title: Culturally-grounded diabetes prevention program for obese Latino youth: Rationale, design, and methods.
abstract: Type 2 diabetes (T2D) disproportionately impacts Latino youth yet few diabetes prevention programs address this important source of health disparities.
  
  
  
  To address this knowledge gap, we describe the rationale, design, and methodology underpinning a culturally-grounded T2D prevention program for obese Latino youth. The study aims to: 1) to test the efficacy of the intervention for reducing T2D risk, 2) explore potential mediators and moderators of changes in health behaviors and health outcomes and, 3) examine the incremental cost-effectiveness for reducing T2D risk. Latino adolescents (N=160, age 14-16) will be randomized to either a 3-month intensive lifestyle intervention or a control condition. The intervention consists of weekly health education delivered by bilingual/bicultural promotores and 3 moderate-to-vigorous physical activity (PA) sessions/week. Control youth receive health information and results from their laboratory testing. Insulin sensitivity, glucose tolerance, and weight-specific quality of life are assessed at baseline, 3-months, 6-months, and 12-months. We will explore whether enhanced self-efficacy and/or social support mediate improvements in nutrition/PA behaviors and T2D outcomes. We will also explore whether effects are moderated by sex and/or acculturation. Cost-effectiveness from the health system perspective will be estimated by the incremental cost-effectiveness ratio using changes in insulin sensitivity at 12-months.
  
  
  
  The results of this study will provide much needed information on how T2D prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent T2D in this and other high-risk populations.
authors.affiliation: Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, United States; Southwest Interdisciplinary Research Center, Arizona State University, United States.
authors.forename: Allison N
authors.initials: AN
authors.lastname: Williams
authors.affiliation: Family Wellness Program, Virginia G. Piper, St. Vincent de Paul Medical and Dental Clinic, United States.
authors.forename: Yolanda P
authors.initials: YP
authors.lastname: Konopken
authors.affiliation: Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, United States.
authors.forename: Colleen S
authors.initials: CS
authors.lastname: Keller
authors.affiliation: Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, United States.
authors.forename: Felipe Gonzalez
authors.initials: FG
authors.lastname: Castro
authors.affiliation: School of Nursing, University of Rochester, United States.
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Arcoleo
authors.affiliation: Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, United States.
authors.forename: Estela
authors.initials: E
authors.lastname: Barraza
authors.affiliation: Seattle Quality of Life Group, Department of Health Services, School of Public Health and Community Medicine, University of Washington, United States.
authors.forename: Donald L
authors.initials: DL
authors.lastname: Patrick
authors.affiliation: Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, United States; Division of Endocrinology and Diabetes, Phoenix Children's Hospital, United States.
authors.forename: Micah L
authors.initials: ML
authors.lastname: Olson
authors.affiliation: Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, United States; Southwest Interdisciplinary Research Center, Arizona State University, United States; Division of Endocrinology and Diabetes, Phoenix Children's Hospital, United States. Electronic address: Gabriel.shaibi@asu.edu.
authors.forename: Gabriel Q
authors.initials: GQ
authors.lastname: Shaibi
mesh_terms: D000069:Acculturation; D000293:Adolescent; D065246:Culturally Competent Care; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000517:prevention & control*; D015444:Exercise; D005951:Glucose Tolerance Test; D006293:Health Promotion; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D007333:Insulin Resistance; D009765:Obesity / Q000378:metabolism / Q000628:therapy*; D010353:Patient Education as Topic / Q000379:methods*; D011788:Quality of Life; D020377:Self Efficacy; D012737:Sex Factors; D012944:Social Support
keywords: Diabetes prevention; Health disparities; Health promotion; Latino; Obesity