Community-based Adolescent Diabetes Prevention Program

Approach: The proposed research addresses diabetes risk and prevention among racial/ethnic minority adolescents in East Harlem (EH), NY. Aim 1 will use qualitative methods to explore the best strategies for using peer education for diabetes risk reduction in youth and the potential role of mobile health technologies in improving adherence to behavioral modification plans. Aim 2 will utilize findings from preliminary studies and Aim 1 to design and evaluate a pilot community-based intervention to 1) maintain/reduce BMI (primary outcome), 2) improve adolescent dietary, physical activity and weight control behaviors, and 3) improve other measures of diabetes risk. Data will be collected at baseline, immediately after the intervention (3 months) and at one year in the intervention and wait list control groups. Aim 3 involves refining the pilot intervention based on an examination of intervention feasibility, acceptability, and sustainability and planning for a future R01.

Inclusion criteria

for pre-diabetes screening:

• Adolescents ages 13-19 years of age
• English speaking
• Residents of East Harlem or members of an East Harlem Institution. Membership in an East Harlem institution includes the following:

• attending a school in East Harlem
• attending an after school or recreational activity in East Harlem
• receiving health care in East Harlem Proof of address or membership in an East Harlem institution will not be asked.
• At risk for diabetes (overweight/obese based on measured BMI percentile and with either a parent or grandparent with type 2 diabetes)
• No plans to relocate from New York City in the next year

Note: additional inclusion criteria for participation in workshops include diagnosis of pre-diabetes based on oral glucose tolerance test

Exclusion criteria

for pre-diabetes screening:

• <13 or >19 years of age
• Previous diagnosis of diabetes
• BMI percentile <85th percentile for age and gender based on Centers for Disease Control and Prevention definition
• Currently pregnant
• Speaking a language other than English
• On medications that may raise or lower blood sugar
• Plans to relocate from New York City within one year of enrollment-

Note: additional exclusion criteria for participation in workshops include fingerstick glucoses outside the pre-diabetes range during oral glucose tolerance testing and any cognitive or physical impairment that would preclude comprehension of the group educational program