title: Supporting At-Risk Youth and Their Families to Manage and Prevent Diabetes: Developing a National Partnership of Medical Residency Programs and High Schools.
abstract: BACKGROUND
  The Stanford Youth Diabetes Coaches Program (SYDCP) is a school based health program in which Family Medicine residents train healthy at-risk adolescents to become diabetes self-management coaches for family members with diabetes. This study evaluates the impact of the SYDCP when disseminated to remote sites. Additionally, this study aims to assess perceived benefit of enhanced curriculum.
  
  
  METHODS
  From 2012-2015, 10 high schools and one summer camp in the US and Canada and five residency programs were selected to participate. Physicians and other health providers implemented the SYDCP with racial/ethnic-minority students from low-income communities. Student coaches completed pre- and posttest surveys which included knowledge, health behavior, and psychosocial asset questions (i.e., worth and resilience), as well as open-ended feedback questions. T-test pre-post comparisons were used to determine differences in knowledge and psychosocial assets, and open and axial coding methods were used to analyze qualitative data.
  
  
  RESULTS
  A total of 216 participating high school students completed both pre-and posttests, and 96 nonparticipating students also completed pre- and posttests. Student coaches improved from pre- to posttest significantly on knowledge (p<0.005 in 2012-13, 2014 camp, and 2014-15); worth (p<0.1 in 2014-15); problem solving (p<0.005 in 2014 camp and p<0.1 in 2014-15); and self-efficacy (p<0.05 in 2014 camp). Eighty-two percent of student coaches reported that they considered making a behavior change to improve their own health as a result of program participation. Qualitative feedback themes included acknowledgment of usefulness and relevance of the program, appreciation for physician instructors, knowledge gain, pride in helping family members, improved relationships and connectedness with family members, and lifestyle improvements.
  
  
  CONCLUSIONS
  Overall, when disseminated, this program can increase health knowledge and some psychosocial assets of at-risk youth and holds promise to empower these youth with health literacy and encourage them to adopt healthy behaviors.
authors.affiliation: Center for Primary Care Research, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States of America.
authors.forename: Liana
authors.initials: L
authors.lastname: Gefter
authors.affiliation: Center for Primary Care Research, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States of America.
authors.forename: Nancy
authors.initials: N
authors.lastname: Morioka-Douglas
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America.
authors.forename: Ashini
authors.initials: A
authors.lastname: Srivastava
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America.
authors.forename: Eunice
authors.initials: E
authors.lastname: Rodriguez
mesh_terms: D000293:Adolescent; D002170:Canada; D002908:Chronic Disease; D003479:Curriculum; D003920:Diabetes Mellitus / Q000628:therapy*; D005192:Family Health; D005194:Family Practice / Q000193:education; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D012307:Risk Factors; D012574:Schools; D012648:Self Care; D013334:Students; D014481:United States; D035862:Vulnerable Populations