Rachel A Chambers1, Summer Rosenstock1, Nicole Neault2, Anne Kenney1, Jennifer Richards3, Kendrea Begay4, Thomasina Blackwater5, Owen Laluk6, Christopher Duggan7, Raymond Reid5, Allison Barlow1. 1. Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Ms Chambers, Dr Rosenstock, Ms Kenney, Dr Barlow) 2. Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Albuquerque, New Mexico (Ms Neault) 3. Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Tuba City, Arizona (Ms Richards) 4. Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Chinle, Arizona (Ms Begay) 5. Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Shiprock, New Mexico (Ms Blackwater, Dr Reid) 6. Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Whiteriver, Arizona (Mr Laluk) 7. Boston Children's Hospital, Division of Gastroenterology, Hepatology and Nutrition, Center for Nutrition, Boston, Massachusetts (Dr Duggan)
Abstract
PURPOSE: The purpose of this study was to test the feasibility of a family-based, home-visiting diabetes prevention/management intervention for American Indian (AI) youth with or at risk for type 2 diabetes. METHODS: The Together on Diabetes program, developed through community-based participatory research, enrolled 255 AI youth (aged 10-19 years) with or at risk for type 2 diabetes and 223 support persons. Delivered by local AI paraprofessionals in 4 rural AI communities, the program included home-based lifestyle education and psychosocial support, facilitated referrals, and community-based healthy living activities. Changes in AI youth participants' knowledge, behavior, psychosocial status, and physiological measurements were assessed over 12 months. RESULTS: Over one-half (56.1%) of youth were boys. The median age was 13.2 years. At baseline, 68.0% of youth reported no physical activity in the past 3 days; median percentages of kilocalories from fat (36.18%) and sweets (13.67%) were higher than US Department of Agriculture recommendations. Nearly 40% of participants reported food insecurity in the past month; 17.1% screened positive for depression. Support persons were predominantly family members, few reported having home Internet access (38.6%), and the majority reported being long distances (>30 minutes) from food stores. Whereas support persons were primarily responsible (≥69%) for obtaining medical care for the youth, the youth had a greater role in behavioral outcomes, indicating joint diabetes prevention/management responsibility. CONCLUSIONS: Baseline results confirmed the need for family-based youth diabetes prevention interventions in rural AI communities and indicated that enrolling at-risk youth and family members is feasible and acceptable.
PURPOSE: The purpose of this study was to test the feasibility of a family-based, home-visiting diabetes prevention/management intervention for American Indian (AI) youth with or at risk for type 2 diabetes. METHODS: The Together on Diabetes program, developed through community-based participatory research, enrolled 255 AI youth (aged 10-19 years) with or at risk for type 2 diabetes and 223 support persons. Delivered by local AI paraprofessionals in 4 rural AI communities, the program included home-based lifestyle education and psychosocial support, facilitated referrals, and community-based healthy living activities. Changes in AI youth participants' knowledge, behavior, psychosocial status, and physiological measurements were assessed over 12 months. RESULTS: Over one-half (56.1%) of youth were boys. The median age was 13.2 years. At baseline, 68.0% of youth reported no physical activity in the past 3 days; median percentages of kilocalories from fat (36.18%) and sweets (13.67%) were higher than US Department of Agriculture recommendations. Nearly 40% of participants reported food insecurity in the past month; 17.1% screened positive for depression. Support persons were predominantly family members, few reported having home Internet access (38.6%), and the majority reported being long distances (>30 minutes) from food stores. Whereas support persons were primarily responsible (≥69%) for obtaining medical care for the youth, the youth had a greater role in behavioral outcomes, indicating joint diabetes prevention/management responsibility. CONCLUSIONS: Baseline results confirmed the need for family-based youth diabetes prevention interventions in rural AI communities and indicated that enrolling at-risk youth and family members is feasible and acceptable.
Authors: Lisa Vincze; Katelyn Barnes; Mari Somerville; Robyn Littlewood; Heidi Atkins; Ayala Rogany; Lauren T Williams Journal: Int J Equity Health Date: 2021-05-22
Authors: Melissa E Lewis; Hannah I Volpert-Esmond; Jason F Deen; Elizabeth Modde; Donald Warne Journal: Int J Environ Res Public Health Date: 2021-02-13 Impact factor: 3.390
Authors: Sarah A Stotz; Kristie McNealy; Rene L Begay; Kristen DeSanto; Spero M Manson; Kelly R Moore Journal: Curr Diab Rep Date: 2021-11-07 Impact factor: 5.430