Translating the Diabetes Prevention Program into the Community
Open accessAbstract
Background The Diabetes Prevention Program (DPP) found that an intensive lifestyle intervention can reduce the development of diabetes by more than half in adults with prediabetes, but there is little information about the feasibility of offering such an intervention in community settings. This study evaluated the delivery of a group-based DPP lifestyle intervention in partnership with the YMCA.Methods This pilot cluster-randomized trial was designed to compare group-based DPP lifestyle intervention delivery by the YMCA to brief counseling alone (control) in adults who attended a diabetes risk-screening event at one of two semi-urban YMCA facilities and who had a BMI>or=24 kg/m2, >or=2 diabetes risk factors, and a random capillary blood glucose of 110-199 mg/dL. Multivariate regression was used to compare between-group differences in changes in body weight, blood pressures, HbA1c, total cholesterol, and HDL-cholesterol after 6 and 12 months.Results Among 92 participants, controls were more often women (61% vs 50%) and of nonwhite race (29% vs 7%). After 6 months, body weight decreased by 6.0% (95% CI=4.7, 7.3) in intervention participants and 2.0% (95% CI=0.6, 3.3) in controls (p<0.001; difference between groups). Intervention participants also had greater changes in total cholesterol (-22 mg/dL vs +6 mg/dL controls; p<0.001). These differences were sustained after 12 months, and adjustment for differences in race and gender did not alter these findings. With only two matched YMCA sites, it was not possible to adjust for potential clustering by site.Conclusions The YMCA may be a promising channel for wide-scale dissemination of a low-cost approach to lifestyle diabetes prevention.
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Randomized controlled trials evaluating the effectiveness of programs that target lifestyle behavior have shown mixed effects and, if effective, have generally resulted in only small changes in target behaviors.
“However, so far, randomized controlled trials evaluating the effectiveness of programs that target lifestyle behavior have shown mixed effects and, if effective, they have generally resulted in only small changes in target behaviors [11-15].”
From Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators (2015) · cites this paper as [11]
Tobacco quit lines, YMCA-based Diabetes Prevention Program treatment, and peer educator-led Diabetes Prevention Program treatment are all examples of effective programs that were originally developed by behavior change professionals and then effectively implemented in the community.
“Tobacco quit lines,74 YMCA-based Diabetes Prevention Program treatment,60 and peer educator–led Diabetes Prevention Program treatment59 are all examples of effective programs that were originally developed by behavior change professionals and then effectively implemented in the community.”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [60]
The addition of allied health experts to the interprofessional healthcare team either by physical colocation, distance consultation, or engagement in staff training can help to achieve higher-quality, more cost-effective care.
“The addition of these experts to the interprofessional healthcare team either by physical colocation, distance consultation, or engagement in staff training can help to achieve higher-quality, more cost-effective care.57–63”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [60]
The DEPLOY study, a pilot cluster-randomized trial comparing group-based DPP lifestyle intervention through a YMCA with brief counseling, found that among 92 randomized participants, at both 4 to 6 and 12 to 14 months, the percent change in weight and BMI, as well as the change in total cholesterol, was significantly greater in the intervention group.
“The DEPLOY (Diabetes Education & Prevention with a Lifestyle Intervention Offered at the YMCA) study was a pilot clusterrandomized trial comparing group-based DPP lifestyle intervention through a Young Men's Christian Association (16 group sessions with goals of 5% to 7% reduction in baseline body weight and 150 min/ week of moderate exercise) with brief counseling.Among 92 randomized participants”
From The CardioMetabolic Health Alliance (2015) · cites this paper as [78]
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- Authors
- Ackermann, R. T., Finch, E. A., Brizendine, E., Zhou, H., & Marrero, D. G.
- Affiliations
- Indiana University Indianapolis (US)
- Indiana University School of Medicine (US)
- Corresponding author
- Ackermann, Ronald T.
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2008-10
- Volume
- 35
- Issue
- 4
- Pages
- 357-363
- ISSN
- 0749-3797 (ISSN-L)
- PMC
- PMC2610485
- OpenAlex
- W2126727521
- Cited by
- 622
- References
- 34
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 7 · 2023: 12 · 2022: 17 · 2021: 34 · 2020: 81 · 2019: 28 · 2018: 43 · 2017: 31 · 2016: 45 · 2015: 50 · 2014: 52 · 2013: 55 · 2012: 57
- FWCI
- 23.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- School of Medicine, Indiana University
- National Institute of Diabetes and Digestive and Kidney Diseases (R34 DK70702-02, R34DK070702)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- Diabetes Prevention Program, prediabetes, lifestyle intervention, diabetes prevention, community-based delivery, YMCA, group intervention, brief counseling, weight loss, blood pressure, HbA1c, total cholesterol, HDL cholesterol, diabetes risk screening, dissemination
- MeSH terms
- Counseling, Diabetes Mellitus, Female, Health Promotion, Humans, Life Style, Male, Middle Aged, Patient Education as Topic, Pilot Projects, United States, Program Evaluation, Least-Squares Analysis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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