; improved; intergenerational; intervention effect; intervention participants; mortality; novel; nutrition; physical conditioning; prevent; preventive intervention; primary outcome; programs; protective factors; psychosocial; racial population; randomized, controlled study; response; skills; stress management; stressor; sugar; support network; sweetened beverage; therapy design; tribal community; tribal health

Project Summary/Abstract Type 2 diabetes is a significant health disparity for many American Indian (AI) communities. The goal of this competitive renewal research is to enhance, implement, and evaluate the effectiveness of a culturally tailored, intergenerational diabetes management and prevention intervention, “Together on Diabetes.” The program activates family and cultural practices that encourage healthy diets and physical activities, promote stress- coping resources and responses, and reconnect families via a home-based intervention taught by AI paraprofessional Family Health Coaches. The proposed Community Based Participatory Research will enroll “target” adult caregivers diagnosed with type 2 diabetes and their children, ages 10-16 years, with the goal of tapping into motivational reciprocity between the two generations. The work builds on an existing research collaboration with five Ojibwe tribal communities in the Midwest to implement a randomized controlled study (N = 280 families) with a wait-list design respectful of cultural norms of inclusion. The study will evaluate effectiveness of the intervention on adult physiological (primary outcome = HbA1c), behavioral, and mental health and children's psychosocial, familial, behavioral and physiological risk and protective factors for diabetes. The research will also identify stress-coping mechanisms that mediate the impact of the intervention on health. A novel collaborative, qualitative evaluation technique will map potential “ripple effects” of the intervention within families and communities. If effective, the intervention will promote dissemination and scaling with tribal health coaches, community involvement, and stakeholder (health providers, health and human service agencies) input.

项目摘要/摘要 对于许多美洲印第安人（AI）社区来说，2型糖尿病是重大健康差异。目标的目标 竞争性更新研究是为了增强，实施和评估文化量身定制的有效性， 代际糖尿病管理和预防干预，“在糖尿病上共同”。该程序 激活鼓励健康饮食和体育锻炼的家庭和文化实践，促进压力 - 应对资源和响应，并通过AI教授的家庭干预来重新建立家庭 专业家庭健康教练。拟议的基于社区的参与研究将注册 “目标”成人护理人员被诊断为2型糖尿病及其孩子，年龄10-16岁，目的是 利用两代人之间的动机互惠。这项工作以现有研究为基础 与中西部的五个Ojibwe部落社区合作，以实施一项随机对照研究（n = 280个家庭）具有尊重文化包容性规范的等待名单设计。该研究将评估 干预对成人生理学（主要结果= HBA1C），行为和心理的有效性 健康与儿童的社会心理，家庭，行为和身体风险以及受保护因素 糖尿病。这项研究还将确定介导干预影响的压力互动机制 关于健康。一种新颖的合作，定性评估技术将绘制出潜在的“连锁反应” 家庭和社区的干预。如果有效，干预将促进传播和 与部落健康教练，社区参与和利益相关者（健康提供者，卫生和卫生和 人类服务机构）输入。