Background: Associated with a tripling in obesity since 1970, type 2 diabetes mellitus (T2DM) in children has risen 9-10 fold. There is a critical need of protocols for trials to prevent T2DM in children.
Methods/Design:This protocol includes the theory, development, evaluation components and lessons learned from a novel YMCA-based T2DM prevention intervention designed specifically for high-BMI African American children from disadvantaged, inner-city neighborhoods of Oakland, California. The intervention was developed on the basis of: review of epidemiological and intervention studies of pediatric T2DM; a conceptual theory (social cognitive); a comprehensive examination of health promotion curricula designed for children; consultation with research, clinical experts and practitioners and; input from community partners. The intervention, Taking Action Together, included culturally sensitive and age-appropriate programming on: healthy eating; increasing physical activity and, improving self esteem.Discussion: Evaluations completed to date suggest that Taking Action Together may be an effective intervention, and results warrant an expanded evaluation effort. This protocol could be used in other community settings to reduce the risk of children developing T2DM and related health consequences.Trial registration: ClinicalTrials.gov NCT01039116.
BackgroundThere is a critical need for trials to be conducted that aim to identify strategies to prevent T2DM mellitus (T2DM) in children. Associated with a tripling in obesity since 1970, T2DM in children has risen 9-10 fold [1]. Additionally, nearly 1 in 6 overweight youth has pre-diabetes [2]. African American youth are among the highest for risk of T2DM with higher rates of obesity and insulin-resistance than other ethnic groups due, in part, to being more insulin resistant [3]. Nearly 50% of African American children born in the U.S. in 2000 are expected to develop diabetes in their lifetimes [4].Taking Action Together (TAT) was a controlled community-based intervention protocol developed by researchers at U.C. Berkeley in partnership with the YMCA of the East Bay to reduce risk of T2DM among low-income, high BMI, 9-10 year old African American children through improvements in nutrient intake, physical activity, and self esteem. To avoid stigmatization due to body fatness, focus was placed on improving diet and physical activity rather than on weight loss. Described are the rationale, theory, design, development, implementation, evaluation components, and lessons learned from TAT.This protocol was designed for delivery to low-income African American children living in disadvantaged, inner-city neighborhoods such as those of East or West Oakland, CA. Compared to a White child living in the Oakland hills (comparatively higher income area), those African American children are more likely to be born low birth weight, live in a low-income household, have parents with only a high school education or less, and have poor access to healthy foods [5]. There is a dearth of cu...