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

11 Scopus citations

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 - Jun 2014

Keywords

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

ASJC Scopus subject areas

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

Fingerprint Dive into the research topics of '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'. Together they form a unique fingerprint.

  • Cite this

    West-Pollak, A., Then, E. P., Podesta, C., Hedelt, A., Perry, M. L., Izarnotegui, W. V., Perez, M., Villegas, A., Baez, N. I., Bassa, R., Mendez, G., Hernandez, K., Lim, D. S., Urena, P., & Taylor, A. M. (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, 6(2), 118-124. [iht039]. https://doi.org/10.1093/inthealth/iht039