In 2005, the Centers for Disease Control and Prevention (CDC) reported that 1 in 3 children born in 2000 would develop type 2 diabetes.1
Type 2 diabetes is most prevalent among obese adolescents from ethnic minority groups, particularly Native Americans, Hispanics, and African Americans.2–5
Overweight adolescents with type 2 diabetes are at risk of developing heart disease and other diabetes related complications before the age of 35 years.6–8
These alarming figures, combined with the increase in ethnic minorities in Wisconsin, will result in enormous personal, societal, and economic costs for many decades. Strategies to address this problem are needed immediately, as prevention of diabetes is far preferable to treatment.
Poverty and race are major contributors to health care disparities in the United States. These factors affect where people live, their access to healthy foods, and neighborhood stability, as well as the presence of safe housing, good schools, parks, and recreational areas. In addition, African Americans, Asians, and Hispanic Americans from underserved communities in Wisconsin are less likely to have a usual source of healthcare and more likely to use the emergency room as their source of care.9,10
These factors make it difficult to identify, screen, and treat ethnic minority children and adolescents at high risk for developing diabetes.
Currently, 43% of African American children and 23% of Hispanic children in Wisconsin are living in poverty.11
As a result, children from these communities are at an increased risk for poor health outcomes. There is a need for culturally sensitive interventions that target obesity, diabetes, nutrition, and physical activity among African American and Latino children, especially those living in underserved communities. While healthy benefits from school-based programs have been reported,12–14
more studies in real world settings that are affordable and accessible are needed to translate research findings into practice.
Community academic partnerships have been found to be an effective means to bridge the gap of health disparities in underserved communities. These partnerships can benefit the university and community by creating innovative and effective ways to provide health related services to ethnic minorities in underserved communities. Utilizing Novel Interventions to Prevent Diabetes in Youth (UNITY) represents a multidisciplinary partnership between the University of Wisconsin-Madison and local community organizations in Madison to screen, identify, and test specific diabetes risk-reduction strategies in adolescents at high risk for developing type 2 diabetes. Adolescents with type 2 diabetes are more likely to be obese, belong to an ethnic minority group, and be sedentary.9
It is these very characteristics that allowed us to identify high-risk adolescents for our study.
The UNITY protocol was designed for delivery to low-income African American and Hispanic/Latino American children living in disadvantaged neighborhoods in Wisconsin. This pilot study was conducted in South Madison, Wisconsin, which is an ethnically diverse community that consists of 35% Latinos, 33% African Americans, 10% Asians, 2% American Indians and/or Eskimos, and 20% whites. Screening children at common neighborhood gathering places can be an effective way to identify children at risk for diabetes as well as other chronic illnesses. Our central hypothesis is that community-based screening and recruitment is effective in identifying ethnic minority children at high risk for diabetes and successfully enrolling them in a lifestyle modification program.