The Participant Experience in Community-Delivered Diabetes Prevention Interventions: Health-Related Quality of Life and Direct Nonmedical ExpensesSchafer, Gerald L (2013) The Participant Experience in Community-Delivered Diabetes Prevention Interventions: Health-Related Quality of Life and Direct Nonmedical Expenses. Doctoral Dissertation, University of Pittsburgh. (Unpublished)
AbstractIntroduction: Behavioral lifestyle interventions to prevent type 2 diabetes have been successful in reducing the risk of diabetes in clinical studies, while translational programs have demonstrated the ability to reduce diabetes risk factors in a variety of community settings. However, there remain important questions about the impact of translational diabetes prevention programs on non-clinical factors like Health-Related Quality of Life (HRQoL) and also the time and expenses that participants experience in these programs. Methods: Data were collected from participants at three sites where the Group Lifestyle Balance (GLB) program, a behavior lifestyle intervention program adapted from the Diabetes Prevention Program (DPP) was delivered. Paper 1 reports on HRQoL among participants in a GLB intervention presented by diabetes educators at outpatient clinics. Paper 2 continues the investigation of HRQoL in a GLB program delivered through a medical clinic using group and DVD delivery modes. In Paper 3, direct nonmedical expenses for food and physical activity, as well as time in intervention-relate activities are reported. Results: Papers 1 and 2 showed that participants in a translational diabetes prevention interventions experienced modest improvements in HRQoL, measured by two different assessment instruments. The findings in Paper 3 indicate that diabetes prevention participants can reduce clinical risk factors for type 2 diabetes without incurring additional expenses for food or physical activity. Only the expense of time due to involvement in activities related to the intervention increased. Public Health Significance: Many individuals at elevated risk of type 2 diabetes consider themselves in quite good health. However, there are debilitating morbidities associated with type 2 diabetes that may be delayed or prevented through lifestyle intervention programs. The improvements in quality of life that participants experience should help individuals at risk find these programs more attractive. This is especially so given that participants need not incur significant additional out-of-pocket expenses. The summary message should be that you can reduce your risk of diabetes through moderate lifestyle intervention; you might feel a bit better in some aspects of your health; and it won’t cost you much as long as you are willing to commit some time to the intervention. Share
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