Anne Kenney1, Rachel A Chambers1, Summer Rosenstock1, Nicole Neault1,2, Jennifer Richards3, Raymond Reid4, Leonela Nelson4, Marissa Begay5, Ryan Grass3, Sean Parker6, Allison Barlow1. 1. Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (Ms Kenney, Ms Chambers, Dr Rosenstock, Dr Barlow) 2. Johns Hopkins Center for American Indian Health: Albuquerque Office, Johns Hopkins Bloomberg School of Public Health, Albuquerque, New Mexico, USA (Ms Neault) 3. Johns Hopkins Center for American Indian Health: Tuba City Office, Johns Hopkins Bloomberg School of Public Health, Tuba City, Arizona, USA (Ms Richards, Mr Grass) 4. Johns Hopkins Center for American Indian Health: Shiprock Office, Johns Hopkins Bloomberg School of Public Health, Shiprock, New Mexico, USA (Dr Reid, Ms Nelson) 5. Johns Hopkins Center for American Indian Health: Chinle Office, Johns Hopkins Bloomberg School of Public Health, Chinle, Arizona, USA (Ms Begay) 6. Johns Hopkins Center for American Indian Health: Whiteriver Office, Johns Hopkins Bloomberg School of Public Health, Whiteriver, Arizona, USA (Mr Parker)
Abstract
PURPOSE: The purpose of this study was to examine the impact of a home-based diabetes prevention and management program on high-risk American Indian youth. METHODS: Together on Diabetes (TOD) was designed via a participatory approach with 4 tribal communities in the southwestern United States. A multisite pre- and postevaluation design was used to evaluate the efficacy of the TOD intervention on improving youth's psychosocial, knowledge, behavioral, and physiological outcomes at 4 time points from baseline to 12 months postenrollment. RESULTS: A total of 256 youth and 225 support persons were enrolled in the TOD program. At 12 months postenrollment, improvements were observed in youth's quality of life (P < .001), depressive symptoms (P < .001), knowledge related to TOD content (P < .001), standardized body mass index scores (P = .004), and hypertension (P = .026). Improvements in mean A1C were observed among diabetic youth with baseline A1C >6.5% (P = .036). CONCLUSIONS: The TOD program was feasible, acceptable, and effective in lowering diabetes risk among reservation-based American Indian youth. It is the first efficacious youth-focused diabetes prevention and management program developed and implemented in partnership with tribal communities.
PURPOSE: The purpose of this study was to examine the impact of a home-based diabetes prevention and management program on high-risk American Indian youth. METHODS: Together on Diabetes (TOD) was designed via a participatory approach with 4 tribal communities in the southwestern United States. A multisite pre- and postevaluation design was used to evaluate the efficacy of the TOD intervention on improving youth's psychosocial, knowledge, behavioral, and physiological outcomes at 4 time points from baseline to 12 months postenrollment. RESULTS: A total of 256 youth and 225 support persons were enrolled in the TOD program. At 12 months postenrollment, improvements were observed in youth's quality of life (P < .001), depressive symptoms (P < .001), knowledge related to TOD content (P < .001), standardized body mass index scores (P = .004), and hypertension (P = .026). Improvements in mean A1C were observed among diabetic youth with baseline A1C >6.5% (P = .036). CONCLUSIONS: The TOD program was feasible, acceptable, and effective in lowering diabetes risk among reservation-based American Indian youth. It is the first efficacious youth-focused diabetes prevention and management program developed and implemented in partnership with tribal communities.
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