The diabetes epidemic, which disproportionately impacts Blacks and Latinos, can be stemmed through lifestyle interventions that lead to weight loss. Unfortunately, these programs either do not target the most vulnerable, low-income minority populations, or cease to exist when their research funding disappears. Seven years ago, community and academic leaders in East Harlem came together to use community-based participatory research to develop an intervention that would sustainably reduce health disparities and evaluate it using rigorous methods. Partners developed HEED, a low-cost, culturally and economically appropriate, peer-led community-based diabetes prevention program, and recruited 400 Black and Latino adults with pre-diabetes to a community-based, multisite randomized controlled trial to test its impact on weight change. HEED led to statisticall significant weight loss, improvements in diet and a leveling of average glucose in this predominantly low-income, Spanish-speaking, uninsured, undereducated population. We now aim to disseminate HEED among the 34,000 adults living in East Harlem at heightened risk for diabetes and the 324 community organizations who serve them. To accomplish this, our partnership will use theoretically-driven implementation strategies to: 1) Identify ways to widely disseminate HEED through assessing organizational and individual barriers to, and facilitators of dissemination;2) Translate HEED for everyday use by tailoring in-person HEED workshops and developing I-HEED online workshops;3) Robustly disseminate HEED using social and organizational networks, social media, and economic incentives;4) Evaluate the extent, reach, and impact of our dissemination efforts, compare effectiveness of different approaches, and identify economically sustainable models;5) Increase the capacity of community members to engage in future research for community benefit through continued partnership and structured learning opportunities. We will use lessons learned to contribute valuable insights that will assis others in real-world dissemination of evidence-based health interventions to eliminate health disparities.
Diabetes is epidemic, but programs to prevent diabetes are out of reach of the low-income, minority populations at highest risk. We will disseminate a proven-effective diabetes prevention intervention developed by and for the East Harlem community, so that research leads to direct community benefit. By testing different dissemination strategies in a real world setting, we will also help others translate research to eliminate disparities into routine community use.
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