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Am J Mens Health ; 12(4): 989-997, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29540129


There is a significant evidence base for the Diabetes Prevention Program, a lifestyle intervention to prevent onset of type 2 diabetes among high-risk individuals; however, translation of this intervention for men has been challenging. This report presents outcomes of the pilot study of an adapted 16-week diabetes prevention program entitled " Power Up for Health." The study goal was to better engage men of color with prediabetes from disadvantaged neighborhoods of New York City. It was implemented at five different recreation centers located in predominantly low-income neighborhoods across New York City. The curriculum was facilitated by male lifestyle coaches only; one group was conducted in Spanish. Primary outcome was weight loss from baseline to 16 weeks. Other measures included lifestyle activities, depressive symptoms, and self-reported health status. Men ( N = 47) were screened by telephone. Of the 29 eligible men who began the program, 25 attended at least 4 sessions (52% non-Latino Black, 32% Latino, mean age 51.7 ± SD 9.9 years, mean body mass index 35 ± SD 6.9 kg/m2). End of program outcomes ( n = 23) varied by site and included a mean weight loss of 3.8% (9.7 lbs); 3 of the 5 sites had a mean weight loss of 5.6%, meeting the national goal of 5%-7%. Men ( n = 23) attended a mean of 11.6 of 16 sessions. Improvement in depressive symptoms, healthy eating and exercise, and health status were also seen. While recruitment was challenging with many lessons learned, the adapted men's diabetes prevention program shows promise of success for participants and their coaches.

Diabetes Mellitus Tipo 2/prevenção & controle , Educação em Saúde/organização & administração , Participação do Paciente/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Populações Vulneráveis/etnologia , Adulto , Afro-Americanos/estatística & dados numéricos , Atitude Frente a Saúde , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Cidade de Nova Iorque , Projetos Piloto , Prevenção Primária/organização & administração , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Medição de Risco , Adulto Jovem
Am J Mens Health ; 12(4): 998-1006, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29540131


The Diabetes Prevention Program (DPP) landmark randomized trial demonstrated that participants with prediabetes could reduce their risk for type 2 diabetes by 58% if they achieved 5%-7% weight loss through healthy eating and increasing physical activity. The National DPP (NDPP) is a group intervention based on the DPP and has been widely disseminated by the Centers for Disease Control and Prevention (CDC) and many healthcare institutions. While data show that the program is effective in diverse populations, enrollment among men from low-income and minority communities is low. Thus, the study piloted a novel adaptation focused on men living in disadvantaged neighborhoods. The study approach to adaptation and implementation used characteristics of participatory research, including input from an expert panel of African American and Latino leaders, ongoing consultation with an Advisory Panel, and focus groups with members of the target population. Discussions with these groups focused on male perspectives regarding health promotion and barriers and facilitators to participation in health programming for men. There was general agreement when reviewing ongoing pilot program implementation that the adapted program should have male-only groups with male coaches, as the Advisory Panel had originally suggested. The pilot programs were implemented at five New York City Department of Parks and Recreation sites in Harlem, the Bronx, and Brooklyn in 2015-2016.

Diabetes Mellitus Tipo 2/prevenção & controle , Educação em Saúde/organização & administração , Cooperação do Paciente/estatística & dados numéricos , Prevenção Primária/organização & administração , Adaptação Psicológica , Adulto , Afro-Americanos/estatística & dados numéricos , Atitude Frente a Saúde , Grupos Focais , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Projetos Piloto , Pobreza/etnologia , Pobreza/estatística & dados numéricos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Populações Vulneráveis/estatística & dados numéricos
Cancer Epidemiol Biomarkers Prev ; 17(11): 3188-92, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18990761


BACKGROUND: Mutations in the ataxia-telangiectasia (A-T) gene cause an autosomal recessive syndrome in homozygotes and compound heterozygotes and predispose female heterozygous carriers to breast cancer. No environmental agent has been previously shown to increase the risk of cancer for women who carry a mutated gene that predisposes to breast cancer. This study assesses the effect of cigarette smoking on the risk of breast cancer in A-T mutation carriers and determines age-specific and cumulative incidence rates for breast cancer among such carriers. METHODS: Clinical data were collected between 1971 and 1999 from blood relatives from 274 families of patients with A-T. The A-T mutation carrier status of 973 females was determined by molecular analysis of blood and tissue samples. The breast cancer rates in carrier smokers and nonsmokers were compared. Age-specific and cumulative breast cancer rates were also compared between carriers and noncarriers using Kaplan-Meier survival curves. RESULTS: The cumulative incidence through age 80 years was 80% for carriers who smoked and 21% for carriers who never smoked (P = 0.01). Six cases of breast cancer were diagnosed between ages 70 and 79 years among carriers who smoked. The cumulative breast cancer incidence among A-T mutation carriers was 43% by age 80 years, compared with 17% for noncarriers (P = 0.002). Carriers had new incident breast cancers at an annual rate of 1.4% from ages 65 through 79 years; for noncarriers the rate was 0.20%. CONCLUSIONS: A-T carrier females had an elevated risk of breast cancer, most pronounced at older ages, compared with noncarriers, and smoking increased this risk substantially.

Ataxia Telangiectasia/genética , Neoplasias da Mama/genética , Mutação , Fumar/genética , Adulto , Fatores Etários , Idoso , Feminino , Predisposição Genética para Doença , Heterozigoto , Humanos , Incidência , Pessoa de Meia-Idade