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 language | English (US) |
|---|---|
| Article number | iht039 |
| Pages (from-to) | 118-124 |
| Number of pages | 7 |
| Journal | International Health |
| Volume | 6 |
| Issue number | 2 |
| DOIs | |
| State | Published - 2014 |
| Externally published | Yes |
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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 journal › Article
}
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 -