In a Latina population at high risk for diabetes, a prevention program delivered by lay community health workers, or promotoras, was feasible, acceptable and effective, according to study findings published in The Diabetes Educator.
“This is the first study to examine a culturally tailored version of the Diabetes Prevention Program focused exclusively on Latinas,” the researchers wrote. “The [Promotora-Led Diabetes Prevention Program] study population is also unique with respect to its low educational attainment and household income — socioeconomic factors that are consistently associated with poor metabolic health.”
Matthew J. O’Brien, MD, MSc, of Northwestern University Feinberg School of Medicine, and colleagues evaluated 20 Latina adults with prediabetes (18 with obesity) in a single-arm pilot trial of the Promotora-Led Diabetes Prevention Program (DL-DPP) to determine its feasibility, acceptability and preliminary effectiveness. The PL-DPP was a year-long lifestyle intervention that included 24 sessions divided in 14 weekly core sessions and 10 post-core sessions biweekly or monthly. All of the sessions were conducted in Spanish.
During the study period, participants achieved a 5.6% (95% CI, 3.3-8) reduction in body weight, with 42% achieving the 7% weight-loss goal and 58% achieving at least the 5% weight-loss goal. By 12 months, 30% of participants reverted to normoglycemia. The researchers also found that there were significant pre- and post-intervention reductions for waist circumference, diastolic blood pressure, LDL cholesterol and insulin levels.
Perceived stress, anxiety and depression mean scores all decreased during the study period.
“The findings reported here suggest that delivery of the DPP by promotoras represents a promising approach for diabetes prevention in socioeconomically disadvantaged Latinas, a particularly high-risk population,” the researchers wrote. “Some of the most effective DPP translations including black and white participants were led by lay people.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.