PRE-STARt
A pilot project for developing and implementing successful prevention strategies for Type 2 diabetes in adolescents aged 12-14 years
Background to the study
This is a 24 month project funded by the European Commission and will involve the UK (i.e., Leicester), Germany, Portugal, Basque Country and Greece. All aspects of the project will be delivered in each country. This project will involve two phases:
Phase 1: The design of a screening programme for the risk identification of type 2 diabetes in children aged of 12-14 years
To date no risk scores developed for adults have been assessed within this adolescent age group and there are no existing risk scores for diabetes developed for use within children. This is probably due to a lack of data from population based screening studies in this age group. To develop a risk questionnaire tool suitable for this age group we will perform three stages:
Stage One: We will use data from a systematic review we are currently conducting assessing risk factors for type 2 diabetes in children and adolescents, the ADA position statement and our existing expertise around developing risk scores for adults to derive a risk assessment tool for this age group. It is envisaged that the tool will probably use an assessment of weight (e.g. BMI>85th percentile for age and gender) plus another risk factor (non-invasive such as family history, sedentary lifestyle, ethnicity) from the systematic review to define “high-risk”.
Stage Two: Following on from the systematic review, the research team will recruit 100 adolescents aged 12-14 years (in each country) from quartiles of the BMI distribution. These adolescents will then complete the risk questionnaire tool developed in stage one and they will be rigorously phenotyped (they will complete lifestyle questionnaires, anthropometric measures and blood tests).
Stage Three: The phenotypes of the low and high risk groups will then be compared to the low and high risk groups identified from the risk questionnaire tool in stage two, and the risk tool will be redefined where required.
Phase 2: The development and evaluation of a lifestyle intervention for diabetes prevention of 12-14 year old children at risk
In collaboration with local stakeholders (i.e., teachers, parents, adolescents, community physical activity co-ordinators) we will develop a lifestyle intervention for adolescents aged 12-14 years old, and their parents, who are identified as being ‘at risk’ for developing type 2 diabetes using the risk score that is developed in Phase 1. We will also develop educational workshops and online support for community health care professionals.
The workshops for children and their parents will be delivered in interactive group-based after school workshops and these workshops will be delivered by a trained educator. Self-monitoring of lifestyle behaviour will be promoted and supported and continuous support for children and their parents alongside these workshops will be available through the use of a dedicated website.
These workshops will be focused on:
Understanding diabetes risk, risk factors and changing risk
Moderate-to-vigorous physical activity
Time spent sitting
Building a better breakfast
Healthy snacks and drinks
Fast food
Action planning
The effectiveness of the intervention will be tested in a clustered randomised controlled trial, with follow up measures at 6 and 14 months. Measures include lifestyle questionnaires, objectively measured physical activity and sedentary behaviour, anthropometrics, psycho-social measures and blood tests.
For more information go to www.pre-start.org