Impact of a novel community-based lifestyle intervention program on type 2 diabetes and cardiovascular risk in a resource-poor setting in the Dominican Republic

Amy West-Pollak, Eddy P. Then, Carlos Podesta, Anne Hedelt, Mary Lou Perry, Wendy V. Izarnotegui, Margarita Perez, Antonio Villegas, Nelson I. Baez, Rimsky Bassa, Gabriella Mendez, Karmina Hernandez, David S. Lim, Pedro Urena, Angela M. Taylor

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The prevalence of type 2 diabetes is increasing at an alarming rate in Latin America and in the Caribbean. We present evidence that a cost-effective and sustainable approach to lifestyle modification in underdeveloped countries can be implemented using community members as healthcare champions. Methods: Of 222 community members screened in the impoverished community of Villa Juana, Santo Domingo, 69% had prediabetes or diabetes and 79 of these were enrolled. In a 1-day session, trained lifestyle educators from the USA trained ten lay community members to lead groups oriented to lifestyle change. Community leaders met with assigned patient groups monthly for 1 year. Glycated hemoglobin (HbA1c; average plasma glucose concentration), blood pressure, weight and waist circumference were measured at baseline, 6 months and 1 year. Results: 59 individuals completed follow-up. Patients showed significant improvements after 6 months in systolic blood pressure (p=0.001), diastolic blood pressure (p=0.000002) and HbA1c (p=0.015). HbA1c improved further at 1 year (p=0.005). Conclusion: Our pilot experience demonstrates the efficacy and feasibility of a novel, low-cost, community-based educational initiative to improve blood glucose control and reduce cardiovascular risk in individuals with type 2 diabetes or prediabetes. Replication of our model in other underserved areas could have a substantial impact on global health.

Original languageEnglish (US)
Article numberiht039
Pages (from-to)118-124
Number of pages7
JournalInternational Health
Volume6
Issue number2
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Dominican Republic
Type 2 Diabetes Mellitus
chronic illness
Life Style
Blood Pressure
resources
community
Prediabetic State
Costs and Cost Analysis
Latin America
Glycosylated Hemoglobin A
Waist Circumference
costs
Blood Glucose
Group
educator
leader
Delivery of Health Care
Weights and Measures
Glucose

Keywords

  • Behavior modification
  • Cardiovascular disease
  • Community-based participatory research
  • Hypertension
  • Lifestyle
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Medicine(all)

Cite this

Impact of a novel community-based lifestyle intervention program on type 2 diabetes and cardiovascular risk in a resource-poor setting in the Dominican Republic. / West-Pollak, Amy; Then, Eddy P.; Podesta, Carlos; Hedelt, Anne; Perry, Mary Lou; Izarnotegui, Wendy V.; Perez, Margarita; Villegas, Antonio; Baez, Nelson I.; Bassa, Rimsky; Mendez, Gabriella; Hernandez, Karmina; Lim, David S.; Urena, Pedro; Taylor, Angela M.

In: International Health, Vol. 6, No. 2, iht039, 2014, p. 118-124.

Research output: Contribution to journalArticle

West-Pollak, A, Then, EP, Podesta, C, Hedelt, A, Perry, ML, Izarnotegui, WV, Perez, M, Villegas, A, Baez, NI, Bassa, R, Mendez, G, Hernandez, K, Lim, DS, Urena, P & Taylor, AM 2014, 'Impact of a novel community-based lifestyle intervention program on type 2 diabetes and cardiovascular risk in a resource-poor setting in the Dominican Republic', International Health, vol. 6, no. 2, iht039, pp. 118-124. https://doi.org/10.1093/inthealth/iht039
West-Pollak, Amy ; Then, Eddy P. ; Podesta, Carlos ; Hedelt, Anne ; Perry, Mary Lou ; Izarnotegui, Wendy V. ; Perez, Margarita ; Villegas, Antonio ; Baez, Nelson I. ; Bassa, Rimsky ; Mendez, Gabriella ; Hernandez, Karmina ; Lim, David S. ; Urena, Pedro ; Taylor, Angela M. / Impact of a novel community-based lifestyle intervention program on type 2 diabetes and cardiovascular risk in a resource-poor setting in the Dominican Republic. In: International Health. 2014 ; Vol. 6, No. 2. pp. 118-124.
@article{718671d1d3f54b73be767635f64df55c,
title = "Impact of a novel community-based lifestyle intervention program on type 2 diabetes and cardiovascular risk in a resource-poor setting in the Dominican Republic",
abstract = "Background: The prevalence of type 2 diabetes is increasing at an alarming rate in Latin America and in the Caribbean. We present evidence that a cost-effective and sustainable approach to lifestyle modification in underdeveloped countries can be implemented using community members as healthcare champions. Methods: Of 222 community members screened in the impoverished community of Villa Juana, Santo Domingo, 69{\%} had prediabetes or diabetes and 79 of these were enrolled. In a 1-day session, trained lifestyle educators from the USA trained ten lay community members to lead groups oriented to lifestyle change. Community leaders met with assigned patient groups monthly for 1 year. Glycated hemoglobin (HbA1c; average plasma glucose concentration), blood pressure, weight and waist circumference were measured at baseline, 6 months and 1 year. Results: 59 individuals completed follow-up. Patients showed significant improvements after 6 months in systolic blood pressure (p=0.001), diastolic blood pressure (p=0.000002) and HbA1c (p=0.015). HbA1c improved further at 1 year (p=0.005). Conclusion: Our pilot experience demonstrates the efficacy and feasibility of a novel, low-cost, community-based educational initiative to improve blood glucose control and reduce cardiovascular risk in individuals with type 2 diabetes or prediabetes. Replication of our model in other underserved areas could have a substantial impact on global health.",
keywords = "Behavior modification, Cardiovascular disease, Community-based participatory research, Hypertension, Lifestyle, Type 2 diabetes mellitus",
author = "Amy West-Pollak and Then, {Eddy P.} and Carlos Podesta and Anne Hedelt and Perry, {Mary Lou} and Izarnotegui, {Wendy V.} and Margarita Perez and Antonio Villegas and Baez, {Nelson I.} and Rimsky Bassa and Gabriella Mendez and Karmina Hernandez and Lim, {David S.} and Pedro Urena and Taylor, {Angela M.}",
year = "2014",
doi = "10.1093/inthealth/iht039",
language = "English (US)",
volume = "6",
pages = "118--124",
journal = "International Health",
issn = "1876-3413",
publisher = "Elsevier Limited",
number = "2",

}

TY - JOUR

T1 - Impact of a novel community-based lifestyle intervention program on type 2 diabetes and cardiovascular risk in a resource-poor setting in the Dominican Republic

AU - West-Pollak, Amy

AU - Then, Eddy P.

AU - Podesta, Carlos

AU - Hedelt, Anne

AU - Perry, Mary Lou

AU - Izarnotegui, Wendy V.

AU - Perez, Margarita

AU - Villegas, Antonio

AU - Baez, Nelson I.

AU - Bassa, Rimsky

AU - Mendez, Gabriella

AU - Hernandez, Karmina

AU - Lim, David S.

AU - Urena, Pedro

AU - Taylor, Angela M.

PY - 2014

Y1 - 2014

N2 - Background: The prevalence of type 2 diabetes is increasing at an alarming rate in Latin America and in the Caribbean. We present evidence that a cost-effective and sustainable approach to lifestyle modification in underdeveloped countries can be implemented using community members as healthcare champions. Methods: Of 222 community members screened in the impoverished community of Villa Juana, Santo Domingo, 69% had prediabetes or diabetes and 79 of these were enrolled. In a 1-day session, trained lifestyle educators from the USA trained ten lay community members to lead groups oriented to lifestyle change. Community leaders met with assigned patient groups monthly for 1 year. Glycated hemoglobin (HbA1c; average plasma glucose concentration), blood pressure, weight and waist circumference were measured at baseline, 6 months and 1 year. Results: 59 individuals completed follow-up. Patients showed significant improvements after 6 months in systolic blood pressure (p=0.001), diastolic blood pressure (p=0.000002) and HbA1c (p=0.015). HbA1c improved further at 1 year (p=0.005). Conclusion: Our pilot experience demonstrates the efficacy and feasibility of a novel, low-cost, community-based educational initiative to improve blood glucose control and reduce cardiovascular risk in individuals with type 2 diabetes or prediabetes. Replication of our model in other underserved areas could have a substantial impact on global health.

AB - Background: The prevalence of type 2 diabetes is increasing at an alarming rate in Latin America and in the Caribbean. We present evidence that a cost-effective and sustainable approach to lifestyle modification in underdeveloped countries can be implemented using community members as healthcare champions. Methods: Of 222 community members screened in the impoverished community of Villa Juana, Santo Domingo, 69% had prediabetes or diabetes and 79 of these were enrolled. In a 1-day session, trained lifestyle educators from the USA trained ten lay community members to lead groups oriented to lifestyle change. Community leaders met with assigned patient groups monthly for 1 year. Glycated hemoglobin (HbA1c; average plasma glucose concentration), blood pressure, weight and waist circumference were measured at baseline, 6 months and 1 year. Results: 59 individuals completed follow-up. Patients showed significant improvements after 6 months in systolic blood pressure (p=0.001), diastolic blood pressure (p=0.000002) and HbA1c (p=0.015). HbA1c improved further at 1 year (p=0.005). Conclusion: Our pilot experience demonstrates the efficacy and feasibility of a novel, low-cost, community-based educational initiative to improve blood glucose control and reduce cardiovascular risk in individuals with type 2 diabetes or prediabetes. Replication of our model in other underserved areas could have a substantial impact on global health.

KW - Behavior modification

KW - Cardiovascular disease

KW - Community-based participatory research

KW - Hypertension

KW - Lifestyle

KW - Type 2 diabetes mellitus

UR - http://www.scopus.com/inward/record.url?scp=84902086822&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902086822&partnerID=8YFLogxK

U2 - 10.1093/inthealth/iht039

DO - 10.1093/inthealth/iht039

M3 - Article

VL - 6

SP - 118

EP - 124

JO - International Health

JF - International Health

SN - 1876-3413

IS - 2

M1 - iht039

ER -