Slowing the rate of increase in type 2 diabetes nationally is one of the most urgent health problems we face. Worst affected are minority populations such as the Mexican American population along the US/Mexico border, where rates have doubled over the last two decades (now over 20% of all adults). Even in children we find rates much higher than nationally of overweight and other predictors of early onset type 2 diabetes. The rate of increase shows no sign of slowing. It is difficult, therefore, to overstate the urgency of addressing effective measures to prevent diabetes in minority populations. This proposal builds on the research opportunities established in the Hispanic Health Research Center of the Lower Rio Grande Valley through NCMHD Project EXPORT (MD000170 P20). This Center of Excellence application aims to 1) understand the changes proximal to the development of overt diabetes, 2) understand the mental health impact of diabetes and the potential for early intervention, 3) utilize the strong family unit in the Mexican American population to reduce the risk of obesity and diabetes in children through parental intervention, and 4) understand how to use the successful technique of behavioral journalism and the media to change diet and physical activity behavior at the population level. The scientific focus of the Center of Excellence is thus to conduct research on the physiologic progression to diabetes and its complications among Mexican Americans, and to develop diabetes prevention strategies and test innovative approaches to effective interventions in a minority population severely affected by type 2 diabetes. We intend our Center of Excellence to be a collaborative resource for diabetes and its complications in Mexican Americans providing critical cultural understanding and appropriate tools for epidemiological, intervention, and physiologic research. The proposed Center of Excellence on Diabetes in Americans of Mexican Descent proposes an administrative core, a research core including three research projects and two pilot studies, a training core and a community engagement core.
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