Preventing Chronic Disease | Implementation and Outcomes of the New York State YMCA Diabetes Prevention Program: A Multisite Community-Based Translation, 2010–2012 - CDC

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Preventing Chronic Disease | Implementation and Outcomes of the New York State YMCA Diabetes Prevention Program: A Multisite Community-Based Translation, 2010–2012 - CDC

Implementation and Outcomes of the New York State YMCA Diabetes Prevention Program: A Multisite Community-Based Translation, 2010–2012

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• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables

Anne Bozack, MPH; Susan Millstein, LCSW, MPH; Jacqueline Martinez Garcel, MPH; Kim Kelly, BA; Rachael Ruberto, MPH, CPH; Linda Weiss, PhD

Suggested citation for this article: Bozack A, Millstein S, Garcel JM, Kelly K, Ruberto R, Weiss L. Implementation and Outcomes of the New York State YMCA Diabetes Prevention Program: A Multisite Community-Based Translation, 2010–2012. Prev Chronic Dis 2014;11:140006. DOI: http://dx.doi.org/10.5888/pcd11.140006.

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Abstract

Introduction
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.

Methods
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.

Results
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.

Conclusion
Outcomes demonstrate the potential for effectively implementing the DPP in community-based settings. Findings also suggest the need for replications among a broader population.

Acknowledgments

This study was funded by the NYS Health Foundation. Technical assistance was provided by the NYS Department of Health. We are grateful to the participants and YMCA staff members for sharing their experiences and insights with us.

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Author Information

Corresponding Author: Anne Bozack, MPH, The New York Academy of Medicine, 1216 Fifth Ave, New York, NY 10029. Telephone: 212-822-7253. E-mail:abozack@nyam.org.

Author Affiliations: Susan Millstein, Kim Kelly, Rachael Ruberto, New York State Department of Health, Albany, New York; Jacqueline Martinez Garcel, New York State Health Foundation, New York, New York; Linda Weiss, The New York Academy of Medicine, New York, New York.

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References

1. Centers for Disease Control and Prevention. National diabetes fact sheet. Atlanta (GA): US Department of Health and Human Services; 2011.
2. Department of Health. A National Service Framework for diabetes. London (GB): UK Department of Health; 2001.
3. Emerging Risk Factors Collaboration, Seshasai SRK, Kaptoge S, Thompson A, Di Angelantonio E, Gao P, et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Engl J Med 2011;364(9):829–41. Erratum in N Engl J Med 2011;364(13):1281. CrossRef PubMed
4. Nichols GA, Hillier TA, Brown JB. Progression from newly acquired impaired fasting glusose to type 2 diabetes. Diabetes Care 2007;30(2):228–33. Erratum in Diabetes Care 2008;31(12):2414. CrossRef PubMed
5. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet 2012;379(9833):2279–90. CrossRef PubMed
6. American Diabetes Association. Standards of medical care in diabetes — 2010. Diabetes Care 2010;33(Suppl 1):S11–61. Erratum in Diabetes Care 2010;33(3):692. PubMed
7. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346(6):393–403. CrossRef PubMed
8. Ackermann RT, Finch EA, Brizendine E, Zhou H, Marrero DG. Translating the Diabetes Prevention Program into the community: the DEPLOY pilot study. Am J Prev Med 2008;35(4):357–63. CrossRef PubMed
9. Ali MK, Echouffo-Tcheugui J, Williamson DF. How effective were lifestyle interventions in real-world settings that were modeled on the Diabetes Prevention Program? Health Aff (Millwood) 2012;31(1):67–75. CrossRef PubMed
10. Boltri JM, Davis-Smith M, Okosun IS, Seale JP, Foster B. Translation of the National Institutes of Health Diabetes Prevention Program in African American churches. J Natl Med Assoc 2011;103(3):194–202. PubMed
11. DeJoy DM, Padilla HM, Wilson MG, Vandenberg RJ, Davis MA. Worksite translation of the Diabetes Prevention Program: formative research and pilot study results from FUEL Your Life. Health Promot Pract 2013;14(4):506–13. CrossRef PubMed
12. Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr 2005;82(1, Suppl):222S–5S. PubMed
13. Kruger J, Blanck HM, Gillespie C. Dietary and physical activity behaviors among adults successful at weight loss maintenance. Int J Behav Nutr Phys Act 2006;3:17. CrossRef PubMed
14. National Diabetes Prevention Program. Get the curriculum. Atlanta (GA): US Department of Health and Human Services, Centers for Disease Control and Prevention, Division of Diabetes Translation. http://www.cdc.gov/diabetes/prevention/recognition/curriculum.htm. Accessed December 11, 2013.
15. Centers for Disease Control and Prevention. Diabetes prevention recognition program: standards and operating procedures. Atlanta (GA): US Department of Health and Human Services; 2011.
16. Centers for Disease Control and Prevention. 2010 Behavioral Risk Factor Surveillance System questionnaire. Atlanta (GA): US Department of Health and Human Services; 2010.
17. EQ-5D-3L. Rotterdam (NL): EuroQol Group; 2014. http://www.euroqol.org/eq-5d-products/eq-5d-3l.html. Accessed May 9, 2014.
18. Mahmoudi E, Jensen GA. Diverging racial and ethnic disparities in access to physician care: comparing 2000 and 2007. Med Care 2012;50(4):327–34.CrossRef PubMed
19. Agency for Healthcare Research and Quality. 2010 national healthcare quality report. Rockville (MD): US Department of Health and Human Services; 2011.