scholarly journals Adapting a Family-Focused Diabetes Prevention Program for a Federally Qualified Health Center: A Qualitative Report

2020 ◽  
Vol 46 (2) ◽  
pp. 161-168
Author(s):  
Patrick Rivers ◽  
Melanie Hingle ◽  
Griselda Ruiz-Braun ◽  
Robert Blew ◽  
Joy Mockbee ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Health Center ◽  
Low Income ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Family Members ◽  
Diabetes Prevention Program ◽  
Willingness To Participate ◽  
Federally Qualified Health Center ◽  
History Of

Purpose The purpose of the study was to explore the needs of high-risk Latinx/Hispanic women with a history of gestational diabetes who were patients at a Federally Qualified Health Center (FQHC) in anticipation of a future family-based program. Methods Six focus group studies were conducted in partnership with El Rio Community Health Center, an FQHC in Tucson, Arizona. Thirty-nine women participated, each identified as Latinx/Hispanic, self-reported a history of gestational diabetes or prediabetes, and had at least 1 child aged 8 to 13. Three investigators independently reviewed transcripts from the focus groups to identify themes that reflected thematic saturation from participants’ responses. Data coding and results were discussed as a group and any differences were collectively adjudicated. Results All participants had a family member with diabetes and worried about their and their immediate family members’ risk for developing the disease. The possible benefits of participating in a lifestyle prevention program were universally recognized, but multiple barriers to participation were described, including scheduling conflicts, access to childcare, transportation, and the need to involve additional family members to reinforce program objectives. Conclusions There is a strong willingness to participate in a diabetes prevention program among respondents, but to be successful, interventions must be tailored to specific needs and challenges. Trying to apply existing prevention curricula with low-income Latinx/Hispanic populations may not be successful without adaptations.

Abstract P121: Comparative Effectiveness Study of the Diabetes Prevention Program in Families: Preliminary Results

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Jennifer Wessel ◽  
Erin O'Kelly-Phillips ◽  
Kelly Palmer ◽  
Chandan Saha ◽  
Tamara Hannon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Intervention Group ◽  
Diabetes Prevention Program ◽  
Comparative Effectiveness Study ◽  
Develop Type ◽  
History Of ◽  
Family Based

The prevalence of gestational diabetes (GDM) is increasing substantially and currently affects up to 14% of pregnancies. As many as 70% of women with GDM will develop type 2 diabetes (T2D) in the next 10 years. Moreover as many as 40% of children exposed to in-utero diabetes will develop obesity and T2D. The Diabetes Prevention Program (DPP) is an evidence-based lifestyle intervention that has been shown to lower T2D risk by 58% in high-risk adults. Family based lifestyle interventions that target either children, parents or both have reported mixed results. We modified the DPP curriculum to use with families (DPPF) and recruited mothers with a history of GDM and their children 8-15 years old. We randomized n=130 families to test which method of delivering the DPPF (mothers only (M) or mothers and their children (M+C)) is more effective at lowering families T2D risk. Baseline characteristics of women were similar among each intervention group (n=65 M and n=65 M+C, respectively): age (38±8 vs 39±11, P=0.5), ethnicity (Black 55% vs 55%, White 20% vs 17%, Latino 20% vs 27%, other 5% vs 2%, P=0.6), body mass index (BMI, 37±8 vs 38±7, P=0.24), systolic blood pressure (SBP, 121±11 vs 122±13, P=0.8), diastolic blood pressure (DBP, 103±26 vs 105±21, P=0.6), HbA1c (5.6±0.4 vs 5.7±0.3, p=0.2). The majority of women self-reported low levels of physical activity (PA): moderate PA (2 days or less per week, 42% vs 26%, P=0.06) or vigorous PA (2 days or less per week, 38% vs 25%, P=0.1), and high levels of sedentary activities (3 or more hours per day, 49% vs 58%, P=0.2). For diet related obesogenic behaviors women self-reported high levels of eating meals while watching TV (3 days or more per week, 58% vs 74%, P=.06) and eating at restaurants (3 days or more per week, 28% vs 41%, P=0.1). Follow-up is ongoing and currently n=32 families have completed the 3-month follow-up. Preliminary analyses of mothers show decreases in HbA1c (-.01±.3 vs -.1±.2), SBP (-9.7±30 vs -3.1±8), DBP (-8±19 vs -1±9) but not BMI (0.07±1.6 vs 0.04±1.2); however results were not significantly different by intervention group.

scholarly journals 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

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Valy Fontil ◽  
Kelly McDermott ◽  
Lina Tieu ◽  
Christina Rios ◽  
Eliza Gibson ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Low Income ◽  
Prevention Program ◽  
Technology Implementation ◽  
Diabetes Prevention ◽  
Digital Health ◽  
Academic Research ◽  
Diabetes Prevention Program ◽  
Safety Net ◽  
Reading Level

Background. The feasibility of digital health programs to prevent and manage diabetes in low-income patients has not been adequately explored. Methods. Researchers collaborated with a digital health company to adapt a diabetes prevention program for low-income prediabetes patients at a large safety net clinic. We conducted focus groups to assess patient perspectives, revised lessons for improved readability and cultural relevance to low-income and Hispanic patients, conducted a feasibility study of the adapted program in English and Spanish speaking cohorts, and implemented real-time adaptations to the program for commercial use and for a larger trial of in multiple safety net clinics. Results. The majority of focus group participants were receptive to the program. We modified the curriculum to a 5th-grade reading level and adapted content based on patient feedback. In the feasibility study, 54% of eligible contacted patients expressed interest in enrolling (n=23). Although some participants’ computer access and literacy made registration challenging, they were highly satisfied and engaged (80% logged in at least once/week). Conclusions. Underserved prediabetic patients displayed high engagement and satisfaction with a digital diabetes prevention program despite lower digital literacy skills. The collaboration between researchers and a digital health company enabled iterative improvements in technology implementation to address challenges in low-income populations.

scholarly journals A Qualitative Study on the Perspectives of Latinas Enrolled in a Diabetes Prevention Program: Is the Cost of Prevention Too High?

2020 ◽  
Vol 11 ◽  
pp. 215013272094542
Author(s):  
Maud Joachim-Célestin ◽  
Thelma Gamboa-Maldonado ◽  
Hildemar Dos Santos ◽  
Susanne B. Montgomery
Keyword(s):  
Qualitative Study ◽  
Low Income ◽  
Behavior Modification ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Prevention Programs ◽  
Theory Approach ◽  
Preventive Behaviors ◽  
Culturally Adapted

Introduction: Latinas are among the groups most affected by diabetes health disparities, yet they often benefit less from diabetes interventions even when these are culturally adapted. The purpose of this qualitative study was to explore readiness of Latinas enrolled in a diabetes prevention program to adopt recommended preventive behaviors, and to identify factors associated with the adoption and maintenance of these recommended lifestyle changes. Insights gained will be used to inform future efforts at reducing diabetes disparities and the burden of chronic diseases among Latinas. Methods: Nine focus group discussions (FGDs) and 3 key informant interviews (KIIs) were conducted after the completion of a culturally adapted diabetes prevention program led by Latino community health workers. A grounded theory approach by Charmaz informed by the transtheoretical model guided the questions. Discussions and interviews were audio-taped with participants’ permission, transcribed, coded, and themed. Results: Forty low-income Latinas contributed to FGDs and KIIs. Baseline readiness to engage in new behaviors varied. Negative personal and family health events and physician referral impacted most readiness to enroll and to adopt preventive behaviors. Built environment, financial constraints, and threat of social alienation constituted major barriers to behavior adoption and maintenance, while physician involvement, awareness of diabetes complications, and social support partially mitigated these impediments. Conclusions: Our results suggest that timing of enrollment, physician-patient dynamics, and the emotional personal/family cost of behavior modification should all be considered when planning diabetes prevention programs for low-income Latinas. Besides appropriately timing referrals to accessible culturally informed prevention programs, health educators and health care providers should be aware of the potentially negative impact of behavior modification on family dynamics and be prepared to address resulting repercussions. Future research on Latinas should also include and report data on physician involvement, family context, and social determinants of health for more consistent program comparisons.

scholarly journals Translation of the National Diabetes Prevention Program to Engage Men in Disadvantaged Neighborhoods in New York City: A Description of Power Up for Health

2018 ◽  
Vol 12 (4) ◽  
pp. 998-1006 ◽  
Author(s):  
Tiffany L. Gary-Webb ◽  
Elizabeth A. Walker ◽  
Lindsey Realmuto ◽  
Alexandra Kamler ◽  
Jennifer Lukin ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Low Income ◽  
York City ◽  
Prevention Program ◽  
Group Intervention ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Advisory Panel ◽  
Disadvantaged Neighborhoods

The Diabetes Prevention Program (DPP) landmark randomized trial demonstrated that participants with prediabetes could reduce their risk for type 2 diabetes by 58% if they achieved 5%–7% weight loss through healthy eating and increasing physical activity. The National DPP (NDPP) is a group intervention based on the DPP and has been widely disseminated by the Centers for Disease Control and Prevention (CDC) and many healthcare institutions. While data show that the program is effective in diverse populations, enrollment among men from low-income and minority communities is low. Thus, the study piloted a novel adaptation focused on men living in disadvantaged neighborhoods. The study approach to adaptation and implementation used characteristics of participatory research, including input from an expert panel of African American and Latino leaders, ongoing consultation with an Advisory Panel, and focus groups with members of the target population. Discussions with these groups focused on male perspectives regarding health promotion and barriers and facilitators to participation in health programming for men. There was general agreement when reviewing ongoing pilot program implementation that the adapted program should have male-only groups with male coaches, as the Advisory Panel had originally suggested. The pilot programs were implemented at five New York City Department of Parks and Recreation sites in Harlem, the Bronx, and Brooklyn in 2015–2016.

Outcomes From a Culturally Tailored Diabetes Prevention Program in Hispanic Families From a Low-Income School

2010 ◽  
Vol 36 (5) ◽  
pp. 784-792 ◽  
Author(s):  
Karen J. Coleman ◽  
Leticia L. Ocana ◽  
Chris Walker ◽  
Rachel A. Araujo ◽  
Veronica Gutierrez ◽  
...  
Keyword(s):  
Low Income ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Hispanic Families ◽  
Culturally Tailored
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