A review of diabetes prevention program translations: use of cultural adaptation and implementation research

Abstract

The Diabetes Prevention Program (DPP) has been shown to prevent type 2 diabetes through lifestyle modification. The purpose of this study was to describe the literature on DPP translation, synthesizing studies using cultural adaptation and implementation research. A systematic search was conducted. Original studies evaluating DPP implementation and/or cultural adaptation were included. Data about cultural adaptation, implementation outcomes, and translation strategies was abstracted. A total of 44 were included, of which 15 reported cultural adaptations and 38 explored implementation. Many studies shortened the program length and reported a group format. The most commonly reported cultural adaptation (13 of 15) was with content. At the individual level, the most frequently assessed implementation outcome (n=30) was adoption. Feasibility was most common (n=32) at the organization level. The DPP is being tested in a variety of settings and populations, using numerous translational strategies and cultural adaptations. Implementation research that identifies, evaluates, and reports efforts to translate the DPP into practice is crucial. Keywords Diabetes prevention, Translation, Cultural adaptation, Implementation INTRODUCTIONNearly 26 million people in the USA-8.3 % of the population-have diabetes, and 90-95 % have type 2 diabetes [1]. Diabetes in adults is the leading cause of new cases of blindness, kidney failure, and non-injury amputations of the feet and legs. In 2007, the cost associated with diabetes was $174 billion [1]. Diabetes and its complications are largely preventable [2,3]; obesity, physical inactivity, and unhealthy eating account for over half of new cases [4,5].Racial/ethnic minorities are at substantially higher risk for type 2 diabetes and continue to experience greater rates of hospitalization due to diabetes-related complications and 50-100 % higher morbidity and mortality than their white counterparts [6][7][8]. To address such health disparities effectively, interventions need to attend to cultural factors to increase engagement of ethnic minority populations in prevention

Adaptation and Feasibility Study of a Digital Health Program to Prevent Diabetes among Low-Income Patients: Results from a Partnership between a Digital Health Company and an Academic Research Team

“…To our knowledge, this is the first digital translation of DPP for an underserved patient population. A recent review found that among the 15 DPP translation studies, only one was conducted in a primary care clinical setting [24]. Our study makes important additions to the body of literature on translation of DPP in the real-world by providing specific recommendations about how the recruitment and initial enrollment process might be better completed within safety net clinical sites.…”

“…Numerous studies have translated DPP to real-world community settings (e.g., YMCA, churches, or workplace) and clinical settings that required cultural adaptation of the program [24, 25]. To our knowledge, this is the first digital translation of DPP for an underserved patient population.…”

Cultural adaptation of a peer-led lifestyle intervention program for diabetes prevention in India: the Kerala diabetes prevention program (K-DPP)

“…The most widely translated and evaluated diabetes prevention program is the US DPP. A 2015 systematic review found 44 studies evaluating the US DPP across a range of settings and populations including various minority groups and populations with low socio-economic status [59]. The Centers for Disease Control and Prevention (CDC) have now developed a curriculum to ensure adapted US DPP programs meet requirements for recognition including complying with the Standards and Operating Procedures [60] and as well as completing a capacity assessment to ensure organizations are able to start and maintain programs successfully.…”

Diabetes prevention in the real world: Insights from the JDPP and J‐DOIT1

“…DPP‐based studies were conducted in various settings. Participants included minority and low‐income members of society . In the EU, the Finnish DPS study was translated in other areas .…”