Adapting the Diabetes Prevention Program for low and middle-income countries: Protocol for a cluster randomised trial to evaluate 'Lifestyle Africa'

Delwyn Catley, Thandi Puoane, Lungiswa Tsolekile, Ken Resnicow, Kandace Fleming, Emily A. Hurley, Joshua M. Smyth, Mara Z. Vitolins, Estelle V. Lambert, Naomi Levitt, Kathy Goggin

Research output: Contribution to journalArticle

Abstract

Introduction Low and middle-income countries like South Africa are experiencing major increases in burden of non-communicable diseases such as diabetes and cardiovascular conditions. However, evidence-based interventions to address behavioural factors related to these diseases are lacking. Our study aims to adapt the CDC's National Diabetes Prevention Program (DPP) within the context of an under-resourced urban community in Cape Town, South Africa. Methods/analysis The new intervention (Lifestyle Africa) consists of 17 weekly sessions delivered by trained community health workers (CHWs). In addition to educational and cultural adaptations of DPP content, the programme adds novel components of text messaging and CHW training in Motivational Interviewing. We will recruit overweight and obese participants (body mass index ≥25 kg/m 2) who are members of 28 existing community health clubs served by CHWs. In a 2-year cluster randomised control trial, clubs will be randomly allocated to receive the intervention or usual care. After year 1, usual care participants will also receive the intervention and both groups will be followed for another year. The primary outcome analysis will compare percentage of baseline weight loss at year 1. Secondary outcomes will include diabetes and cardiovascular risk indicators (blood pressure, haemoglobin A1C, lipids), changes in self-reported medication use, diet (fat and fruit and vegetable intake), physical activity and health-related quality of life. We will also assess potential psychosocial mediators/moderators as well as cost-effectiveness of the programme. Ethics/dissemination Ethical approval was obtained from the University of Cape Town and Children's Mercy. Results will be submitted for publication in peer-reviewed journals and training curricula will be disseminated to local stakeholders.

Original languageEnglish (US)
Article numbere031400
JournalBMJ open
Volume9
Issue number11
DOIs
StatePublished - Nov 1 2019

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Life Style
South Africa
Fitness Centers
Text Messaging
Motivational Interviewing
Centers for Disease Control and Prevention (U.S.)
Ethics
Vegetables
Curriculum
Cost-Benefit Analysis
Publications
Weight Loss
Fruit
Hemoglobins
Body Mass Index
Fats
Quality of Life
Exercise
Diet
Blood Pressure

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Catley, Delwyn ; Puoane, Thandi ; Tsolekile, Lungiswa ; Resnicow, Ken ; Fleming, Kandace ; Hurley, Emily A. ; Smyth, Joshua M. ; Vitolins, Mara Z. ; Lambert, Estelle V. ; Levitt, Naomi ; Goggin, Kathy. / Adapting the Diabetes Prevention Program for low and middle-income countries : Protocol for a cluster randomised trial to evaluate 'Lifestyle Africa'. In: BMJ open. 2019 ; Vol. 9, No. 11.
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Catley, D, Puoane, T, Tsolekile, L, Resnicow, K, Fleming, K, Hurley, EA, Smyth, JM, Vitolins, MZ, Lambert, EV, Levitt, N & Goggin, K 2019, 'Adapting the Diabetes Prevention Program for low and middle-income countries: Protocol for a cluster randomised trial to evaluate 'Lifestyle Africa'', BMJ open, vol. 9, no. 11, e031400. https://doi.org/10.1136/bmjopen-2019-031400

Adapting the Diabetes Prevention Program for low and middle-income countries : Protocol for a cluster randomised trial to evaluate 'Lifestyle Africa'. / Catley, Delwyn; Puoane, Thandi; Tsolekile, Lungiswa; Resnicow, Ken; Fleming, Kandace; Hurley, Emily A.; Smyth, Joshua M.; Vitolins, Mara Z.; Lambert, Estelle V.; Levitt, Naomi; Goggin, Kathy.

In: BMJ open, Vol. 9, No. 11, e031400, 01.11.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Adapting the Diabetes Prevention Program for low and middle-income countries

T2 - Protocol for a cluster randomised trial to evaluate 'Lifestyle Africa'

AU - Catley, Delwyn

AU - Puoane, Thandi

AU - Tsolekile, Lungiswa

AU - Resnicow, Ken

AU - Fleming, Kandace

AU - Hurley, Emily A.

AU - Smyth, Joshua M.

AU - Vitolins, Mara Z.

AU - Lambert, Estelle V.

AU - Levitt, Naomi

AU - Goggin, Kathy

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Introduction Low and middle-income countries like South Africa are experiencing major increases in burden of non-communicable diseases such as diabetes and cardiovascular conditions. However, evidence-based interventions to address behavioural factors related to these diseases are lacking. Our study aims to adapt the CDC's National Diabetes Prevention Program (DPP) within the context of an under-resourced urban community in Cape Town, South Africa. Methods/analysis The new intervention (Lifestyle Africa) consists of 17 weekly sessions delivered by trained community health workers (CHWs). In addition to educational and cultural adaptations of DPP content, the programme adds novel components of text messaging and CHW training in Motivational Interviewing. We will recruit overweight and obese participants (body mass index ≥25 kg/m 2) who are members of 28 existing community health clubs served by CHWs. In a 2-year cluster randomised control trial, clubs will be randomly allocated to receive the intervention or usual care. After year 1, usual care participants will also receive the intervention and both groups will be followed for another year. The primary outcome analysis will compare percentage of baseline weight loss at year 1. Secondary outcomes will include diabetes and cardiovascular risk indicators (blood pressure, haemoglobin A1C, lipids), changes in self-reported medication use, diet (fat and fruit and vegetable intake), physical activity and health-related quality of life. We will also assess potential psychosocial mediators/moderators as well as cost-effectiveness of the programme. Ethics/dissemination Ethical approval was obtained from the University of Cape Town and Children's Mercy. Results will be submitted for publication in peer-reviewed journals and training curricula will be disseminated to local stakeholders.

AB - Introduction Low and middle-income countries like South Africa are experiencing major increases in burden of non-communicable diseases such as diabetes and cardiovascular conditions. However, evidence-based interventions to address behavioural factors related to these diseases are lacking. Our study aims to adapt the CDC's National Diabetes Prevention Program (DPP) within the context of an under-resourced urban community in Cape Town, South Africa. Methods/analysis The new intervention (Lifestyle Africa) consists of 17 weekly sessions delivered by trained community health workers (CHWs). In addition to educational and cultural adaptations of DPP content, the programme adds novel components of text messaging and CHW training in Motivational Interviewing. We will recruit overweight and obese participants (body mass index ≥25 kg/m 2) who are members of 28 existing community health clubs served by CHWs. In a 2-year cluster randomised control trial, clubs will be randomly allocated to receive the intervention or usual care. After year 1, usual care participants will also receive the intervention and both groups will be followed for another year. The primary outcome analysis will compare percentage of baseline weight loss at year 1. Secondary outcomes will include diabetes and cardiovascular risk indicators (blood pressure, haemoglobin A1C, lipids), changes in self-reported medication use, diet (fat and fruit and vegetable intake), physical activity and health-related quality of life. We will also assess potential psychosocial mediators/moderators as well as cost-effectiveness of the programme. Ethics/dissemination Ethical approval was obtained from the University of Cape Town and Children's Mercy. Results will be submitted for publication in peer-reviewed journals and training curricula will be disseminated to local stakeholders.

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