Translating the Diabetes Prevention Program into an Urban Medically Underserved Community: A Non-Randomized Prospective Intervention Study

Abstract

Objective: The objective of this study was to determine if a community-based, modified DPP Group Lifestyle Balance (GLB) intervention, for individuals with Metabolic Syndrome (MetS), was effective in decreasing risk for type 2 diabetes (T2D) and cardiovascular disease (CVD) in an urban, medically underserved community; and subsequently to determine if improvements in clinical outcomes could be sustained in the short-term.

Research Design and Methods: This non-randomized prospective intervention study utilized a one group design to test the effectiveness of a community-based GLB intervention. Residents from eleven targeted neighborhoods were screened for MetS (n=573) and took part in a 12 week GLB intervention (n=88) that addressed safe weight loss and physical activity.

Results: A marked decline in weight (46.4% lost ≥ 5% and 26.1% lost ≥ 7%) was observed in individuals following completion of the intervention. 87.5% (28) and 66.7% (12) of these subjects sustained the 5% and 7% reduction, respectively, at the 6-month reassessment. Over 1/3 of the population (43.5%, n=30) experienced improvements in ≥ one component of MetS, and 73.3% (22) sustained this improvement at the 6-month reassessment. Additional improvements occurred in waist circumference (p<0.009) and blood pressure levels (p=0.04) after adjustment for age, gender, race, mean number of GLB classes attended, and time.

Conclusions: Adults in an urban, medically underserved community can decrease their risk for T2D and CVD through participation in a GLB intervention and short-term sustainability is feasible. Future research will include long-term follow-up of these subjects.