A home-based diabetes prevention and management program was effective in lowering the risk for type 2 diabetes among American Indian youths, according to a study published in The Diabetes Educator.
American Indian children and adolescents have the highest rate of childhood obesity in the United States, and the highest and fastest-growing type 2 diabetes rate of any ethnic or racial group in the country, according to researchers. “In general, complex [type 2 diabetes] risk and protective factors indicate the need for multilevel interventions,” Anne Kenney, MPH, of the Johns Hopkins Center for American Indian Health at Johns Hopkins Bloomberg School of Public Health, and colleagues wrote. “Improved parenting-skill and family-based interventions have been linked to improvements in diabetes and weight-related comorbidities.”
Researchers enrolled 256 American Indian youth (median age, 13.6 years; range 10-16+ years) in the home-based Together on Diabetes program, gathering participants from four rural reservation-based communities in the southwestern United States. One hundred forty-three (55.9%) were boys. At baseline, 13.2% of participants had type 2 diabetes, 50.5% had prediabetes and 36.4% were “at risk.” The majority of participants had obesity, at 82.4%, while 13.7% were considered overweight.
The intervention program consisted of 12 biweekly lessons over 6 months, followed by another six lessons conducted over a 6-month follow-up period. Each lesson focused on topics such as nutrition, physical activity and “life skills,” setting small goals to better manage or prevent type 2 diabetes. The program also included collaboration with local health care providers and referrals to community services.
The participants filled out questionnaires to track their progress. After a year of enrollment, participants reported an improvement in quality of life (P < .001), depressive symptoms (P < .001), knowledge related to program content (P < .001), BMI (P = .004) and hypertension (P = .026), according to the researchers. The percentage of participants who screened positive for depression decreased from 17.3% at baseline to 6.8% at 6 months (P < .001). The percentage of participants with hypertension also decreased, at both 6 months (32.6% vs. 20.9%, P = .002) and 12 months (32.6% vs. 24.2%, P = .026). Researchers did not observe significant changes in consumption of sweets and fats, however.
“Results indicated that a home-based, multilevel intervention can effectively decrease diabetes risk factors, including [BMI z score] and hypertension, in [American Indian youths] diagnosed or at risk for [type 2 diabetes],” the researchers wrote. “Furthermore, results indicate the feasibility and effectiveness of paraprofessionals to implement and evaluate home-based diabetes programs.” – by Andy Polhamus
Disclosures: The researchers report no relevant financial disclosures.