In Chicago’s Greater Lawn community, 41% of the residents are Hispanic or Latino and 36% are African American. Local surveys show that rates of diabetes and diabetes risk factors, such as physical inactivity, overweight, and obesity, are higher for the Hispanic or Latino and African American residents than for the non-Hispanic white residents in the same community. The rates also are higher than the national averages for Hispanics or Latinos and African Americans.
Researchers and community partners adapted a clinic-based effective lifestyle-modification intervention, the Diabetes Prevention Program (DPP), for the Greater Lawn community. The adapted program, called Healthy Living, consisted of 16, one-hour core sessions delivered over 6 months and 6, one-hour post-core sessions delivered monthly. A community health worker (CHW) received intensive training and ongoing supervision to implement the program in small community groups (9 participants on average). The sessions and curriculum, translated into Spanish, closely followed the DPP’s intensive lifestyle curriculum. The CHW described type 2 diabetes and its complications to participants and explained that making lifestyle changes can prevent type 2 diabetes. The program aims to teach participants how to make healthy food choices, cook healthy foods, increase physical activity, and manage stress.
Researchers partnered with the National Kidney Foundation of Illinois to recruit participants at the foundation’s community screening events. Community members were screened for kidney disease, high blood pressure, overweight or obesity, and diabetes. During the course of 20 events, 1,162 people were screened; 120 were eligible to participate (no current diagnosis of diabetes or possible diabetes based on screening results) and were interested, and 69 enrolled (57.5% of people eligible and interested) in Healthy Living.
Researchers measured participants’ weight, waist circumference, and body fat percentage, and participants completed surveys about their physical activity and eating habits at baseline, at the end of the core sessions (6 months after baseline), and after the post-core sessions (12 months after baseline). Measurements and surveys were completed by 69 participants at baseline, 45 at 6 months, and 57 at 12 months. After 6 months, researchers found significant decreases in participants’ weight, waist circumference, body fat, and self-reported time spent sitting when compared with participants’ baseline data. They also found significant increases in participants’ self-reported minutes spent walking and some healthy eating habits such as avoiding fried foods and replacing unhealthy snacks with fruit and vegetables when compared with participants’ baseline data. However, researchers found no significant changes in participants’ healthy eating habits such as avoiding fats and modifying meat choices. At 12 months significant changes persisted for participants’ waist circumference, self-reported time spent sitting, and a few healthy eating habits— except for avoiding fats.
The Healthy Living program resulted in positive lifestyle changes similar to those achieved by the DPP. Because this translation effort shows promise for reaching people at increased risk of developing type 2 diabetes, diabetes educators could consider training CHWs to deliver Healthy Living.
Ruggiero L, Oros S, Choi YK. Community-based translation of the diabetes prevention program's lifestyle intervention in an underserved Latino population. The Diabetes Educator. 2011;37(4):564-72. Epub 2011 Jun 20.