Type 2 diabetes (T2DM) is a disease that clusters in families due to genetic, behavioral, and cultural risk factors.1 T2DM accounts for at least 90% of diabetes in the United States and an additional 7.9 million individuals have prediabetes (American Diabetes Association, 2011). African Americans are disproportionately represented among those diagnosed with T2DM and prediabetes (CDC).2~3 Effective, culturally-relevant, family-based diabetes prevention interventions are critically needed for African Americans. The Diabetes Prevention Program (DPP) and other clinical trials over the past decade have demonstrated that T2DM can be successfully prevented or delayed with intensive lifestyle interventions addressing diet and physical activity.4-6 Two recent effective community-based translations of the DPP have achieved similar outcomes with less intensive interventions delivered by community-health workers7 and trained YMCA lifestyle coaches.8 Both of these studies focused solely on individual adults~ little is known about how best to translate DPP from a family perspective. Power to Prevent is an existing CDC diabetes prevention program, based on DPP, and designed specifically for use with African American families at risk for T2DM. To our knowledge, this program has not yet been evaluated in a randomized trial with African American families. We propose to leverage the evidence on the effectiveness of YMCA lifestyle coaches in delivering diabetes prevention interventions and train YMCA fitness staff to serve as """"""""family health coaches"""""""" to implement the Power to Prevent program with overweight/obese African American parents and their overweight/obese 8-10 year old children. We propose the Parents and Children Together Preventing Diabetes (PACT-PD) study, a two-condition randomized family-based pilot study translation of DPP. Our group is ideally positioned to implement and evaluate the family-based diabetes prevention intervention with African American families having extensive experience in conducting community- and family-based interventions, particularly with African Americans. If our study is successful, our translated intervention could be disseminated rapidly to thousands of YMCAs in the United States, thereby making a substantial impact on the public health burden of obesity, diabetes, and other lifestyle related chronic diseases.
Narrative African American adults and children experience higher rates of obesity and T2DM, compared to their Caucasian counterparts.21 Alarmingly, about 50% of AA U.S. children are expected to develop T2DM in their lifetime.22 We propose to conduct a randomized pilot study to evaluate the early efficacy of a diabetes prevention intervention specifically designed for African American families.
