title: The Impact of a Home-Based Diabetes Prevention and Management Program on High-Risk American Indian Youth.
abstract: 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.
authors.affiliation: Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (Ms Kenney, Ms Chambers, Dr Rosenstock, Dr Barlow)
authors.forename: Anne
authors.initials: A
authors.lastname: Kenney
authors.affiliation: Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (Ms Kenney, Ms Chambers, Dr Rosenstock, Dr Barlow)
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Chambers
authors.affiliation: Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (Ms Kenney, Ms Chambers, Dr Rosenstock, Dr Barlow)
authors.forename: Summer
authors.initials: S
authors.lastname: Rosenstock
authors.affiliation: Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (Ms Kenney, Ms Chambers, Dr Rosenstock, Dr Barlow)|Johns Hopkins Center for American Indian Health: Albuquerque Office, Johns Hopkins Bloomberg School of Public Health, Albuquerque, New Mexico, USA (Ms Neault)
authors.forename: Nicole
authors.initials: N
authors.lastname: Neault
authors.affiliation: Johns Hopkins Center for American Indian Health: Tuba City Office, Johns Hopkins Bloomberg School of Public Health, Tuba City, Arizona, USA (Ms Richards, Mr Grass)
authors.forename: Jennifer
authors.initials: J
authors.lastname: Richards
authors.affiliation: Johns Hopkins Center for American Indian Health: Shiprock Office, Johns Hopkins Bloomberg School of Public Health, Shiprock, New Mexico, USA (Dr Reid, Ms Nelson)
authors.forename: Raymond
authors.initials: R
authors.lastname: Reid
authors.affiliation: Johns Hopkins Center for American Indian Health: Shiprock Office, Johns Hopkins Bloomberg School of Public Health, Shiprock, New Mexico, USA (Dr Reid, Ms Nelson)
authors.forename: Leonela
authors.initials: L
authors.lastname: Nelson
authors.affiliation: Johns Hopkins Center for American Indian Health: Chinle Office, Johns Hopkins Bloomberg School of Public Health, Chinle, Arizona, USA (Ms Begay)
authors.forename: Marissa
authors.initials: M
authors.lastname: Begay
authors.affiliation: Johns Hopkins Center for American Indian Health: Tuba City Office, Johns Hopkins Bloomberg School of Public Health, Tuba City, Arizona, USA (Ms Richards, Mr Grass)
authors.forename: Ryan
authors.initials: R
authors.lastname: Grass
authors.affiliation: Johns Hopkins Center for American Indian Health: Whiteriver Office, Johns Hopkins Bloomberg School of Public Health, Whiteriver, Arizona, USA (Mr Parker)
authors.forename: Sean
authors.initials: S
authors.lastname: Parker
authors.affiliation: Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (Ms Kenney, Ms Chambers, Dr Rosenstock, Dr Barlow)
authors.forename: Allison
authors.initials: A
authors.lastname: Barlow
mesh_terms: D000293:Adolescent; D003863:Depression / Q000523:psychology; D003920:Diabetes Mellitus / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D007198:Indians, North American; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation; D011788:Quality of Life; D000073278:Self-Management / Q000193:education*; D015206:Southwestern United States; D011795:Surveys and Questionnaires