Cited by 622Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and EducationPhysical Activity and Health

Translating the Diabetes Prevention Program into the Community

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Ackermann, Ronald T., Finch, Emily A., Brizendine, Edward, Zhou, Honghong, Marrero, David G.·2008·American Journal of Preventive Medicine

Abstract

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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Crossref · 10.1016/j.amepre.2008.06.035

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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].”
  • 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.”
  • 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”
  • 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)
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
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

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