Results of a Pilot Diabetes Prevention Intervention in East Harlem, New York City: Project HEED

Abstract

Objectives-Our community-academic partnership employed community-based participatory research to develop and pilot a simple, peer-led intervention to promote weight loss, which can prevent diabetes and eliminate racial/ethnic disparities in incident diabetes among overweight adults with prediabetes.Methods-We recruited overweight adults at community sites, performed oral glucose tolerance testing to identify persons with blood glucose levels in the prediabetes range, and randomized eligible people to a peer-led lifestyle intervention group or delayed intervention in 1 year. Outcomes, including weight, blood pressure, and health behaviors, were measured at baseline and 3, 6, and 12 months.Results-More than half of those tested (56%, or 99 of 178) had prediabetes and enrolled in the study. Participants were predominantly Spanish-speaking, low-income, undereducated women. The intervention group lost significantly more weight than the control group and maintained weight loss at 12 months (7.2 versus 2.4 pounds; P < .01). One fourth (24 of 99) of participants progressed to diabetes.Correspondence should be sent to Carol R. Horowitz, Dept of Health Evidence and Policy, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1077, New York, New York 10029 (carol.horowitz@ mountsinai.org). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link. . Contributors P. Parikh managed data collection and analysis, and led the writing. E. P. Simon codirected study implementation and reviewed and interpreted focus group transcripts. K. Fei and H. Looker performed data analysis and led interpretation of results. C. Goytia assisted with recruitment and data collection and reviewed and interpreted focus group transcripts. C. R. Horowitz directed the research design and oversaw all aspects of study implementation and analysis. All authors helped to conceptualize ideas, interpret findings, and write and review drafts of the article. Human Participant ProtectionThis study was approved by the Mount Sinai School of Medicine's institutional review board. NIH Public Access Author ManuscriptAm J Public Health. Author manuscript; available in PMC 2011 March 16. NIH-PA Author ManuscriptConclusions-In underserved minority communities, prediabetes prevalence may be higher than previously reported. Low-cost, community-based interventions can succeed in encouraging weight loss to prevent diabetes.Despite compelling evidence that diabetes is escalating in the United States and that promoting weight loss can mitigate its rise, implementation of effective, sustainable diabetes prevention interventions has been slow and sporadic. [1][2][3][4] More than 1 in 8 American adults have diabetes. 5 Blacks and Hispanics are hit hardest by this epidemic: diabetes mortality for these groups is nearly double that of Whites. [6][7][8] Half of Hispanic and nearly half of Black children born in the first decade of this century will develop diabetes if adequate preventive measures are not taken. 9 To date, the most ef...

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“…Andrews et al 22 (1) Andrews et al 22 (2) Appel et al 19 Balducci et al 25 Bennett et al 27 Burke et al 34 (F) Burke et al 34 (M) Christian et al 33 Cohen et al 35 de Mello et al 50 Dekkers et al 17 DPP 84 (1) Foster-Schubert et al 49 (1F) Foster-Schubert et al 49 (2F) Foster-Schubert et al 49 (3F) Haapala et al 36 Janus et al 53 Kirby et al 23 Kulzer et al 37 Langford et al 38 Lim et al 31 Ma et al 47 Martin et al 39 (F) Morey et al 46 Nakade et al 52 (F) Nakade et al 52 (M) Nanchahal et al 54 Parikh et al 45 Patrick et al 18 (M) Ross et al 28 (F) Ross et al 28 (M) Stevens et al 40 (F) Stevens et al 40 (M) Stevens et al 41 (F) Stevens et al 41 (M) ter Bogt et al 21 Vissers et al 26 (1) Vissers et al 26 (2) Wadden et al 20 Wood et al 42 (1M) Wood et al 42 (2M) Wood et al 43 (1F) Wood et al 43 (1M) Wood et al 43 (2F) Wood et al …”

“…[45][46][47]50,51,55,72,82,84 A diagnosis of new onset type 2 diabetes was less likely to occur in intervention participants compared with the control group (Table 3). There was no evidence that the effect of treatment differed based on focus of intervention (Table 3).…”

“…Appel et al 19 Bennett et al 27 Christian et al 33 Dekkers et al 17 Haapala et al 36 Janus et al 53 Langford et al 38 Martin et al 39 (F) Nanchahal et al 54 Parikh et al 45 Wadden et al 20 Subtotal (95% CI) Total events Heterogeneity: I² = 57%…”

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