Table 2—

DPP 16-session core curriculum

Session 1. Welcome to the Lifestyle Balance Program
 Build commitment to the DPP lifestyle change program by recording personal reasons for joining the DPP and perceived benefits to self, family, and others. Highlight the two study goals: 7% weight loss and 150 minutes of weekly physical activity and review key aspects of the relationship between the lifestyle coach and participant in working towards these goals. Introduce self-monitoring of food intake.
Session 2. Be a Fat Detective
 Introduce regular self-monitoring of weight at home. Help participants find the main sources of fat in their diet through self-monitoring fat grams using the “DPP Fat Counter” and by reading food labels. Assign a fat gram goal based on starting weight.
Session 3. Three Ways to Eat Less Fat
 Practice self-monitoring skills, including weighing and measuring foods and estimating portion size of foods. Teach three ways to eat less fat: eat high-fat foods less often, eat smaller portions, and substitute lower fat foods and cooking methods.
Session 4. Healthy Eating
 Emphasize the importance of a regular meal pattern and eating slowly. Use the Food Guide Pyramid (USDA) as a model for healthy eating and compare personal eating patterns to these recommendations. Recommend specific low-fat, low-calorie substitutes at each level of the Food Pyramid.
Session 5. Move Those Muscles
 Introduce physical activity and begin to build to 150 minutes of physical activity over the next 4 weeks, using activities such as brisk walking. Begin self-monitoring of physical activity as well as food intake. Review personal activity history and likes and dislikes about physical activity. Encourage attendance at group supervised activity sessions.
Session 6. Being Active: A Way of Life
 Help participants learn to find the time to be physically active each day by including short bouts (10–15 min) and healthy lifestyle activities, e.g., climbing stairs and walking extra blocks from the bus stop. Teach the basic principles for exercising safely, what to do in the event of injury, and knowing when to stop.
Session 7. Tip the Calorie Balance
 Teach the fundamental principle of energy balance and what it takes to lose 1–2 lbs per week. For those individuals who have made little progress with weight loss, assign self-monitoring of calories as well as fat grams or provide a structured meal plan at reduced calorie levels.
Session 8. Take Charge of What’s Around You
 Introduce the principle of stimulus control. Identify cues in the participant’s home environment that lead to unhealthy food and activity choices and discuss ways to change them.
Session 9. Problem Solving
 Present the five-step model of problem solving: describe the problem as links in a behavior chain, brainstorm possible solutions, pick one solution to try, make a positive action plan, evaluate the success of the solution. Apply the problem-solving model to eating and exercise problems.
Session 10. The Four Keys to Healthy Eating Out
 Introduce four basic skills for managing eating away from home: anticipating and planning ahead, positive assertion, stimulus control, and making healthy food choices.
Session 11. Talk Back to Negative Thoughts
 Practice identifying common patterns of self-defeating, negative thoughts and learn to counter these thoughts with positive statements.
Session 12. The Slippery Slope of Lifestyle Change
 Stress that slips are normal and learning to recover quickly is the key to success. Teach participants to recognize personal triggers for slips, their reactions to those slips, and what it takes to get back on track.
Session 13. Jump Start Your Activity Plan
 Introduce the basic principles of aerobic fitness: frequency, intensity, time, type of activity (FITT). Teach participants to measure their heart rate and perceived level of exertion as a way of determining the appropriate levels of activity. Discuss ways to cope with boredom by adding variety to the physical activity plan.
Session 14. Make Social Cues Work for You
 Present strategies for managing problem social cues, e.g., being pressured to overeat, and help participants learn to use social cues to promote healthy behaviors, e.g., making regular dates with a walking partner or group. Review specific strategies for coping with social events such as parties, vacations, and holidays.
Session 15. You Can Manage Stress
 Highlight the importance of coping with stress, including stress caused by the DPP, by using all of the skills previously taught, e.g., positive assertion, engaging social support, problem solving, planning, talking back to negative thoughts, and being physically active.
Session 16. Ways to Stay Motivated
 Enhance motivation to maintain behavior change by reviewing participants’ personal reasons for joining DPP and by recognizing personal successes thus far. Introduce other strategies for staying motivated including posting signs of progress, setting new goals, creating friendly competition, and seeking social support from DPP staff and others.