Vanderwood, Karl
(2014)
Translation of the diabetes prevention program to the community: evaluation of implementation issues.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
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: |
| Creators | Email | Pitt Username | ORCID  |
|---|
| Vanderwood, Karl | kkv5@pitt.edu | KKV5 | |
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| ETD Committee: |
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| 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: |
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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