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| Name | Class |
|---|---|
| Children's Hospital Research Institute of Manitoba | OTHER |
| Canadian Institutes of Health Research (CIHR) | OTHER_GOV |
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The overall objective: to co-design and implement targeted and timely community led strategies to improve the health of the Next Generation and end the intergenerational impact of T2D in this population.
Guided by gaps in knowledge and care identified by participant advisors, community, and First Nations leadership, we have developed a multifaceted and multidisciplinary research program which leverages the existing NextGen Cohort to enhance metabolic screening and evaluate novel intervention strategies. With our First Nations partners we will 1) Co-develop a perinatal support program led by a community-based navigator to support maternal and early childhood nutrition and activity, including breastfeeding supports, aimed at diabetes prevention, 2) Implement community-based early childhood screening for evidence of dysglycemia, and 3) Co-develop and implement a community led land-based program for children ages 4-5 years and their caregivers to encourage and educate about the benefits of traditional nutrition and activities to maintain wellness. In partnership with the Four Arrows Regional Health Authority (FARHA) and its four governing Anisininew First Nations in Manitoba, this program of research will address the lifecycle of intergenerational T2D by implementation of pre and post-natal/early childhood interventions in a population with the highest rates of childhood-onset T2D observed in the world (2).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Co-develop and implement a community-based perinatal education and support program using navigators | Active Comparator | The implementation of a community-based navigator to facilitate multiple points of pre and post-partum contact as well as individualized connection to preexisting and co-developed urban and northern pre- and post-natal supports, will increase rates of initiation and duration (≥6 month) of breastfeeding in the NextGen mothers from 58% to ≥75%. |
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| Extend the scope of the NextGen Cohort | Active Comparator | Community based point of care HbA1c testing will improve access to annual screening for pre-diabetes and diabetes in the Next Gen Cohort. CGM can detect early dysglycemia (below the threshold for the diagnosis of prediabetes) in young children at high risk for childhood-onset T2D. In addition, we hypothesize that CGM use will be well tolerated and feasible in young children. |
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| Co-develop and implement community led land-based programming for parent(s) and preschool children | Active Comparator | Land-based community programming for caregivers and children aged 4-5 years is feasible and will encourage healthy nutrition choices and physical activity. Ultimately, we hypothesize that this will improve the health and well-being of this high-risk population and improve cardiometabolic health. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Breastfeeding and perinatal education and support | Behavioral | Co-develop and implement a community-based perinatal education and support program using navigators to support breast feeding, maternal nutrition and activity, and early infancy/childhood nutrition and activity. |
| Measure | Description | Time Frame |
|---|---|---|
| Obesity | Development of obesity defined by the International task force on obesity cut offs for age and gender. | 18 years |
| Type 2 Diabetes | Development of type 2 diabetes defined by diagnostic criteria in the Canadian Diabetes association 2008 guidelines in childhood (≤ 7 years) or adolescence (12-16 years). | 18 years |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Brandy A Wicklow, MD, MSc | Contact | 204-787-1222 | bwicklow@hsc.mb.ca | |
| Elizabeth AC Sellers, MD, MSc | Contact | 204-787-3011 | esellers@hsc.mb.ca |
| Name | Affiliation | Role |
|---|---|---|
| Brandy A Wicklow, MD, MSc | University of Manitoba, Children's Hospital Research Institute of Manitoba | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children's Hospital Research Institute of Manitoba/University of Manitoba | Winnipeg | Manitoba | R3E 3P4 | Canada |
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| Label | URL |
|---|---|
| Website that has all the current projects that deal with diabetes. | View source |
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In cooperation with OCAP principles.
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| Purchasing HbA1c machines for communities | Device | This will allow study participants to conduct earlier and more frequent screening for early dysglycemia, prediabetes and T2D. |
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| Continuous Glucose Monitoring | Device | We will investigate the use of continuous glucose monitoring (CGM) to detect early dysglycemia in the Next Gen cohort. |
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| Land-based Wellness Programming | Behavioral | Co-develop and implement community led land-based programming for parent(s) and preschool children aged 4-5 years to encourage traditional nutrition and activities to maintain wellness. |
|
| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| D016640 | Diabetes, Gestational |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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| ID | Term |
|---|---|
| D007774 | Lactation |
| D010166 | Palliative Care |
| D000095583 | Continuous Glucose Monitoring |
| ID | Term |
|---|---|
| D055703 | Reproductive Physiological Phenomena |
| D012101 | Reproductive and Urinary Physiological Phenomena |
| D049590 | Postpartum Period |
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
| D001774 | Blood Chemical Analysis |
| D019963 | Clinical Chemistry Tests |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D003940 | Diagnostic Techniques, Endocrine |
| D008991 | Monitoring, Physiologic |
| D008919 | Investigative Techniques |
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