REQUEST FOR ADDITIONAL FIELD SITES TO PARTICIPATE IN A SCHOOL-BASED TRIAL OF PREVENTION OF TYPE 2 DIABETES IN CHILDREN AND ADOLESCENTS RELEASE DATE: July 22, 2003 NOTICE: NOT-DK-03-006 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (http://www.niddk.nih.gov) The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) seeks additional field sites to participate in a multi-center school-based trial to prevent the development of type 2 diabetes in middle school children. Type 2 diabetes has been traditionally viewed as a disease of adults; however, recent epidemiologic data reveal an increasing number of cases of type 2 diabetes in the pediatric population, especially among adolescents and in certain minority populations. The increase of type 2 diabetes in youth is presumed to be a consequence of widespread obesity and decreased physical activity. Controlled, clinical trials in adults have demonstrated that lifestyle interventions can be used to prevent the development of type 2 diabetes in high risk adults. These interventions may not be directly applicable to the high risk pediatric population, which is predominantly in the pre-adolescent or adolescent age range. The adolescent period presents special challenges when attempting to promote behavior or lifestyle changes. In addition, while lifestyle interventions have worked in the context of a highly controlled clinical trial directed at individuals, more cost-effective population-based primary prevention programs are needed to decrease risk factors for type 2 diabetes and lower the incidence of the disorder. Children represent a unique "target" population, which may be amenable to population-based public health interventions delivered in the school setting. NIDDK is sponsoring a multi-site primary prevention trial to reduce risk factors for type 2 diabetes in middle-school aged children. Middle schools were chosen as a target for several reasons. Children in the 6th-8th grades (middle school) are generally 11-14 years old and in early adolescence. This is a time when obesity markedly increases. This is also a time when children assume more responsibility for their own diet and physical activity patterns. By developing a comprehensive intervention to alter the diet and physical activity practices of middle school children, obesity could be prevented or lessened. By preventing or lessening obesity, insulin resistance should be ameliorated and glucose intolerance (prediabetes) and diabetes prevented. Planning for this trial has begun under a cooperative agreement, Studies to Treat or Prevent PediatricType 2 Diabetes (STOPP-T2D), funded under RFAs DK-01-010 (https://grants.nih.gov/grants/guide/rfa-files/RFA-DK-01-010.html) and DK-01-011 (https://grants.nih.gov/grants/guide/rfa-files/RFA-DK-01-011.html) which invited applications for field sites and a Coordinating Center. The cooperative agreement is funded for 7 years, anticipating three phases: 1) planning, 2) recruitment and study, and 3) analysis. Currently, a Steering Committee, composed of the Principal Investigators from the field sites, the Principal Investigator of the Coordinating Center, an NIDDK representative, and several outside experts, has begun protocol development for this trial. However, additional field sites are needed to assure adequate power, as well as geographic and racial/ethnic diversity. It is the intent of the NIDDK to add new field sites in a timely manner, so that these new sites can participate in the planning process for the trial. Awards to the additional field centers will be made through subcontracts to the Coordinating Center. The Principal Investigators from the new sites will serve on the Steering Committee and be full partners in the development of the trial. Funding is available for travel of the principal investigator and other key personnel to planning meetings, as well as for effort commensurate with the level of participation in protocol development. Once the trial begins, the subcontracts will provide funds to each center to support personnel, supplies, equipment, communication, travel and school/subject costs associated with the study. The award of each subcontract will depend on the requirements of the protocol ultimately designed by the Steering Committee. It is anticipated that several pilot studies will be conducted in the 2004- 2005 school year and that the full trial will begin in August/September 2005. Requests to participate may be submitted by institutions in the United States. This geographic constraint is necessary because of the need for close communication and meetings among members of the Steering Committee and because of the need to work within the school system. Requests should be submitted on a PHS 398 (https://grants.nih.gov/grants/funding/phs398/phs398.html). Each request should have a face page, abstract, biographical sketches for the principal investigator and other proposed key personnel, description of resources including the number, size and demographic composition of middle schools to which the investigators will have access, and a research plan. The biosketch should include a description of all active research support and a description of recently completed projects. A budget is not needed, since the budget will be determined by the design of the protocol by the Steering Committee. The research plan should not exceed 5 pages and should include: 1) a brief proposal for the design of the trial, with a discussion of the rationale for selecting this trial design, focusing on the choice of interventions and the choice of outcome measures; 2) a detailed description of the demographics of the proposed trial population at the site, and 3) a description of the Principal Investigator's experience in school-based interventions, and in multi-center or large clinical trials. The investigator should discuss all trials in which he/she played a significant role, and include an explanation of that role, as well as a description of the numbers (or per cent) of eligible subjects successfully recruited to those trials. It is anticipated that each site will develop a team with multi-disciplinary expertise. The PI and key personnel must have experience in conducting school-based interventions, as well as expertise in diabetes and/or obesity and related metabolic disorders. Requesters must also document their willingness to participate on the Steering Committee and appropriate subcommittees, work cooperatively with the other members of the Steering Committee, and follow the common protocols established cooperatively by the Steering Committee. Details regarding the "Terms and Conditions" of this cooperative agreements can be found in the original RFA. Request (2 copies) should be submitted no later than August 27, 2003 to: Barbara Linder, M.D., Ph.D. Division of Diabetes, Endocrinology and Metabolic Diseases National Institute of Diabetes and Digestive and Kidney Diseases 6707 Democracy Blvd., Rm. 699, MSC 5460 Bethesda, MD 20892-5460 (for courier service, use zip code 20817) Telephone: (301) 594-0021 FAX: (301) 480-3503 E-mail: linderb@extra.niddk.nih.gov All inquiries should be directed to Dr. Linder. Requests will be evaluated by a panel convened by the Coordinating Center (the George Washington University), according to the following criteria: o documented ability of the potential site to recruit and retain schools and subjects for the trial o qualifications of the principal investigator and proposed key personnel as documented by their biosketches an the proposed research plan o contribution of the potential site to geographic and racial/ethnic diversity within the study population o completeness of the request It is anticipated that up to four additional sites will be supported.
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