Title | Translating the Diabetes Prevention Program into American Indian and Alaska Native communities: results from the Special Diabetes Program for Indians Diabetes Prevention demonstration project |
Publication Type | Journal Article |
Year of Publication | 2013 |
Authors | Jiang, L, Manson, SM, Beals, J, Henderson, WG, Huang, H, Acton, KJ, Roubideaux, Y |
Journal | Diabetes CareDiabetes Care |
Volume | 36 |
Pagination | 2027-34 |
Date Published | Jul |
ISBN Number | 1935-5548 (Electronic)<br/>0149-5992 (Linking) |
Accession Number | 23275375 |
Keywords | Adult, Alaska/epidemiology, Diabetes Mellitus/ epidemiology/ prevention & control, Female, Humans, Indians, North American, Life Style, Male, Middle Aged, Prediabetic State/ epidemiology/ therapy, Weight Loss, Young Adult |
Abstract | OBJECTIVE: The landmark Diabetes Prevention Program (DPP) showed that lifestyle intervention can prevent or delay the onset of diabetes for those at risk. We evaluated a translational implementation of this intervention in a diverse set of American Indian and Alaska Native (AI/AN) communities. RESEARCH DESIGN AND METHODS: The Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented the DPP lifestyle intervention among 36 health care programs serving 80 tribes. A total of 2,553 participants with prediabetes were recruited and started intervention by 31 July 2008. They were offered the 16-session Lifestyle Balance Curriculum and underwent a thorough clinical assessment for evaluation of their diabetes status and risk at baseline, soon after completing the curriculum (postcurriculum), and annually for up to 3 years. Diabetes incidence was estimated. Weight loss, changes in blood pressure and lipid levels, and lifestyle changes after intervention were also evaluated. RESULTS: The completion rates of SDPI-DP were 74, 59, 42, and 33% for the postcurriculum and year 1, 2, and 3 assessments, respectively. The crude incidence of diabetes among SDPI-DP participants was 4.0% per year. Significant improvements in weight, blood pressure, and lipid levels were observed immediately after the intervention and annually thereafter for 3 years. Class attendance strongly correlated with diabetes incidence rate, weight loss, and change in systolic blood pressure. CONCLUSIONS: Our findings demonstrate the feasibility and potential of translating the lifestyle intervention in diverse AI/AN communities. They have important implications for future dissemination and institutionalization of the intervention throughout the Native American health system. |
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