Development and evaluation of an enhanced diabetes prevention program with psychosocial support for urban American Indians and Alaska natives: A randomized controlled trial.

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Tytuł:: Development and evaluation of an enhanced diabetes prevention program with psychosocial support for urban American Indians and Alaska natives: A randomized controlled trial.
Autorzy:: Rosas LG; Palo Alto Medical Foundation, 795 El Camino Real, Palo Alto, CA 94301, USA; Stanford Department of Medicine, Stanford Prevention Research Center, USA. Electronic address: .
Vasquez JJ; Timpany Center, 730 Empey Way, San Jose, CA 95128, USA. Electronic address: .
Naderi R; Timpany Center, 730 Empey Way, San Jose, CA 95128, USA. Electronic address: .
Jeffery N; Stanford Prevention Research Center, 1070 Arastradero Rd, Palo Alto, CA 94304, USA. Electronic address: .
Hedlin H; Stanford University Department of Medicine, Quantitative Sciences Unit, 1070 Arastradero Road, Palo Alto, CA 94304, USA. Electronic address: .
Qin F; Stanford University Department of Medicine, Quantitative Sciences Unit, 1070 Arastradero Road, Palo Alto, CA 94304, USA. Electronic address: .
LaFromboise T; Stanford University Graduate School of Education, 485 Lasuen Mall, Stanford, CA 94305-3096, USA. Electronic address: .
Megginson N; Timpany Center, 730 Empey Way, San Jose, CA 95128, USA. Electronic address: .
Pasqua C; Timpany Center, 730 Empey Way, San Jose, CA 95128, USA. Electronic address: .
Flores O; Timpany Center, 730 Empey Way, San Jose, CA 95128, USA. Electronic address: .
McClinton-Brown R; Palo Alto Medical Foundation, 795 El Camino Real, Palo Alto, CA 94301, USA.
Evans J; Palo Alto Medical Foundation, 795 El Camino Real, Palo Alto, CA 94301, USA.
Stafford RS; Stanford Prevention Research Center, Program on Prevention Outcomes and Practices, 1265 Welch Road, Stanford, CA 94305-5411, USA. Electronic address: .
Źródło:: Contemporary clinical trials [Contemp Clin Trials] 2016 Sep; Vol. 50, pp. 28-36. Date of Electronic Publication: 2016 Jul 02.
Typ publikacji:: Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial
Język:: English
Imprint Name(s):: Original Publication: New York, N.Y. : Elsevier, c2005-
MeSH Terms:: Alaska Natives*
Indians, North American*
Diabetes Mellitus, Type 2/*prevention & control
Health Behavior/*ethnology
Health Promotion/*organization & administration
Mental Health/*ethnology
Blood Glucose ; Blood Pressure ; Body Mass Index ; Community-Institutional Relations ; Cultural Competency ; Diabetes Mellitus, Type 2/ethnology ; Female ; Humans ; Life Style ; Lipids/blood ; Male ; Metabolic Syndrome/ethnology ; Obesity/ethnology ; Quality of Life ; Research Design ; Risk Factors ; Stress, Psychological/ethnology ; Universities/organization & administration ; Urban Population ; Waist Circumference
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Grant Information:: K24 HL086703 United States HL NHLBI NIH HHS; UL1 RR025744 United States RR NCRR NIH HHS
Contributed Indexing:: Keywords: American Indian; Community-based participatory research; Diabetes prevention; Obesity; Prediabetes; Weight loss
Substance Nomenclature:: 0 (Blood Glucose)
0 (Lipids)
Entry Date(s):: Date Created: 20160707 Date Completed: 20171219 Latest Revision: 20240109
Update Code:: 20240109
PubMed Central ID:: PMC6691492
DOI:: 10.1016/j.cct.2016.06.015
PMID:: 27381232
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Diabetes is highly prevalent, affecting over 25 million adults in the US, yet it can be effectively prevented through lifestyle interventions, including the well-tested Diabetes Prevention Program (DPP). American Indian/Alaska Native (AIAN) adults, the majority of whom live in urban settings, are more than twice as likely to develop diabetes as non-Hispanic whites. Additionally, prevalent mental health issues and psychosocial stressors may facilitate progression to diabetes and hinder successful implementation of lifestyle interventions for AIAN adults. This 2-phased study first engaged community stakeholders to develop culturally-tailored strategies to address mental health concerns and psychosocial stressors. Pilot testing (completed) refined those strategies that increase engagement in an enhanced DPP for urban AIAN adults. Second, the enhanced DPP will be compared to a standard DPP in a randomized controlled trial (ongoing) with a primary outcome of body mass index (BMI) and a secondary outcome of quality of life (QoL) over 12months. Obese self-identified AIAN adults residing in an urban setting with one or more components of the metabolic syndrome (excluding waist circumference) will be randomized to the enhanced or standard DPP (n=204). We hypothesize that addressing psychosocial barriers within a culturally-tailored DPP will result in clinical (BMI) and superior patient-centered (QoL) outcomes as compared to a standard DPP. Exploratory outcomes will include cardiometabolic risk factors (e.g., waist circumference, blood pressure, fasting glucose) and health behaviors (e.g., diet, physical activity). Results of this trial may be applicable to other urban AIAN or minority communities or even diabetes prevention in general.
(Copyright © 2016 Elsevier Inc. All rights reserved.)

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