RESUMO
INTRODUCTION: Latino communities are disproportionately affected by type 2 diabetes and experience disparities in access to diabetes prevention programs. The purpose of this study was to test the preliminary efficacy of a culturally grounded, diabetes prevention program for high-risk Latino families delivered through an integrated research-practice partnership. STUDY DESIGN: The integrated research-practice partnership was established in a predominantly Latino community and consisted of a Federally Qualified Health Center, a YMCA, an accredited diabetes education program, and an academic research center. Data were collected and analyzed from 2015 to 2018. SETTING/PARTICIPANTS: Latino families consisting of a parent with an obese child between age 8 and 12 years. INTERVENTION: The 12-week lifestyle intervention included nutrition education and behavioral skills training (60 minutes, once/week) and physical activity classes (60 minutes, three times/week) delivered at a YMCA. MAIN OUTCOME MEASURES: Outcomes included measures of adiposity (BMI, waist circumference, and body fat); HbA1c; and weight-specific quality of life. RESULTS: Over the course of the 2-year project period, 58 families (parents n=59, children n=68) were enrolled with 36% of parents and 29% of children meeting the criteria for prediabetes at baseline. Feasibility and acceptability were high, with 83% of enrolled families completing the program, 91% of the intervention sessions attended, and 100% of families stating they would recommend the program. The intervention led to significant decreases in percentage body fat among parents (46.4% [SD=10.8] to 43.5% [SD=10.5], p=0.001) as well as children (43.1% [SD=8.0] to 41.8% [SD=7.2], p=0.03). Additionally, HbA1c was significantly reduced in parents (5.6% [SD=0.4] to 5.5% [SD=0.3], p=0.03), and remained stable in children (5.5% [SD=0.3] vs 5.5% [SD=0.3], p>0.05). Significant improvements in quality of life were reported in parents (64.6 [SD=15.8] to 71.0 [SD=13.7], p=0.001) and children (69.7 [SD=15.8] to 72.6 [SD=13.7], p=0.05). CONCLUSIONS: These findings support the preliminary efficacy of an integrated research-practice partnership to meet the diabetes prevention needs of high-risk Latino families within a vulnerable community.
Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Pais/educação , Obesidade Infantil/epidemiologia , Estado Pré-Diabético/epidemiologia , Adulto , Criança , Comportamento Cooperativo , Diabetes Mellitus Tipo 2/etnologia , Saúde da Família/etnologia , Feminino , Educação em Saúde/métodos , Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde , Hispânico ou Latino/estatística & dados numéricos , Humanos , Estilo de Vida , Masculino , Obesidade Infantil/etnologia , Estado Pré-Diabético/etnologia , Qualidade de Vida , Populações VulneráveisRESUMO
Analysis of grip strength force curves has successfully detected suboptimal effort in industrial rehabilitation research. This study examined force curve analysis as an effort measure when grip strength was administered according to standardized neuropsychological procedures in a sample without reported neurologic and upper extremity injury. Eighty-two undergraduates were randomized to control (n = 26), naïve simulator (n = 28), and coached simulator (n = 28) conditions. Outcome measures included grip strength in kilograms, variables calculated from grip strength force curves, and the Word Memory Test (WMT). While average force in kilograms was not significantly different between groups, significant differences were found on the average to peak force ratio as calculated from grip strength force curves. The classification accuracy of average to peak force ratio was lower than the WMT, but comparable to other effort measures. Force curve analysis may warrant further study in a clinical sample.