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

Clinics and community-based organizations (CBOs) are priority settings for implementing the evidence-based National Diabetes Prevention Program (DPP). Both program settings present theoretical advantages and disadvantages for engaging and helping populations most at risk for diabetes achieve lifestyle change goals. To date, few studies have compared implementation across them. The present study describes participant characteristics and lifestyle change outcomes across a sample of clinic- and community-based National DPPs which delivered services in Los Angeles during 2015 to 2018 (two clinics, two CBOs, combined n = 265 participants). Analyses examined participant gender, age, race/ethnicity, baseline body mass index, and program attributes such as screening method and language of instruction. Negative binomial regression models tested for differences in program attendance, mean weekly physical activity, and percent change in body weight by setting. Overall, participants were largely Hispanic/Latinx (81.51%) and female (90.19%). Programs operated by CBOs engaged other race/ethnic groups including Black participants more frequently than those operated by clinics (20.56% vs. 0%); the latter engaged more men (15.29% vs. 7.22%). Few participants in any setting met the National DPP’s weight loss goal (clinic: 15.29%, CBO: 20.00%). Participating in a community-based program was initially associated with higher attendance and mean weekly physical activity, but associations were not significant after adjusting for covariates. Study results have practice implications for National DPP implementation and can help inform future efforts to scale and spread the program in Los Angeles and nationally.

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Community-Based Participatory Research Needs Assessment Strategies

PsycEXTRA Dataset ◽

10.1037/e589862013-001 ◽

2013 ◽

Author(s):

Samantha Pasena

Keyword(s):

Needs Assessment ◽

Participatory Research ◽

Community Based Participatory Research ◽

Research Needs ◽

Community Based ◽

Assessment Strategies

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804-P: How Barriers Affect Primary Care Providers’ Referral to the National Diabetes Prevention Program Lifestyle Change Program

Diabetes ◽

10.2337/db20-804-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 804-P

Author(s):

XUANPING ZHANG ◽

MICHAEL CANNON ◽

KUNTHEA NHIM ◽

TAMKEEN KHAN

Keyword(s):

Primary Care ◽

Prevention Program ◽

Diabetes Prevention ◽

Diabetes Prevention Program ◽

Lifestyle Change ◽

Primary Care Providers ◽

Care Providers

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The Impact of a Yearlong Diabetes Prevention Program-Based Lifestyle Intervention on Cardiovascular Health Metrics

Journal of Primary Care & Community Health ◽

10.1177/21501327211029816 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110298

Author(s):

Susan M. Devaraj ◽

Bonny Rockette-Wagner ◽

Rachel G. Miller ◽

Vincent C. Arena ◽

Jenna M. Napoleone ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Lifestyle Intervention ◽

Prevention Program ◽

Diabetes Prevention ◽

Cardiovascular Health ◽

Diabetes Prevention Program ◽

Behavioral Risk ◽

Community Based ◽

The Impact

Introduction The American Heart Association created “Life’s Simple Seven” metrics to estimate progress toward improving US cardiovascular health in a standardized manner. Given the widespread use of federally funded Diabetes Prevention Program (DPP)-based lifestyle interventions such as the Group Lifestyle Balance (DPP-GLB), evaluation of change in health metrics within such a program is of national interest. This study examined change in cardiovascular health metric scores during the course of a yearlong DPP-GLB intervention. Methods Data were combined from 2 similar randomized trials offering a community based DPP-GLB lifestyle intervention to overweight/obese individuals with prediabetes and/or metabolic syndrome. Pre/post lifestyle intervention participation changes in 5 of the 7 cardiovascular health metrics were examined at 6 and 12 months (BMI, blood pressure, total cholesterol, fasting plasma glucose, physical activity). Smoking was rare and diet was not measured. Results Among 305 participants with complete data (81.8% of 373 eligible adults), significant improvements were demonstrated in all 5 risk factors measured continuously at 6 and 12 months. There were significant positive shifts in the “ideal” and “total” metric scores at both time points. Also noted were beneficial shifts in the proportion of participants across categories for BMI, activity, and blood pressure. Conclusion AHA-metrics could have clinical utility in estimating an individual’s cardiovascular health status and in capturing improvement in cardiometabolic/behavioral risk factors resulting from participation in a community-based translation of the DPP lifestyle intervention.

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Choice of Intensive Lifestyle Change and/or Metformin after Shared Decision Making for Diabetes Prevention: Results from the Prediabetes Informed Decisions and Education (PRIDE) Study

Medical Decision Making ◽

10.1177/0272989x211001279 ◽

2021 ◽

pp. 0272989X2110012

Author(s):

Tannaz Moin ◽

Jacqueline M. Martin ◽

Carol M. Mangione ◽

Jonathan Grotts ◽

Norman Turk ◽

...

Keyword(s):

Decision Making ◽

Usual Care ◽

Shared Decision Making ◽

Diabetes Prevention ◽

Lifestyle Change ◽

Diabetes Incidence ◽

Shared Decision ◽

Informed Decisions ◽

Unit Increase ◽

Pride Study

Introduction While the Diabetes Prevention Program Study demonstrated that intensive lifestyle change and metformin both reduce type 2 diabetes incidence, there are little data on patient preferences in real-world, clinical settings. Methods The Prediabetes Informed Decisions and Education (PRIDE) study was a cluster-randomized trial of shared decision making (SDM) for diabetes prevention. In PRIDE, pharmacists engaged patients with prediabetes in SDM using a decision aid with information about both evidence-based options. We recorded which diabetes prevention option(s) participants chose after the SDM visit. We also evaluated logistic regression models examining predictors of choosing intensive lifestyle change ± metformin, compared to metformin or usual care, and predictors of choosing metformin ± intensive lifestyle change, compared to intensive lifestyle change or usual care. Results Among PRIDE participants ( n = 515), 55% chose intensive lifestyle change, 8.5% chose metformin, 15% chose both options, and 21.6% declined both options. Women (odds ratio [OR] = 1.60, P = 0.023) had higher odds than men of choosing intensive lifestyle change. Patients >60 years old (OR = 0.50, P = 0.028) had lower odds than patients <50 years old of choosing metformin. Participants with higher body mass index (BMI) had higher odds of choosing intensive lifestyle change (OR = 1.07 per BMI unit increase, P = 0.005) v. other options and choosing metformin (OR = 1.06 per BMI unit increase, P = 0.008) v. other options. Conclusions Patients with prediabetes are making choices for diabetes prevention that generally align with recommendations and expected benefits from the published literature. Our results are important for policy makers and clinicians, as well as program planners developing systemwide approaches for diabetes prevention.

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Patterns of Metabolic Progression to Type 1 Diabetes in the Diabetes Prevention Trial-Type 1

Diabetes Care ◽

10.2337/diacare.29.03.06.dc05-1006 ◽

2006 ◽

Vol 29 (3) ◽

pp. 643-649 ◽

Cited By ~ 112

Author(s):

J. M. Sosenko ◽

J. P. Palmer ◽

C. J. Greenbaum ◽

J. Mahon ◽

C. Cowie ◽

...

Keyword(s):

Type 1 Diabetes ◽

Trial Type ◽

Diabetes Prevention ◽

Prevention Trial

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Adolescents and Young Adults With Spina Bifida Transitioning to Adulthood: A Comprehensive Community-Based Needs Assessment

Academic Pediatrics ◽

10.1016/j.acap.2021.02.002 ◽

2021 ◽

Author(s):

Ashley M. Jenkins ◽

Diane Burns ◽

Rhonda Horick ◽

Brittany Spicer ◽

Lisa M. Vaughn ◽

...

Keyword(s):

Young Adults ◽

Spina Bifida ◽

Needs Assessment ◽

Adolescents And Young Adults ◽

Community Based

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Educational Principles of Community-based Education

PEDIATRICS ◽

10.1542/peds.98.6.1259 ◽

1996 ◽

Vol 98 (6) ◽

pp. 1259-1263

Author(s):

Kenneth B. Roberts

Keyword(s):

Medical Education ◽

Adult Learning ◽

Medical School ◽

Needs Assessment ◽

Teaching And Learning ◽

Educational Experiences ◽

Community Based ◽

Community Based Education ◽

Primary Focus ◽

School Curricula

Much of medical education remains teacher centered, as exemplified by the continued emphasis on lectures. Increasingly, however, the importance of the learner is being recognized and acknowledged in medical school curricula. The distinction between teaching and learning is also an issue for graduate medical education; accreditation bodies focus on programs and teaching, and credentialing bodies determine whether individuals have accomplished sufficient learning. The true mission of teaching is to facilitate learning, and adult learning is enhanced by four elements: respect, building on previous experiences, immediacy of application, and the opportunity to practice. These elements should be considered when designing educational experiences in the community. Educational planning includes five steps, represented by the mnemonic GNOME: goals, needs assessment, objectives, methods, and evaluation. Goals are broad aspirations, which are refined by the learners' needs to specific, measurable objectives. Methods are selected to match the objective, and evaluation determines whether the objectives were achieved. The results of the evaluation serve as another needs assessment, and the process continues until the goals are achieved. Throughout the process, the primary focus should be on the resident, with the program in a supporting role.

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