Significant disparities in prevention and treatment of type two diabetes mellitus and its complications persist among African Americans. Although definitive studies including the National Institutes of Health (NIH) diabetes prevention program (DPP) on which this study is modeled have demonstrated methods to delay or prevent type two diabetes mellitus, numerous barriers limit the implementation of these interventions on a large scale. What is needed is translation of these effective diabetes prevention interventions into the larger community. The proposed CBDPT-2 (Church-Based Diabetes Prevention and Translation-2 study) is a 3-year effectiveness study in 42 African American congregations. This study will compare a minimal intervention (MI) program with an intensive church-based lifestyle intervention (ILI) that includes both a focused 6- session program and a monthly Faith-Based Maintenance Program. Churches will be randomized to one of these two interventions. A community-based participatory approach will be used to develop the three-year Faith-Based Maintenance Program. Participants will be recruited via a diabetes risk assessment administered during Sunday church services, followed by fasting glucose (FG) testing. Persons with prediabetes (FG 100-125mg/dl) and body mass index (BMI) =25 will participate in the CBDPT-2. MI participants will have educational sessions conducted by a research assistant at baseline, 6 months, and 12 months. The MI group will also receive monthly educational mailings over 36 months. The ILI will include an intensive 6-session DPP based on the NIH DPP with sessions led by certified diabetes educators (CDEs), followed by a tailored FBMP with monthly meetings for 36 months. Data collection will occur at baseline, 6, 12, 24, and 36 months, measuring both the primary outcomes (weight and fasting glucose) and secondary outcomes (blood pressure, BMI, and change in physical activity and dietary intake). The primary hypothesis is that the ILI group will have lower weight, FG, blood pressure, and BMI compared to the MI group. We also hypothesize that the ILI group will have improved diet and physical activity compared to the MI group and the changes will be more cost-effective compared to the MI group.
This project will translate the NIH DPP into a community setting, thereby meeting the Healthy People 2010 objective of reducing the disease and economic burden of diabetes. The project curriculum is brief, relatively inexpensive, and suitable for widespread dissemination. The proposed church-based lifestyle intervention will both contribute to a greater understanding of community-based health promotion for delaying or preventing diabetes and its complications and help alleviate the burden of suffering from diabetes in African Americans.
|Seale, J Paul; Fifield, Judith; Davis-Smith, Y Monique et al. (2013) Developing culturally congruent weight maintenance programs for African American church members. Ethn Health 18:152-67|