This program is open to the public. Having prediabetes greatly increases the chance of developing type 2 diabetes and other serious health conditions. To simplify the test, only health traits that people would know about themselves were included, such as age, height, and weight, but not blood sugar or cholesterol levels. A person with a high score on the online risk test five or higher is at significant risk for having prediabetes. However, only a blood test can determine an official diagnosis.
Fill out this contact form with your information. Qualitative findings provide more detail:. I've become more aware of food portions in weight and liquid form and calories.
My wife started calling me a born-again nutritionist. I used to leave things at the bottom of the stairs and whoever went up next, took them. Now I just make a trip up. It was encouraged in the class to do that extra.
Each YMCA had a program coordinator and 1 or more coaches who were generally current staff. Program coordination, including outreach and recruitment, required from 2 to 20 hours of staff time per week median, 7. Coach time per class varied between coaches from 2 to 10 hours per week median, 4. At most branches, other staff members or additional coach time was necessary to support publicity, recruit participants, engage clinical partners, and perform administrative activities.
Overall, perceptions were positive, even among participants who did not complete the program. An earlier introduction to physical activity was also suggested, to take advantage of early motivation of participants and access to YMCA facilities. All coaches were available either by telephone or at the YMCA to assist participants outside of scheduled sessions. Participants and YMCA staff felt that coaches had knowledge and ability to address issues related to diet, exercise, social and psychological factors that may affect the ability to make lifestyle changes, and the skills and experience necessary to encourage group interaction.
The success of the program. Numerous participants reported that the group setting provided social support and a forum to exchange ideas. Participants also felt accountable to the larger group and were therefore more likely to attend sessions and maintain lifestyle changes. However, negative perceptions of the groups were also reported, focusing on limited sociodemographic diversity or feelings of noninclusion. For example,. I wish it had been geared toward people of a lower economic strata. It was like everyone in the class was in a different world than I was.
Participants generally found the length of the Y-DPP to be appropriate, enabling them to change habits and form healthy routines. Participants were more likely to suggest a longer rather than a shorter program or more sessions during the maintenance period.
Furthermore, this study expands on previous research by demonstrating effects on general health, quality of life, and knowledge and behavior, and providing findings important for program replication, including staff time commitments and participant and coach perspectives.
Consistent with other research 8—10 , our study provides evidence for the effectiveness of the DPP model to promote weight loss. Mean weight loss was 4.
Overall, the program was well-received among participants and coaches. Contrary to common concerns, participants felt that a relatively lengthy program was necessary for changing habits. Similarly, the positive association between attendance and weight loss and slight decrease in lifestyle changes reported 6 months after program completion suggests the importance of program length and ongoing support. Minor concerns regarding the curriculum focused on the emphasis on fat and the late introduction of physical activity; the rationale behind these practices should be explained to participants and coaches.
Findings indicate lower levels of engagement, and although numbers were too small for definitive comparisons, data suggest the possibility of poorer outcomes. Qualitative findings indicate that low-income and minority participants may not have felt a connection or sense of inclusion within the groups. Given the prevalence of diabetes among these populations, such findings suggest the need for targeted recruitment and possible program adaptations.
This study had several limitations. Participation in the program and evaluation were voluntary; therefore, results may have differed for less motivated populations.
Insufficient data were available regarding the suitability and effectiveness of the Y-DPP among some sociodemographic groups with low enrollment rates, including minorities, low-income individuals, and individuals who are underinsured or uninsured.
Although demographic characteristics of people who were referred but did not enroll are unknown, recruitment through clinical provider referrals likely limited enrollment among low-income and minority individuals, who are less likely to have a regular source of care 18, In addition, compared with participants who completed follow-up surveys, participants who did not complete follow-up surveys were younger, more likely to be black, less likely to be white, and had less education and lower income, possibly affecting the generalizability of findings.
Quantitative data were limited to preanalysis and postanalysis information collected by the YMCA and through surveys. Although most participants had a clinical diagnosis of prediabetes, follow-up clinical indicators of diabetes risk were not available. Follow-up data were also limited to 6 months after program completion; an extended follow-up period is necessary to assess the long-term sustainability of lifestyle changes.
Despite these limitations, this article makes an important contribution to the literature, because of the scope of the Y-DPP and its evaluation. As insurers and policy makers consider reimbursement for disease-prevention programs as a cost-effective alternative to clinical treatment, comprehensive evaluations of programs implemented under a range of conditions are crucial.
The YMCA has the unique advantage of on-site fitness facilities, experienced staff, and connections to clinical providers; other organizations may need to consider their capacity in these areas before replication. Wise Rd. Stephanie Carpenter. Mary Kate Owens. Lisa Behounek. Danielle Puckett. Jenn Segelken. Maribel Tandazo. Courtney Sims. Stacy Baumann. Penny Greenlee. Rachel Martinez. Rachel LaValley. Margaret Warner. Anthony Shovlowsky.
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