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Browsing by Author "Pike, Julie"
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Item The Art of Diabetes Prevention Education in Youth(Office of the Vice Chancellor for Research, 2014-04-11) Pike, Julie; Smith, Lisa; Clapp, Sarah; Hannon, Tamara S.; Kester, Laura; Lynch, Dustin; Kuhstoss, Courtney; Sanematsu, HelenBackground: The obesity epidemic has led to an increase in type 2 diabetes as well as the precursor condition “prediabetes.” Prediabetes is defined as blood glucose or hemoglobin A1c levels higher than normal, but not high enough for diabetes. Approximately 30% of obese adolescents in the U.S. have prediabetes. Youth with prediabetes have significantly increased risk for developing type 2 diabetes. Literature demonstrates the significant impact of modest weight loss and physical activity on the prevention or delay of type 2 diabetes. Education on diabetes risk and initiation of lifestyle change is the primary treatment modality. Materials are needed to more effectively educate youth on diabetes progression and risk reduction while using consistent information from evidence-based behavior change methods. Objective: The Youth Diabetes Prevention Clinic is collaborating with the Herron School of Art and Design and a professional design firm to develop an effective tool for communicating the importance of preventing type 2 diabetes while using adolescent-friendly language, visually exciting graphics and relevant messaging. Methods: The team consists of physicians who specialize in adolescent diabetes, a registered dietician, health educators, and graphic design professionals. The project is being completed in four phases: exploration, design, analysis, and refinement. Results: Exploration: The design professionals conducted key personnel interviews and a clinic site visit to determine the appropriate product design. Design: A 16-page booklet was created to incorporate the use of age-appropriate graphics, medical language in lay terms, and cohesive messaging in one package. Analysis: Usability will be measured through user-group testing, key personnel interviews, pre and post knowledge assessments and readiness to change scales. Refinement: Messaging will be revised based on analytical findings. Conclusions: This collaboration exemplifies the benefit of a multidisciplinary approach in the development of patient-centered education materials and provides a framework for others when developing age-specific health communication strategies.Item Associations between Diet Behaviors and Measures of Glycemia, in Clinical Setting, in Obese Adolescents(Mary Ann Leibert, 2016-10-01) Wagner, Kelly A.; Armah, Seth M.; Smith, Lisa G.; Pike, Julie; Tu, Wanzhu; Campbell, Wayne W.; Boushey, Carol J.; Hannon, Tamara S.; Gletsu-Miller, Nana; Biostatistics, School of Public HealthObjective: To determine the influence of dietary behaviors, assessed in a clinical setting, on measures of glycemia in overweight and obese adolescents., Study Design: The study is a retrospective, cross-sectional chart review. Eligible participants were overweight youth (N = 146, age 9–21 years) who attended the Youth Diabetes Prevention Clinic in Indianapolis, IN. Glycemic status was assessed during a 2-hour oral glucose tolerance test (OGTT). In the Bright Futures Questionnaire, a recommended clinical tool for assessing unhealthy behaviors in youth, nutrition-specific questions were modified to quantify dietary habits. Associations between dietary habits and measures of glycemia were determined using multiple linear regression models. Skewed data are presented as geometric means and 95% confidence intervals., Results: Of the 146 adolescents who were assessed [60% girls, age 13.7 years (13.3, 14.0), BMI 33.9 kg/m2 (33.3, 34.5)], 40% were diagnosed with prediabetes. Higher intake of dessert foods was associated with increased glucose levels at 2 hours following the OGTT (β = 0.23, p = 0.004), and higher intake of packaged snack foods was associated with elevated levels of hemoglobin A1c (β = 0.04, p = 0.04), independent of adiposity., Conclusions: In obese youth, high intakes of dessert and packaged snack items were associated with elevated concentrations of glucose at 2 hours following the OGTT and hemoglobin A1c. Findings demonstrate the usefulness of a modified Bright Futures Questionnaire, used in a clinical setting, for identifying dietary behaviors associated with hyperglycemia in obese adolescents., ClinicalTrials.gov registration number: NCT02535169Item Blood Sugar, Your Pancreas, and Unicorns: The Development of Health Education Materials for Youth With Prediabetes(Sage, 2018) Yazel-Smith, Lisa G.; Pike, Julie; Lynch, Dustin; Moore, Courtney; Haberlin, Kathryn; Taylor, Jennifer; Hannon, Tamara S.; Health Policy and Management, School of Public HealthBackground. The obesity epidemic has led to an increase in prediabetes in youth, causing a serious public health concern. Education on diabetes risk and initiation of lifestyle change are the primary treatment modalities. There are few existing age-appropriate health education tools to address diabetes prevention for high-risk youth. Aim. To develop an age-appropriate health education tool(s) to help youth better understand type 2 diabetes risk factors and the reversibility of risk. Method. Health education tool development took place in five phases: exploration, design, analysis, refinement, and process evaluation. Results. The project resulted in (1) booklet designed to increase knowledge of risk, (2) meme generator that mirrors the booklet graphics and allows youth to create their own meme based on their pancreas’ current mood, (3) environmental posters for clinic, and (4) brief self-assessment that acts as a conversation starter for the health educators. Conclusion. Patients reported high likability and satisfaction with the health education tools, with the majority of patients giving the materials an “A” rating. The process evaluation indicated a high level of fidelity and related measures regarding how the health education tools were intended to be used and how they were actually used in the clinic setting.Item Dietary Intervention for Glucose Tolerance In Teens (DIG IT): Protocol of a randomized controlled trial using health coaching to prevent youth-onset type 2 diabetes(Elsevier, 2017-02) Wagner, Kelly A.; Braun, Ethan; Armah, Seth M.; Horan, Diarmuid; Smith, Lisa G.; Pike, Julie; Tu, Wanzhu; Hamilton, Marc T.; Delp, Edward J.; Campbell, Wayne W.; Boushey, Carol J.; Hannon, Tamara S.; Gletsu-Miller, Nana; Pediatrics, School of MedicineBACKGROUND: Youth-onset type 2 diabetes (T2D) is a disease that is newly emerging and behavioral strategies for its prevention are limited. Interventions that target the lifestyle behaviors of adolescents, to improve poor dietary quality and reduce excessive sedentariness, promise to reduce the risk of developing T2D. Health coaching is effective for promoting healthy behaviors in patients who have chronic disease, but few experimental studies are in adolescents. This randomized controlled trial, in adolescents with prediabetes, will determine the effectiveness of a health coaching intervention to facilitate adoption of healthy diet and activity behaviors that delay or prevent development of T2D. METHODS/DESIGN: The Dietary Intervention for Glucose Tolerance In Teens (DIG IT) trial will involve an evaluation of a health coaching intervention in adolescents with prediabetes. Eligible participants will be randomized to receive 6months of health coaching or a single dietary consultation that is standard-of-care. The primary outcome will be 2-hour oral glucose tolerance test concentration. Secondary outcomes will include measures of glycemia and insulin action as well as dietary, physical activity and sedentary behaviors measured using an electronic food record, and by inclinometer. Data will be collected before and after the intervention (at 6months) and at 12months (to assess sustainability). DISCUSSION: This trial will determine whether a health coaching intervention, a personalized and low-cost approach to modify dietary and activity behaviors, is effective and sustainable for prevention of youth-onset T2D, relative to standard-of-care. Health coaching has the potential to be widely implemented in clinical or community settings.Item Forever-Fit Summer Camp: The Impact of a 6-Week Summer Healthy Lifestyle Day Camp on Anthropometric, Cardiovascular, and Physical Fitness Measures in Youth With Obesity(SAGE, 2020-01) El Mikati, Hala K.; Boateng, Anthony O.; McKinney, Brett M.; Haberlin-Pittz, Katie; Pike, Julie; Perry, Patrick; Hannon, Tamara S.; Yazel-Smith, Lisa; Medicine, School of MedicinePediatric obesity is a public health concern with lifestyle intervention as the first-line treatment. Forever-Fit Summer Camp (FFSC) is a 6-week summer day program offering physical activity, nutrition education, and well-balanced meals to youth at low cost. The aim of the study was to assess the efficacy of this program that does not emphasize weight loss rather emphasizes healthy behaviors on body mass index, cardiovascular and physical fitness. Methods: The inclusion criteria were adolescents between 8 and 12 years and body mass index (BMI) ≥85th percentile. The data were collected at baseline and week 6 (wk-6) and was analyzed for 2013-2018 using paired-sample t tests. Results: The participants' (N = 179) average age was 10.6 ± 1.6 years with a majority of females (71%) and black race/ethnicity (70%). At wk-6, BMI and waist circumference decreased by 0.8 ± 0.7 kg/m2 and 1.0 ± 1.3 in, respectively. Resting heart rate, diastolic and systolic blood pressure decreased by 8.5 ± 11.0 bpm, 6.3 ± 8.8 mmHg, and 6.4 ± 10.1 mmHg, respectively. The number of pushups, curl-ups, and chair squats were higher by 5.8 ± 7.5, 6.7 ± 9.1, and 7.7 ± 8.5, respectively. Conclusion: The FFSC is efficacious for improving BMI, cardiovascular, and physical fitness in the short term. The effect of similar episodic efforts that implement healthy lifestyle modifications throughout the school year should be investigated.