Outcomes of a Latino community-based intervention for the prevention of diabetes: the Lawrence Latino Diabetes Prevention Project
Department of Medicine, Division of Preventive and Behavorial Medicine; Department of Medicine, Division of Cardiovascular Medicine; Department of Medicine, Division of Endocrinology and Metabolism
Adult; Aged; Community Health Services; *Cultural Competency; Diabetes Mellitus, Type 2; Diet; Exercise; Health Behavior; Health Promotion; Hemoglobin A, Glycosylated; *Hispanic Americans; Humans; Insulin Resistance; Life Style; Massachusetts; Middle Aged; *Outcome Assessment (Health Care); Poverty; Socioeconomic Factors; Weight Loss
Behavioral Disciplines and Activities | Behavior and Behavior Mechanisms | Community Health and Preventive Medicine | Endocrine System Diseases | Preventative Medicine
OBJECTIVES: We tested the effectiveness of a community-based, literacy-sensitive, and culturally tailored lifestyle intervention on weight loss and diabetes risk reduction among low-income, Spanish-speaking Latinos at increased diabetes risk.
METHODS: Three hundred twelve participants from Lawrence, Massachusetts, were randomly assigned to lifestyle intervention care (IC) or usual care (UC) between 2004 and 2007. The intervention was implemented by trained Spanish-speaking individuals from the community. Each participant was followed for 1 year.
RESULTS: The participants' mean age was 52 years; 59% had less than a high school education. The 1-year retention rate was 94%. Compared with the UC group, the IC group had a modest but significant weight reduction (-2.5 vs 0.63 lb; P = .04) and a clinically meaningful reduction in hemoglobin A1c (-0.10% vs -0.04%; P = .009). Likewise, insulin resistance improved significantly in the IC compared with the UC group. The IC group also had greater reductions in percentage of calories from total and saturated fat.
CONCLUSIONS: We developed an inexpensive, culturally sensitive diabetes prevention program that resulted in weight loss, improved HbA1c, and improved insulin resistance in a high-risk Latino population.