Evidence that lifestyle intervention can prevent or delay the development of type 2 diabetes has been demonstrated in several clinical trials including a multi center clinical trial in the US, the Diabetes Prevention Program or DPP. The challenge for public health is to translate this promising and proven behavioral intervention utilized in the DPP research effort to the """"""""real world"""""""", i.e., how to make it work in diverse communities in a variety of local settings at a reduced cost so that the maximal number of those at risk can benefit. The purpose of this application is to test a framework for translation of the DPP that includes: 1) demonstration of a training model for community health care professionals that includes initial training, support, and supervision in the delivery of a diabetes prevention curriculum and the needed behavioral lifestyle materials;2) evaluation of a more compact and flexible DPP intervention program administered to each participant in a version of his or her choice (standard face-to-face group format or a DVD version of the same lifestyle intervention program content). These lifestyle intervention programs will be carried out in three different community settings;i.e. a health care practice, a worksite, and local senior community centers. Lastly, the cost- effectiveness analyses of the LIFESTYLE intervention program in each of the three community settings will be tested. If proven to be effective, this framework for diabetes and cardiovascular risk prevention translation is one that could be adapted throughout the United States and abroad.
This proposal is a logical next step in the progression from promising randomized clinical trials utilizing behavioral, goal-based lifestyle interventions to prevent type 2 diabetes to effectiveness efforts in the community. We have convened a team of investigators to guide and evaluate all aspects of a community- based lifestyle intervention program, including a training model, to expand the reach of standardized effective interventions delivery. A cost-analysis of these efforts will be done as well.
