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Description
Background
Obese Latino adolescents are disproportionately impacted by insulin resistance and type 2 diabetes. Prediabetes is an intermediate stage in the pathogenesis of type 2 diabetes and represents a critical opportunity for intervention. However, to date, no diabetes prevention studies have been conducted in obese Latino youth with prediabetes, a highly vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the short-term (6-month) and long-term (12-month) efficacy of a culturally-grounded, lifestyle intervention, as compared to usual care, for improving glucose tolerance and reducing diabetes risk in 120 obese Latino adolescents with prediabetes.
Methods
Participants will be randomized to a lifestyle intervention or usual care group. Participants in the intervention group will attend weekly nutrition and wellness sessions and physical activity sessions twice a week for six months, followed by three months of booster sessions. The overall approach of the intervention is framed within a multilevel Ecodevelopmental model that leverages community, family, peer, and individual factors during the critical transition period of adolescence. The intervention is also guided by Social Cognitive Theory and employs key behavioral modification strategies to enhance self-efficacy and foster social support for making and sustaining healthy behavior changes. We will test intervention effects on quality of life, explore the potential mediating effects of changes in body composition, total, regional, and organ fat on improving glucose tolerance and increasing insulin sensitivity, and estimate the initial incremental cost effectiveness of the intervention as compared with usual care for improving glucose tolerance.
Discussion
The proposed trial builds upon extant collaborations of a transdisciplinary team of investigators working in concert with local community agencies to address critical gaps in how diabetes prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent type 2 diabetes in this and other populations of high-risk youth.
Obese Latino adolescents are disproportionately impacted by insulin resistance and type 2 diabetes. Prediabetes is an intermediate stage in the pathogenesis of type 2 diabetes and represents a critical opportunity for intervention. However, to date, no diabetes prevention studies have been conducted in obese Latino youth with prediabetes, a highly vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the short-term (6-month) and long-term (12-month) efficacy of a culturally-grounded, lifestyle intervention, as compared to usual care, for improving glucose tolerance and reducing diabetes risk in 120 obese Latino adolescents with prediabetes.
Methods
Participants will be randomized to a lifestyle intervention or usual care group. Participants in the intervention group will attend weekly nutrition and wellness sessions and physical activity sessions twice a week for six months, followed by three months of booster sessions. The overall approach of the intervention is framed within a multilevel Ecodevelopmental model that leverages community, family, peer, and individual factors during the critical transition period of adolescence. The intervention is also guided by Social Cognitive Theory and employs key behavioral modification strategies to enhance self-efficacy and foster social support for making and sustaining healthy behavior changes. We will test intervention effects on quality of life, explore the potential mediating effects of changes in body composition, total, regional, and organ fat on improving glucose tolerance and increasing insulin sensitivity, and estimate the initial incremental cost effectiveness of the intervention as compared with usual care for improving glucose tolerance.
Discussion
The proposed trial builds upon extant collaborations of a transdisciplinary team of investigators working in concert with local community agencies to address critical gaps in how diabetes prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent type 2 diabetes in this and other populations of high-risk youth.
ContributorsSoltero, Erica (Author) / Konopken, Yolanda P. (Author) / Olson, Micah (Author) / Keller, Colleen (Author) / Castro, Felipe (Author) / Williams, Allison (Author) / Patrick, Donald L. (Author) / Ayers, Stephanie (Author) / Hu, Houchun H. (Author) / Sandoval, Matthew (Author) / Pimentel, Janiel (Author) / Knowler, William C. (Author) / Frick, Kevin D. (Author) / Shaibi, Gabriel (Author) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Center for Health Promotion and Disease Prevention (Contributor) / College of Public Service and Community Solutions (Contributor) / Southwest Interdisciplinary Research Center (Contributor) / School of Social Work (Contributor)
Created2017-03-16
Description
In the face of rising rates of substance use among Mexican youth and rapidly narrowing gender differences in use, substance use prevention is an increasingly urgent priority for Mexico. Prevention interventions have been implemented in Mexico but few have been rigorously evaluated for effectiveness. This article presents the long term effects of a Mexico-based pilot study to test the feasibility of a linguistically specific (Mexican Spanish) adapted version of keepin’ it REAL, a school-based substance abuse prevention model program. University affiliated researchers from Mexico and the US collaborated on the study design, program implementation, data collection, and analysis. Students and their teachers from two middle schools (secundarias) in Guadalajara participated in this field trial of Mantente REAL (translated to Spanish). The schools were randomly assigned to treatment and control conditions. The sample of 431 students reported last 30 day substance use at three times (one pretest and two posttests). Changes in substance use behaviors over time were examined using growth curve models. Long term desired intervention effects were found for alcohol and marijuana use but not for cigarettes. The intervention effects were greater for girls than for boys in slowing the typical developmental increase over time in alcohol use. Marijuana effects were based on small numbers of users and indicate a need for larger scale studies. These findings suggest that keepin’ it REAL is a promising foundation for cultural program adaptation efforts to create efficacious school-based universal prevention interventions for middle school students in Mexico.
ContributorsMarsiglia, Flavio (Author) / Kulis, Stephen (Author) / Booth, Jaime (Author) / Nuno-Gutierrez, Bertha L. (Author) / Robbins, Danielle (Author) / College of Public Service and Community Solutions (Contributor) / School of Social Work (Contributor) / College of Liberal Arts and Sciences (Contributor) / Sanford School of Social and Family Dynamics (Contributor) / Southwest Interdisciplinary Research Center (Contributor)
Created2015-04-01