Lifestyle change in Kerala, India: needs assessment and planning for a community-based diabetes prevention trial

Daivadanam, Meena; Absetz, Pilvikki; Sathish, Thirunavukkarasu; Thankappan, KR; Fisher, Edwin B.; Philip, Neena Elezebeth; Mathews, Elezebeth; Oldenburg, Brian

doi:10.1186/1471-2458-13-95

Cited by 61 publications

(76 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, there are some successful community intervention programs for diabetes such as Kerala Diabetes Intervention Studies, 16,17 Da Qing Diabetes Prevention Study, 18 Finnish Diabetes Prevention Study (DPS) 19 which incorporated various strategies such as peer support, lifestyle changes/modification (diet, physical activity), education sessions, health education booklet etc.…”

Section: Resultsmentioning

confidence: 99%

Non-Communicable Diseases: A Major Problem Worldwide

Fatt¹

2016

Public Health Open J

View full text Add to dashboard Cite

Non-Communicable Diseases (NCDs) are a worldwide major problem. NCDs are accounted for over 36 million deaths each year and highly prevalent in low-and middle-income countries.1 It is estimated that 16 million people die prematurely before reaching the age of 70.2 It is also the leading cause of hospital admission and premature deaths. NCD comprises diabetes, asthma, hypertension, heart attacks, cancer, obesity, depression etc. Some of the major NCDs such as diabetes, hypertension, dyslipidemia are attributed to unhealthy lifestyle behaviours. Four prominent risk factors namely smoking, physical inactivity, alcohol and unhealthy diet have been found to be associated with NCD deaths. Tables 1 and 2 show worldwide mortality in 2012 based on the 4 main non-communicable diseases and total, premature NCD and preventable risk factors relating to deaths respectively. Non-Communicable Diseases MortalityCardiovascular Diseases 17.5 million Mortality and risk factors Data based on year 2012Overall NCD mortality 38 million deaths (out of 56 million deaths globally)Premature NCD mortality 48% of NCD deaths before age 70 (in low-and middle-income countries)Preventable risk factors 80% of premature heart disease, stroke and diabetes can be prevented REASONS NON-COMMUNICABLE DISEASES ON THE RISENumerous efforts have been taken to tackle NCDs. For example in diabetes, health awareness campaigns with regards to diet, physical activity, education and health policies have been implemented. Although some awareness have been created, it is hardly successful. The awareness through education is important in preventing NCDs. According to a study done by Snyder on the effectiveness of health communication campaigns, it was noted that if the awareness were to focus on the objective which is to reduce the prevalence or incidence of the disease, it may not necessarily lead to behavioural changes and would be better to focus on the aims of behavioural changes. 5It has been shown in many studies that NCDs such as diabetes and risk factors are inversely associated with education 6 and low education is not a hindrance to behavioural lifestyle changes. 7 The knowledge of the progression and symptomatology of the disease as well as the awareness and management of the disease and the risk factors such as diabetes and hypertension that could be prevented by lifestyle changes are still lacking among the general population. This was noted in a diabetes prevention program in Finland (FIN-D2D) where awareness of diabetes and its risk factors were raised and which resulted in lifestyle changes as well as health behaviour and early facilitation of diagnosis and management of type II diabetes.8 However, the *Cardiovascular Diseases, Cancer, Respiratory Diseases, Diabetes contributed to 82% of all NCD deaths worldwide. 3

show abstract

Section: Resultsmentioning

confidence: 99%

Non-Communicable Diseases: A Major Problem Worldwide

Fatt¹

2016

Public Health Open J

View full text Add to dashboard Cite

show abstract

“…All participants had pre-diabetes (fasting blood glucose 110-125 mg/dl) and came from the Thiruvananthapuram District. Content analysis of the FGDs revealed: a general interest to know more about diabetes and its prevention; the commonplace and somewhat 'normalized' nature of lifestyle risk factors such as unhealthy diet and physical inactivity; a lack of awareness of T2DM risk; a limited understanding of measures to prevent T2DM; and low self-efficacy regarding the ability to make and sustain lifestyle changes [43].…”

Section: Phase 1: Needs Assessmentmentioning

confidence: 99%

“…Further a sub-group of individuals with prediabetes identified through an earlier community-based survey in Trivandrum were contacted and invited to take part in a focus group discussion (FGD). Four main areas were discussed during the groups including: 1) participants' understanding of diabetes and interest to know more; 2) health information sources and access to them; 3) participants' motivation to participate in a communitybased diabetes prevention program; and 4) how such a program should best be delivered [43]. Main themes from the FGDs were identified through content analysis.…”

Section: Phase 1: Needs Assessmentmentioning

confidence: 99%

“…The complete detail of the needs assessment has been previously published, [43] however, in brief, a literature review of relevant Indian Government sites was undertaken to search for policy documents related to national and state capacity, legislation, programmes and guidelines for non-communicable disease (NCD) prevention and corroborated with key Government officials in Kerala for accuracy. A literature review was also undertaken on empirical studies related to diet, physical activity, and tobacco use in relation to NCDs in India.…”

Section: Phase 1: Needs Assessmentmentioning

confidence: 99%

“…Although screening and recruitment are important parts of diabetes prevention programs, it is outside the scope of this paper to describe the process undertaken in K-DPP, however, details have been previously published [42]. The description of the needs assessment and the intervention protocol for K-DPP have also been published earlier [43,44].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2017

Self Cite

View full text Add to dashboard Cite

Background: Type 2 diabetes mellitus (T2DM) is now one of the leading causes of disease-related deaths globally. India has the world's second largest number of individuals living with diabetes. Lifestyle change has been proven to be an effective means by which to reduce risk of T2DM and a number of "real world" diabetes prevention trials have been undertaken in high income countries. However, systematic efforts to adapt such interventions for T2DM prevention in low-and middle-income countries have been very limited to date. This research-to-action gap is now widely recognised as a major challenge to the prevention and control of diabetes. Reducing the gap is associated with reductions in morbidity and mortality and reduced health care costs. The aim of this article is to describe the adaptation, development and refinement of diabetes prevention programs from the USA, Finland and Australia to the State of Kerala, India.

show abstract