Culturally adapting the prevention of diabetes and obesity in South Asians (PODOSA) trial
Abstract
Type 2 diabetes is extremely common in South Asians, e.g. in men from Pakistani and Indian populations it is about three times as likely as in the general population in England, despite similarities in body mass index. Lifestyle interventions reduce the incidence of diabetes. Trials in Europe and North America have not, however, reported on the impact on South Asian populations separately or provided the details of their cross-cultural adaptation processes. Prevention of diabetes and obesity in South Asians (PODOSA) is a randomized, controlled trial in Scotland of an adapted, lifestyle intervention aimed at reducing weight and increasing physical activity to reduce type 2 diabetes in Indians and Pakistanis. The trial was adapted from the Finnish Diabetes Prevention Study. We describe, reflect on and discuss the following key issues: The core adaptations to the trial design, particularly the delivery of the intervention in homes by dietitians rather than in clinics. The use of both a multilingual panel and professional translators to help translate and/or develop materials. The processes and challenges of phonetic translation. How intervention resources were adapted, modified, newly developed and translated into Urdu and Gurmukhi (written Punjabi). The insights gained in PODOSA (including time pressures on investigators, imperfections in the adaptation process, the power of verbal rather than written information, the utilization of English and the mother-tongue languages simultaneously by participants and the costs) might help the research community, given the challenge of health promotion in multi-ethnic, urban societies.
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Evidence to support the effectiveness of culturally adapted complex interventions for UK South Asian populations with type 2 diabetes is inconclusive in demonstrating sufficient health-related gain to make such interventions cost effective.
“However, evidence to support the effectiveness of these interventions is inconclusive in demonstrating sufficient health-related gain to make such interventions cost effective [32,33].”
Culturally adapted health promotion interventions aimed at British South Asians have shown only moderate effect and were inconclusive in demonstrating cost effectiveness.
“Although a culturally adapted SMS has never been trialed in the United Kingdom, culturally adapted health promotion interventions aimed at British South Asians have shown only moderate effect and were inconclusive in demonstrating cost effectiveness [33].”
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- Authors
- Wallia, S., Bhopal, R. S., Douglas, A., Bhopal, R., Sharma, A., Hutchison, A., Murray, G., Gill, J., Sattar, N., Lawton, J., Tuomilehto, J., Mcknight, J., Forbes, J., Lean, M., & Sheikh, A.
- Affiliations
- University of Edinburgh (GB)
- University of Glasgow (GB)
- Universität für Weiterbildung Krems (AT)
- Western General Hospital (GB)
- Corresponding author
- Bhopal, R. S.
- Venue
- Health Promotion International
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-04-10
- Volume
- 29
- Issue
- 4
- Pages
- 768-779
- ISSN
- 0957-4824 (ISSN-L)
- 1460-2245
- OpenAlex
- W2146609466
- Cited by
- 42
- References
- 38
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2023: 2 · 2022: 6 · 2021: 1 · 2020: 5 · 2019: 2 · 2018: 5 · 2017: 4 · 2016: 4 · 2015: 3 · 2014: 2 · 2013: 1
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Promotion International (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Funders
- Cancer Research UK
- National Institute for Health and Care Research
- British Heart Foundation
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes prevention, obesity prevention, South Asians, cross-cultural adaptation, lifestyle intervention, multilingual materials, phonetic translation, Urdu language, health promotion
- MeSH terms
- Culture, Diabetes Mellitus, Type 2, Diet, Health Education, Health Promotion, Humans, India, Life Style, Obesity, Pakistan, Risk Factors, Scotland, Socioeconomic Factors, Translations, Health Behavior, Exercise, Body Mass Index, Nutritionists
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