Implementation and Outcomes of the New York State YMCA Diabetes Prevention Program: A Multisite Community-Based Translation, 2010–2012

Abstract

IntroductionWeight loss and physical activity achieved through the Diabetes Prevention Program (DPP) have been shown to reduce type 2 diabetes risk among individuals with prediabetes. The New York State Young Men’s Christian Association (YMCA) delivered the 16-week evidence-based model at 14 YMCAs. A mixed methods process and outcomes evaluation was conducted.MethodsMost participants were referred by clinicians and were encouraged to achieve 5% to 7% weight loss. Participants were weighed weekly; additional data were gathered from participant surveys and focus groups and staff surveys and interviews. ResultsParticipants (N = 254) lost a mean of 9 pounds (P < .001), or 4.2% of body weight, by program completion; 40% achieved 5% or more weight loss and 25% achieved 7% or more weight loss. Ten months after baseline, 61% of participants reported 5% or more weight loss and 48% reported 7% or more weight loss. In multivariate models, weight loss was negatively associated with black race (16 weeks: adjusted odds ratio [AOR], 0.190, P = .002; 10 months: AOR, 0.244, P = .005) and positively associated with attendance (16 weeks: AOR, 18.699, P < .001; 10 months: AOR, 2.808, P = .024). Participants reported improvements in health and lifestyle changes after program completion. Factors contributing to program success included coaches who motivated participants, the group setting, curriculum, and program duration. However, sociodemographic diversity was limited.ConclusionOutcomes demonstrate the potential for effectively implementing the DPP in community-based settings. Findings also suggest the need for replications among a broader population.

Improving physical activity program adoption using integrated research-practice partnerships: an effectiveness-implementation trial

“…While our study supported the use of integrated research-practice partnership processes to develop physical activity programs with broad reach and organizational adoption, it does not devalue the contributions of interventions developed through the traditional pipeline model. First, it is possible that ALED would be a better fit in organizations such as the YMCA or Parks and Recreation settings where weekly community programs align with the existing delivery structure and regular programming [41,42]. Second, evidence-based interventions provide information on evidence-based principles that can be used to adapt existing, or create new, programs [38].…”

Assessing the psychosocial factors associated with adherence to exercise referral schemes: A systematic review

“…Nine studies used interviews, 27,43,46,[48][49][50][51]58,59 three studies used focus groups, 41,53,54 and one study used a combination of interviews and focus groups. 45 The duration of the ERS across studies varied from 8 weeks, 43 10 weeks, 48,49,51 12 weeks, 45,53,58 14 weeks, 46 16 weeks, 27 26 weeks, 54 and 16 sessions over an unspecified period.…”

“…45 The duration of the ERS across studies varied from 8 weeks, 43 10 weeks, 48,49,51 12 weeks, 45,53,58 14 weeks, 46 16 weeks, 27 26 weeks, 54 and 16 sessions over an unspecified period. 41 The following section provides overarching themes, which represent the prominent psychosocial factors identified through qualitative studies.…”

National Strategies to Decrease the Burden of Diabetes and Its Complications

“…The DPP reported a 24 % decrease in the incidence of diabetes 8 years following the completion of the trial [35], and the Diabetes Prevention Study (DPS) in Finland demonstrated a 43 % reduction 4 years after its completion [36]. The lifestyle intervention model of the DPP has been translated into real-world settings through primary care clinics, cardiac rehabilitation programs, churches, YMCAs, health-care facilities, and communitybased facilities [37][38][39][40][41][42][43][44][45][46] and delivered by nurse practitioners, volunteer medical personnel, YMCA trainers, lay health educators, and community health workers [26,38,41,43,[46][47][48].…”