The Impact of a Home-Based Diabetes Prevention and Management Program on High-Risk American Indian Youth
2016
Kenney, Anne | Chambers, Rachel A. | Rosenstock, Summer | Neault, Nicole | Richards, Jennifer | Reid, Raymond | Nelson, Leonela | Begay, Marissa | Grass, Ryan | Parker, Sean | Barlow, Allison
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. 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. 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). 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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