Every Little Step Counts An Effective Model for Culturally Grounded - - PowerPoint PPT Presentation

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Every Little Step Counts An Effective Model for Culturally Grounded - - PowerPoint PPT Presentation

Apr 30, 2023 290 likes •578 views

Every Little Step Counts An Effective Model for Culturally Grounded Pediatric Diabetes Prevention Learning Objectives Define the impact of type 2 diabetes in the U.S. pediatric population Recognize need for culturally grounded evidence

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Every Little Step Counts

An Effective Model for Culturally Grounded Pediatric Diabetes Prevention

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Learning Objectives

  • Define the impact of type 2 diabetes in the U.S.

pediatric population

  • Recognize need for culturally grounded

evidence based intervention for T2D in at risk pediatric population

  • Describe strategies for a successful diabetes

prevention program in minority pediatric population

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Content source: Centers for Disease Control and Prevention

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Latino Youth

  • Conversion from prediabetes to

T2D is accelerated during adolescence due to pubertal insulin

  • resistance. 2
  • Up to 50% of Latino children are

projected to develop T2D in their lifetime1

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Complications

  • Physical Health Consequences

– Insulin resistance – High BP – High Cholesterol – Polycystic ovary syndrome

  • Psychosocial Maladjustments

– Lower quality of life – Increased premature mortality in adulthood – Depression 3 – Anxiety 3

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Every Little Step Counts...

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The Center for Family Wellness

To improve the overall health and well-being of the community through disease management and prevention by providing education and counseling services for persons at risk or diagnosed with diabetes, focusing

  • n long-term healthy lifestyle

changes.

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Every Little Step Counts

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2015-2019 2012-2017

The Evolution

Every Little Step Counts 2005

Pilot 2010-2012

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Conceptual Framework

Castro J Behav Med 2009 Contemporary Clinical Trials 54 (2017) 68-76

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Results

  • Feasibility – Could we actually do IT?
  • Acceptability – Would families ‘want’ IT?
  • Efficacy – Would IT work?
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Changes in BMI Percentile

97 97.2 97.4 97.6 97.8 98 98.2 98.4 98.6 98.8 99

Baseline 12-weeks 6-months 12-months BMI %

P=0.003 P=0.001 Intervention Control

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Changes in Percent Fat

40 41 42 43 44 45 46 47 48

Baseline 12-weeks 6-months 12-months Total fat %

P<0.01 P<0.001 Control Intervention

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Glucose Tolerance Among Youth with IGT

100 110 120 130 140 150 160 Baseline 3-months 6-months 12-months 2-hr Glucose (mg/dl)

P<0.001 P<0.05 P<0.05

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Processes

  • Vested Community

Partners

  • Opportunities for

funding

  • Shared expertise
  • Culture of trust and

understanding

  • Mobilization of

community of resources

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2015-2019 2012-2017

The Evolution

Every Little Step Counts (2005)

Pilot 2010-2012 2017-Today

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Nutrition and PA

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Outcomes- Parents

42 43 44 45 46 47 48

Body Fat % PRE POST

p = 0.001 5 5.2 5.4 5.6 5.8

HbA1c (%) PRE POST

p = 0.03

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Outcomes-Children

40 41 42 43 44 45

Body Fat % PRE POST

p = 0.03 5 5.2 5.4 5.6 5.8

HbA1c (%) PRE POST

p = N.S.

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Creating a Scalable Model for Pediatric Diabetes Prevention

  • Strategies

– Community based

  • utreach

– Building capacity-

workforce development

– Collaboration-

interinstitutional

– Next generation

approach

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Creating a Scalable Model for Pediatric Diabetes Prevention

  • Next steps

– Dissemination &

Replication

– National Model for

Pediatric Diabetes Prevention

– Workforce – Sustainability – Policy

Content Source: Livewellaz.org

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References

1. Soltero EG, Ramos C, Williams AN, et al. ¡Viva Maryvale!: A Multilevel, Multisector Model to Community-Based Diabetes Prevention. Am J Prev Med 2019;56(1):58−65 2. Soltero EG, Konopken YP, Olson ML, et al. Preventing diabetes in obese Latino Youth with prediabetes: A study protocol for a randomized controlled

  • trial. BMC Public Health. 2017; 17: 261. doi: 10.1186/s12889-017-4174-2

3. Williams AN, Konopken YP, Keller CS, et al. Culturally-grounded diabetes prevention program for obese Latino youth: Rationale, design, and methods. Contemporary Clinical Trials . 54 (2017) 68–76. DOI: https://doi.org/10.1016/j.cct.2017.01.004 4. Prevent Type 2 Diabetes in Kids. https://www.cdc.gov/features/prevent- diabetes-kids/index.html. Published June 29 2017. Accessed May 13, 2019. 5. Haire-Joshu D, Hill-Briggs F. The Next Generation of Diabetes Translation: A Path to Health Equity. Annu. Rev. Public Health 2019.40:391-410.

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QUESTIONS?

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Maria Silva

RDN, CDE msilva@svdpaz.org 602-850-6740 Manager l Center for Family Wellness Society of St. Vincent de Paul Phoenix, AZ