The overall goal of this K23 proposal is to train Matthew J. O'Brien, MD, MSc for a career as an independent investigator in obesity and diabetes prevention, with a specific focus on Latinas-a demographic group at high risk for these related disorders. While there have been attempts to translate the evidence-based Diabetes Prevention Program (DPP) into community settings, very few of these studies have included Latinas. Community health workers, or promotoras, are trained lay people who provide health education, and could serve as leaders of weight loss and diabetes prevention efforts in Latinas. Previous research has demonstrated that promotoras are an effective lay health workforce, but no published studies have applied this intervention model to diabetes prevention in Latinas. Dr. O'Brien plans to address this gap in knowledge by developing a promotora-led lifestyle intervention (PLI), informed by the DPP, to promote weight loss and reduce cardiometabolic risk in Latinas. There are 3 Phases to the proposed research that will address corresponding specific aims: Phase 1 uses focus groups to explore the social and cultural context surrounding weight-related behaviors in Latinas at-risk for diabetes, applying the findings to develop PLI;Phase 2 involves piloting PLI in a single-arm trial, and assessing its feasibility and acceptabilit;Phase 3 will test the effects of PLI on changing at-risk Latinas'weight and cardiometabolic markers in a randomized controlled trial. In order to successfully complete the proposed research plan, Dr. O'Brien will receive additional training through formal coursework and structured mentorship in the following 3 areas: 1) qualitative methods;2) randomized controlled trials for weight loss and diabetes prevention;and 3) foundations in obesity, diabetes, and metabolism. Temple University is home to internationally-recognized researchers in each of these areas of study, who will serve as Dr. O'Brien's mentors. The site for the proposed research is a community health center founded by Dr. O'Brien-Puentes de Salud (""""""""Bridges of Health"""""""")-which serves a Latino population and has been the site of several promotora-based studies involving the target population since 2007.

Public Health Relevance

Latinas have a higher lifetime risk of developing diabetes than any other demographic group, and therefore, focusing on diabetes prevention in this population is a public health priority. A landmark study showed that lifestyle interventions are effective at promoting weight loss and preventing diabetes, and efforts are underway to replicate this study's findings in diverse populations. The proposed research will test the effectiveness of community health workers, or promotoras, in delivering a similar lifestyle intervention to promote weight loss and lower cardiometabolic risk in Latinas.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Mentored Patient-Oriented Research Career Development Award (K23)
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Study Section
Special Emphasis Panel (ZDK1-GRB-2 (M2))
Program Officer
Hyde, James F
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Temple University
Internal Medicine/Medicine
Schools of Medicine
United States
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O'Brien, Matthew J; Perez, Alberly; Scanlan, Adam B et al. (2017) PREVENT-DM Comparative Effectiveness Trial of Lifestyle Intervention and Metformin. Am J Prev Med 52:788-797
Hafez, Dina; Fedewa, Allison; Moran, Margaret et al. (2017) Workplace Interventions to Prevent Type 2 Diabetes Mellitus: a Narrative Review. Curr Diab Rep 17:9
Konchak, Juleigh Nowinski; Moran, Margaret R; O'Brien, Matthew J et al. (2016) The State of Diabetes Prevention Policy in the USA Following the Affordable Care Act. Curr Diab Rep 16:55
O'Brien, Matthew J; Lee, Ji Young; Carnethon, Mercedes R et al. (2016) Detecting Dysglycemia Using the 2015 United States Preventive Services Task Force Screening Criteria: A Cohort Analysis of Community Health Center Patients. PLoS Med 13:e1002074
O'Brien, Matthew J; Moran, Margaret R; Tang, Joyce W et al. (2016) Patient Perceptions About Prediabetes and Preferences for Diabetes Prevention. Diabetes Educ 42:667-677
Perez, Alberly; Alos, Victor A; Scanlan, Adam et al. (2015) The rationale, design, and baseline characteristics of PREVENT-DM: A community-based comparative effectiveness trial of lifestyle intervention and metformin among Latinas with prediabetes. Contemp Clin Trials 45:320-327
O'Brien, Matthew J; Perez, Alberly; Alos, Victor A et al. (2015) The feasibility, acceptability, and preliminary effectiveness of a Promotora-Led Diabetes Prevention Program (PL-DPP) in Latinas: a pilot study. Diabetes Educ 41:485-94
Chen, Jie; O'Brien, Matthew J; Mennis, Jeremy et al. (2015) Latino Population Growth and Hospital Uncompensated Care in California. Am J Public Health 105:1710-7
O'Brien, Matthew J; Whitaker, Robert C; Yu, Daohai et al. (2015) The comparative efficacy of lifestyle intervention and metformin by educational attainment in the Diabetes Prevention Program. Prev Med 77:125-30
O'Brien, Matthew J; Garland, Joseph M; Murphy, Katie M et al. (2014) Training medical students in the social determinants of health: the Health Scholars Program at Puentes de Salud. Adv Med Educ Pract 5:307-14

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