REACH - OUT Diabetes risk reduction program for African American youth and families

Background/Introduction: Obesity rates are rising in all age groups. Type 2 diabetes incidence is increasing in youth, especially among minorities. Methods: REACH-OUT, a family-based nutrition and exercise program for overweight African American youth ages 9-12 and their families, is led by lay health leaders and conducted in a community setting on Chicago's South Side. Age appropriate interactive sessions focus on skills building, problem solving and setting goals during 14 weekly sessions, with monthly meetings thereafter. Results: Twenty-nine families (62 subjects) participated in a pilot study of the REACH-OUT intervention. Children's mean BMI z-score fell from 2.46 at baseline to 2.38 at 14 weeks and 2.39 at 1 year (p=.02), while parents' BMI remained stable. Children's mean insulin sensitivity index (ISI) showed modest sustained improvement from baseline (1.66) to 14 weeks (1.75) and one year (2.06) (p=0.34), during a developmental phase when ISI commonly worsens. Parents' mean ISI increased significantly from baseline (3.29) to 14 weeks (4.56) and 1 year (5.63)(p=.004). Children reported improved nutrition and exercise behaviors, and exhibited a corresponding rise in serum HDL. Qualitative assessment showed that participants enjoyed the program but felt the program could be improved by making the sessions even more interactive. Conclusion: A community-based program for overweight minority youth and families can successfully address overweight, with potential to decrease diabetes risk in youth.