7 research outputs found

    Recruitment in Clinical Versus Community-Based Sites for a Pilot Youth Diabetes Prevention Program, East Harlem, New York, 2011–2012

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    Introduction\ud \ud Little is known about successful strategies for recruitment of youth for research. The objective of this study was to compare clinical sites with community sites in the recruitment of teenagers for a new youth diabetes prevention program in East Harlem, New York.\ud \ud Methods\ud \ud We assessed diabetes risk for youth (aged 13–19 y) by measuring body mass index (BMI). We then screened overweight and obese youth for prediabetes using oral glucose tolerance testing, had them complete a health and lifestyle survey, and enrolled prediabetic youth into peer-led workshops. The recruitment strategies were 1) clinical referrals and 2) screenings at community sites. We compared the number of adolescents screened, the proportion eligible for testing, the proportion diagnosed with prediabetes, baseline characteristics, and the retention rates between those recruited in clinical and community sites.\ud \ud Results\ud \ud In 3 months, we completed BMI screening for 156 adolescents from community sites and 30 from clinical sites. Overall, 47% were at risk for diabetes on the basis of BMI, and 63% returned for diabetes testing; 35% had prediabetes, and 1 teenager had diabetes. Clinical sites yielded higher rates of diabetes risk on the basis of BMI and higher rates of return for screening and diagnosed prediabetes. Although demographics and BMI did not vary by recruitment site, we found differences in behaviors, self-efficacy, body image, and social support. There were no differences by recruitment site in workshop enrollment or completion or return for follow-up.\ud \ud Conclusion\ud \ud Both recruitment strategies were successful, and participants from both groups had high rates of undiagnosed prediabetes. Our approach allowed access to more adolescents and opportunities for education about diabetes in the community.\u

    A community-engaged approach to select geographic areas for interventions to reduce health disparities.

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    Background: While neighborhood-based approaches to eliminate health disparities are on the rise, there is little guidance on how researchers may engage with community partners to select geographic areas for interventions to reduce health disparities. We aimed to identify a small geographic area to target interventions to improve diabetes-related outcomes. Objectives: We describe lessons learned from a community-engaged approach to specify the geographic area of focus. Methods: A community-academic partnership of more than 20 organizations collaborated to develop and employ a 5-stage process to specify a target area for diabetes preventions and control activities. Lessons Learned: A coalition with local knowledge and ties to the community can develop criteria and direct a process leading to selection of a geographic area, increased research capacity, and strengthened relationships among partners. Conclusion: A participatory approach can be effective in defining a geographic area for targeting interventions to reduce health disparities

    Diabetes prevention in the Caribbean using Lifestyle Intervention and Metformin Escalation (LIME): Protocol for a hybrid Type-1 effectiveness-implementation trial using a quasi-experimental study design

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    Background: Globally, several diabetes prevention interventions have been shown to be cost-effective, yet they have had limited adaptation, implementation, and evaluation in the Caribbean and among Caribbean-descent individuals, where the burden of type 2 diabetes is high. We report on the protocol for the Lifestyle Intervention with Metformin Escalation (LIME) study – an evidence-based diabetes prevention intervention to reduce the incidence of diabetes among Caribbean-descent individuals with prediabetes. Methods: LIME is a hybrid type-I effectiveness-implementation quasi-experimental study taking place in 4 clinical sites in Barbados, Trinidad, the U.S. Virgin Islands, and Puerto Rico. LIME targets individuals who self-identify as Caribbean or Caribbean-descent and have high-risk prediabetes with a hemoglobin A1c (HbA1c) between 6 and 6.4%. Eligible participants in the intervention arm are enrolled in a six-week lifestyle modification workshop. Six months later, individuals who have not lost at least 5% of their bodyweight or continue to have an HbA1c of 6% or higher are prescribed metformin medication. In total, participants are followed for one year. The primary effectiveness outcome is proportion of individuals who lower their HbA1c below 6%. Discussion: LIME is a unique diabetes prevention intervention for Caribbean and Caribbean-descent individuals. LIME utilizes a tailored lifestyle change curriculum, incorporates appropriate metformin prescribing when lifestyle change alone is insufficient, targets the highest-risk individuals with prediabetes, and is based in a clinical setting to ensure sustainability