Bozack Anne, Millstein Susan, Garcel Jacqueline Martinez, Kelly Kim, Ruberto Rachael, Weiss Linda
The New York Academy of Medicine, 1216 Fifth Ave, New York, NY 10029. E-mail:
New York State Department of Health, Albany, New York.
Prev Chronic Dis. 2014 Jul 10;11:E115. doi: 10.5888/pcd11.140006.
Weight loss and physical activity achieved through the Diabetes Prevention Program (DPP) have been shown to reduce type 2 diabetes risk among individuals with prediabetes. The New York State Young Men's Christian Association (YMCA) delivered the 16-week evidence-based model at 14 YMCAs. A mixed methods process and outcomes evaluation was conducted.
Most participants were referred by clinicians and were encouraged to achieve 5% to 7% weight loss. Participants were weighed weekly; additional data were gathered from participant surveys and focus groups and staff surveys and interviews.
Participants (N = 254) lost a mean of 9 pounds (P < .001), or 4.2% of body weight, by program completion; 40% achieved 5% or more weight loss and 25% achieved 7% or more weight loss. Ten months after baseline, 61% of participants reported 5% or more weight loss and 48% reported 7% or more weight loss. In multivariate models, weight loss was negatively associated with black race (16 weeks: adjusted odds ratio [AOR], 0.190, P = .002; 10 months: AOR, 0.244, P = .005) and positively associated with attendance (16 weeks: AOR, 18.699, P < .001; 10 months: AOR, 2.808, P = .024). Participants reported improvements in health and lifestyle changes after program completion. Factors contributing to program success included coaches who motivated participants, the group setting, curriculum, and program duration. However, sociodemographic diversity was limited.
Outcomes demonstrate the potential for effectively implementing the DPP in community-based settings. Findings also suggest the need for replications among a broader population.
通过糖尿病预防计划(DPP)实现的体重减轻和体育活动已被证明可降低糖尿病前期个体患2型糖尿病的风险。纽约州基督教青年会(YMCA)在14个YMCA场所实施了为期16周的循证模式。进行了混合方法的过程和结果评估。
大多数参与者由临床医生推荐,并被鼓励减重5%至7%。参与者每周称重;还从参与者调查、焦点小组以及工作人员调查和访谈中收集了其他数据。
到项目结束时,参与者(N = 254)平均减重9磅(P <.001),即体重的4.2%;40%的参与者减重达到或超过5%,25%的参与者减重达到或超过7%。在基线后的十个月,61%的参与者报告减重达到或超过5%,48%的参与者报告减重达到或超过7%。在多变量模型中,体重减轻与黑人种族呈负相关(16周:调整后的优势比[AOR],0.190,P =.002;10个月:AOR,0.244,P =.005),与出勤率呈正相关(16周:AOR,18.699,P <.001;10个月:AOR,2.808,P =.024)。参与者报告在项目结束后健康状况有所改善,生活方式也发生了变化。促成项目成功的因素包括激励参与者的教练、团体环境、课程设置和项目持续时间。然而,社会人口学多样性有限。
结果表明在社区环境中有效实施糖尿病预防计划具有潜力。研究结果还表明需要在更广泛的人群中进行推广。