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Funded by a $1.2 million award from the National Institutes of Health, the "ASU Every Little Step Counts" study will examine the effects of a community-based diabetes prevention program for Latino adolescents, with the goal of reducing obesity-related health disparities in this population.
The stakes are high: the Center for Disease Control estimates that up to 50 percent of all Latino youth born in the year 2000 will develop Type 2 diabetes in their lifetime, an alarming statistic that could lead to other severe health and societal consequences. Latino youth have the highest rates of metabolic syndrome, which includes insulin resistance, obesity and elevated glucose levels or “prediabetes.”
“This is a vulnerable population, many which are uninsured or underserved, and we learned that the inner-city clinics are inundated with adults who have diabetes,” says Gabriel Shaibi, principal investigator of the study, SIRC faculty research affiliate and assistant professor in the College of Nursing and Health Innovation and the School of Nutrition and Health Promotion. “It became clear that prevention programs for youth were needed.
“A strength of the program is that it is culturally grounded to meet the needs of Latino youth and families," Shaibi adds. "It was developed largely by the community, to be delivered in the community. Given the community focus, word about the program has spread through churches, schools and health fairs. ASU research faculty and staff work alongside health educators from the St. Vincent de Paul clinic and exercise trainers from the Y.
“We have worked in partnership with the community from the start, which will allow us to more readily speed up the translation of our research findings into the real world.”
In the past 10 years Arizona has experienced the largest statewide increase – 45.3 percent -- in the number of children and adolescents who are overweight or obese. Latinos represent about a third of Arizona’s population.
Several previous studies by Shaibi have shown that lifestyle changes including improvements in nutrition habits and physical activity, can increase insulin sensitivity and lower cardiovascular risk factors such as cholesterol in youth – even without significant weight loss.
The 14- to 16-year-olds in the current study participate in structured exercise and games as well as nutrition education at the YMCA for 12 weeks, followed by monthly support meetings for them and their parents. They’ll be provided with a one-year membership to the Y to encourage regular exercise. At the end of a year, they’ll return to ASU to see whether health improvements have been sustained.
“A critical part of their development is instilling healthy behaviors as they build their independence,” says Shaibi. “There are a lot of factors that influence their health behaviors and choices, so we help them develop support systems from their friends and family. A key factor in success is helping the kids build social support and skills, exposing them to the YMCA and its philosophy. Many of the kids live near the Y but have never utilized the facility.”
Parents are often the biggest proponents of the program, as diabetes often runs in the family so parents realize their children are at risk. The project uses bilingual lay health educators, or promotoras, to deliver the diabetes prevention education to families.
“Parents are extremely excited when offered an opportunity they have never been offered before to benefit the overall health of their kids,” says Saray Vera, health education coordinator at the St. Vincent clinic. “They are anxious and eager to get their kids started on the program. Partnering with ASU on this project is extremely valuable to us, and we are eternally grateful and honored to work with the institution.”
Co-investigators from ASU include two professors from the College of Nursing and Health Innovation, Colleen Keller and Darya McClain. Researchers hope the program may serve as a foundation for future large-scale interventions.
Kerri O’Brien, senior vice president for healthy living at the YMCA, says teaching healthy living habits to youth and their families can help them be successful in making lifestyle changes for the long term. The partnership with ASU makes their outreach all the stronger.
“This program can lead to communities of people leading more productive and enjoyable lives,” she says. “Getting there will take time, energy and focus, but every little step counts.”
The NIH study is part of a larger $6.3 million research award to the Southwest Interdisciplinary Research Center at ASU from the National Institute of Minority Health and Health Disparities.