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Translation of the diabetes prevention program to the community: evaluation of implementation issues

Vanderwood, Karl (2014) Translation of the diabetes prevention program to the community: evaluation of implementation issues. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

INTRODUCTION: Clinical trials around the world have demonstrated that behavioral lifestyle interventions can prevent or delay the onset of type 2 diabetes. In the United States, the Diabetes Prevention Program (DPP) lifestyle intervention significantly reduced the incidence of diabetes by 58% compared to a control group and prompted the implementation of numerous community based translations. However, questions concerning intervention implementation in the community remain. The purpose of this dissertation is to evaluate some of these translation-related issues. Specifically, the ability of non-invasive screening methods to identify high-risk participants and the impact of pre-intervention delays and participant willingness to engage in healthy lifestyle practices on outcomes are examined.
METHODS: The foundation of this dissertation is data from an NIH-funded randomized delayed control group trial evaluating the feasibility and effectiveness of the DPP Group Lifestyle Balance (DPP-GLB) program, a direct adaptation of the DPP lifestyle intervention. A total of 223 participants were enrolled from a worksite and three community centers. Paper 1 describes the ability of non-invasive screening measures to identify participants with prediabetes and/or the metabolic syndrome. Paper 2 evaluates the impact of a pre-intervention delay and weight change during the lag time on participant success at 6 and 12 months. Paper 3 describes the association of participants’ willingness to engage in health lifestyle practices and other factors to achieving weight loss and physical activity goals.
RESULTS: Paper 1 demonstrated a lack of acceptable discrimination among all non-invasive methods in the identification of prediabetes and/or the metabolic syndrome. In paper 2, assignment to the delayed-control group and weight change during the pre-intervention delay did not affect weight loss, self-monitoring or attendance at 6 and 12 months. The results of paper 3 demonstrated the importance of willingness to engage in healthy lifestyle practices and self-monitoring and attendance for weight loss and physical activity (PA) goal achievement.
PUBLIC HEALTH SIGNIFICANCE: The results of this dissertation provide information regarding important issues in the implementation of community diabetes prevention programs. This knowledge will be extremely beneficial for organizations planning to implement a behavioral weight loss intervention in the community and will facilitate program delivery on a widespread basis.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Vanderwood, Karlkkv5@pitt.eduKKV5
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairKramer, Mary Kayekramerk@edc.pitt.eduMKK3
Committee MemberKriska, Andrea Mkriskaa@edc.pitt.eduAKY
Committee MemberArena, Vincent C.arena@pitt.eduARENA
Committee MemberVenditti, Elizabeth Mvendittiem@umpc.edu
Committee MemberSiminerio, Linda Msimilx@umpc.edu
Date: 27 June 2014
Date Type: Publication
Defense Date: 3 April 2014
Approval Date: 27 June 2014
Submission Date: 3 March 2014
Access Restriction: 1 year -- Restrict access to University of Pittsburgh for a period of 1 year.
Number of Pages: 228
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: diabetes prevention, translation, prediabetes, metabolic syndrome
Date Deposited: 27 Jun 2014 20:34
Last Modified: 15 Nov 2016 14:17
URI: http://d-scholarship.pitt.edu/id/eprint/20718

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