TY - JOUR
T1 - Lessons Learned From a Program to Reduce Diabetes Risk Among Low-Income Hispanic Women in a Community Health Clinic
AU - Lindberg, Nangel M.
AU - Vega-López, Sonia
AU - LeBlanc, Erin S.
AU - Leo, Michael C.
AU - Stevens, Victor J.
AU - Gille, Sara
AU - Arias-Gastelum, Mayra
AU - Meenan, Richard
N1 - Publisher Copyright:
© Copyright © 2021 Lindberg, Vega-López, LeBlanc, Leo, Stevens, Gille, Arias-Gastelum and Meenan.
PY - 2021/1/8
Y1 - 2021/1/8
N2 - Background: The Diabetes Prevention Program (DPP) and Look AHEAD studies demonstrated that modest weight loss and increased physical activity can significantly reduce the incidence of diabetes among overweight individuals with prediabetes. However, these studies involved costly interventions, all of which are beyond the reach of most real-world settings serving high-risk, low-income populations. Our project, De Por Vida, implemented a diabetes risk-reduction intervention for Hispanic women in a Federally Qualified Health Center and assessed the program’s efficacy. This report describes the methodology used to develop and implement De Por Vida, the cultural adaptations made, the community–academic partnership formed to carry out this program, and the barriers and challenges encountered through the implementation process. Methods: Our goal was to translate the DPP and Look AHEAD programs into an intervention to prevent diabetes and reduce diabetes complications among high-risk Hispanic women at a federally qualified health center in Hillsboro, Oregon, where more than half of clinic patients are Spanish-speaking, and nearly all live in poverty. This randomized clinical trial targeted overweight Spanish-speaking women at risk for, or diagnosed with, type 2 diabetes. We developed a 12-month behavioral diabetes risk-reduction intervention that was responsive to the cultural practices of the Hispanic population and that could be implemented in low-income clinical settings. Study planning and implementation involved close collaboration among the clinic leadership, a research team from the Kaiser Permanente Center for Health Research, and Arizona State University. Discussion: Creating a fully informed partnership between research and clinical institutions is the first step in successful cooperative research projects. The adoption of a bidirectional, rather than a top-down, approach to communication between researchers and health-care providers, and between clinic management and the clinic frontline staff, gave the research study team crucial information about barriers, constraints, and needs that clinic staff experienced in implementing the program. This allowed clinic management and front-line clinic staff to play an active role in study implementation, identifying problem areas, and collaborating in finding practical solutions. Clinical Trial Registration: www.clinicaltrials.gov, NCT03113916.
AB - Background: The Diabetes Prevention Program (DPP) and Look AHEAD studies demonstrated that modest weight loss and increased physical activity can significantly reduce the incidence of diabetes among overweight individuals with prediabetes. However, these studies involved costly interventions, all of which are beyond the reach of most real-world settings serving high-risk, low-income populations. Our project, De Por Vida, implemented a diabetes risk-reduction intervention for Hispanic women in a Federally Qualified Health Center and assessed the program’s efficacy. This report describes the methodology used to develop and implement De Por Vida, the cultural adaptations made, the community–academic partnership formed to carry out this program, and the barriers and challenges encountered through the implementation process. Methods: Our goal was to translate the DPP and Look AHEAD programs into an intervention to prevent diabetes and reduce diabetes complications among high-risk Hispanic women at a federally qualified health center in Hillsboro, Oregon, where more than half of clinic patients are Spanish-speaking, and nearly all live in poverty. This randomized clinical trial targeted overweight Spanish-speaking women at risk for, or diagnosed with, type 2 diabetes. We developed a 12-month behavioral diabetes risk-reduction intervention that was responsive to the cultural practices of the Hispanic population and that could be implemented in low-income clinical settings. Study planning and implementation involved close collaboration among the clinic leadership, a research team from the Kaiser Permanente Center for Health Research, and Arizona State University. Discussion: Creating a fully informed partnership between research and clinical institutions is the first step in successful cooperative research projects. The adoption of a bidirectional, rather than a top-down, approach to communication between researchers and health-care providers, and between clinic management and the clinic frontline staff, gave the research study team crucial information about barriers, constraints, and needs that clinic staff experienced in implementing the program. This allowed clinic management and front-line clinic staff to play an active role in study implementation, identifying problem areas, and collaborating in finding practical solutions. Clinical Trial Registration: www.clinicaltrials.gov, NCT03113916.
KW - Hispanic (demographic)
KW - diabetes mellitus type 2
KW - disparities (health)
KW - intervention—behavioral
KW - women—diseases
UR - http://www.scopus.com/inward/record.url?scp=85099773189&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85099773189&partnerID=8YFLogxK
U2 - 10.3389/fendo.2020.489882
DO - 10.3389/fendo.2020.489882
M3 - Article
AN - SCOPUS:85099773189
SN - 1664-2392
VL - 11
JO - Frontiers in Endocrinology
JF - Frontiers in Endocrinology
M1 - 489882
ER -