Translating the Diabetes Prevention Program Into Practice in the General Community

Amundson, Helen A.; Butcher, Marcene K.; Gohdes, Dorothy; Hall, Taryn O.; Harwell, Todd S.; Helgerson, Steven D.; Vanderwood, Karl K.; Workgroup, Diabetes Prevention Program

doi:10.1177/0145721709333269

Cited by 148 publications

(56 citation statements)

References 29 publications

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“…The largest community-based translation study published to date reported achieving weight loss goals nearly identical to those of the DPP 10 . During the 16-week intervention, weight loss was 6.7%, and 45% of the 293 participants lost 7% or more of their body weight.…”

Section: Barriers To Identification Of Persons With Pre-diabetesmentioning

confidence: 99%

“…One can only speculate about why progress in the US has been slow, but a combination of factors including concerns about clinician workload, a bias toward requiring prevention activities to be cost-saving rather than cost-effective, little precedent for effective clinical-community partnerships, and uncertainty about the direction of health care reform likely account for the lack of progress. There is now increasing evidence, however, that structured lifestyle intervention programs conducted in US communities, and outside the walls of the clinical sector, can closely approximate the weight losses achieved during active intervention in the highly efficacious DPP diabetes prevention trial 10,29 , and at substantially lower cost 39 . However, no organized effort, even on a pilot demonstration basis, currently exists to design, develop, and evaluate the impact of practical referral mechanisms between primary care and community-based lifestyle programs for diabetes prevention.…”

Section: What Is Needed To Improve Identification and Prevention In Tmentioning

confidence: 99%

“…However, based on our experience working with public health programs, as well as the emerging literature on translation of lifestyle programs for diabetes prevention, these efforts may include a high proportion of low-risk, normoglycemic participants. For example, in a recent journal issue reporting on nine studies that attempted to translate the DPP lifestyle intervention into real-world settings, only about 50% of study participants had evidence of pre-diabetes [9][10][11] . If limited resources for intensive lifestyle interventions are devoted to large numbers of persons who are unlikely to develop diabetes, we believe it will be difficult to realize the hoped-for health and economic benefits of diabetes prevention.…”

mentioning

confidence: 99%

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Prevention of Type 2 Diabetes: Risk Status, Clinic, and Community

Narayan

Williamson

2009

J GEN INTERN MED

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Although the idea of preventing type 2 diabetes has been articulated since the discovery of insulin, only in the past decade have clinical trials demonstrated that diabetes can be prevented or delayed. These trials found lifestyle intervention reduces diabetes incidence by over 50% and is more efficacious than metformin. Evidence from prevention trials comes from persons with "pre-diabetes" in which blood glucose levels are elevated but not yet in the diabetes range. In normoglycemic persons, lifestyle or drug intervention has little impact on diabetes incidence. Prevention programs are often conducted outside the clinical sector where participants' glycemic status is usually unknown; these programs may include many normoglycemic participants, which greatly reduces cost-effectiveness. An economically sustainable system for diabetes prevention will require effective partnerships among the clinical sector, community-based lifestyle programs, and third-party payers to ensure that limited resources for diabetes prevention are focused on persons at high risk of diabetes.

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Section: Barriers To Identification Of Persons With Pre-diabetesmentioning

confidence: 99%

Section: What Is Needed To Improve Identification and Prevention In Tmentioning

confidence: 99%

mentioning

confidence: 99%

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Prevention of Type 2 Diabetes: Risk Status, Clinic, and Community

Narayan

Williamson

2009

J GEN INTERN MED

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“…Diabetes is preventable through dietary changes and weight loss, increased physical activity, and other lifestyle changes [10,11], and in addition to lowering clinical measurements such as weight and glucose [11,12,13,14,15,16,17,18,19,20,21,22,23], community-based interventions modeled after the DPP have also been shown to promote health benefits such as improved nutrition and increased exercise [12,13,15,22,23,24,25,26,27,28]. DPP studies that have been translated into community settings have included various modifications to the original DPP protocol in order to address feasibility and sustainability challenges associated with the program, and to address the specific needs of the target communities in which studies are implemented.…”

Section: Introductionmentioning

confidence: 99%

Diabetes Prevention in the New York City Sikh Asian Indian Community: A Pilot Study

Islam

Zanowiak

Wyatt

et al. 2014

IJERPH

148

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India has one of the highest burdens of diabetes worldwide, and rates of diabetes are also high among Asian Indian immigrants that have migrated into the United States (U.S.). Sikhs represent a significant portion of Asian Indians in the U.S. Diabetes prevention programs have shown the benefits of using lifestyle intervention to reduce diabetes risk, yet there have been no culturally-tailored programs for diabetes prevention in the Sikh community. Using a quasi-experimental two-arm design, 126 Sikh Asian Indians living in New York City were enrolled in a six-workshop intervention led by community health workers. A total of 108 participants completed baseline and 6-month follow-up surveys between March 2012 and October 2013. Main outcome measures included clinical variables (weight, body mass index (BMI), waist circumference, blood pressure, glucose, and cholesterol) and health behaviors (changes in physical activity, food behaviors, and diabetes knowledge). Changes were significant for the treatment group in weight, BMI, waist circumference, blood pressure, glucose, physical activity, food behaviors, and diabetes knowledge, and between group differences were significant for glucose, diabetes knowledge, portion control, and physical activity social interaction. Retention rates were high. Findings demonstrate that a diabetes prevention program in the Sikh community is acceptable, feasible, and efficacious.

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“…Lifestyle intervention and delivery through telehealth A description of this intervention has been published previously [8,9,11]. Briefly, the Montana DPHHS began implementing the DPP in a group setting through multiple intervention sites in 2008.…”

Section: Settingmentioning

confidence: 99%

Telehealth delivery of the diabetes prevention program to rural communities

Vadheim

Patch

Brokaw

et al. 2017

Behav. Med. Pract. Policy Res.

Self Cite

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The Centers for Disease Control and Prevention, State and Local Health Departments, and other organizations in the USA are working to increase population access to the Diabetes Prevention Program (DPP) lifestyle intervention. Delivering the DPP through telehealth videoconference may increase access to this intervention, particularly in rural communities. The purpose of this study was to compare participation, monitoring of diet and physical activity, and weight loss in participants receiving the intervention on-site and those participating virtually through telehealth. Beginning in 2008, Holy Rosary Healthcare collaborated with the Montana Department of Public Health and Human Services to provide the DPP to participants on-site in one community and simultaneously through telehealth to participants in multiple other communities. From 2008 through 2015, 894 participants were enrolled in the program (29% at telehealth sites). The mean age of participants was 51.7 years and 84% were female. Overall, participants attended 14.4, 3.9, and 15.0 weekly core, post-core, and total sessions, respectively. There were no statistically significant differences in number of intervention sessions attended by the telehealth or on-site participants. There were no statistically significant differences in the mean weight loss or reduction in BMI between the telehealth and the on-site groups. There also were no statistically significant differences in the percentage of telehealth or on-site participants who achieved ≥5% weight loss (56 vs. 57%) or the 7% weight loss goal (38 vs. 41%). Our findings suggest that participants receiving the DPP through telehealth have similar rates of participation and achieve similar weight loss as participants attending the program on-site.

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Translating the Diabetes Prevention Program Into Practice in the General Community

Abstract: The findings suggest that it is feasible to recruit and retain high-risk participants and achieve weight loss and physical goals in a group setting that are comparable with those achieved in the DPP.

Cited by 148 publications

References 29 publications

Prevention of Type 2 Diabetes: Risk Status, Clinic, and Community

Prevention of Type 2 Diabetes: Risk Status, Clinic, and Community

Diabetes Prevention in the New York City Sikh Asian Indian Community: A Pilot Study

Telehealth delivery of the diabetes prevention program to rural communities

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