Prevention in Prison: The Diabetes Prevention Program in a Correctional Setting.

Area of Science:

• Public Health
• Preventive Medicine
• Correctional Healthcare

Background:

• Diabetes and cardiometabolic diseases pose significant health challenges within correctional facilities.
• Implementing evidence-based lifestyle interventions in unique environments like prisons requires careful adaptation and evaluation.

Purpose of the Study:

• To assess the feasibility and effectiveness of an adapted Diabetes Prevention Program (DPP) in a correctional setting.
• To evaluate the program's impact on weight loss, glycated hemoglobin (A1C) levels, and other cardiometabolic risk factors among incarcerated individuals with prediabetes.

Main Methods:

• A quasi-experimental, staggered-start control study was conducted in federal correctional institutions involving overweight individuals with prediabetes.
• Participants were assigned to an immediate intervention group or a delayed-start control group, with data collected over 18 months.
• The intervention involved a 12-month Group Lifestyle Balance program adapted for the correctional environment.

Main Results:

• The adapted DPP intervention led to significant reductions in weight, body mass index (BMI), and A1C levels from baseline.
• Participants in the immediate intervention group showed greater average weight loss at 6 months compared to the control group.
• Overall, both groups demonstrated significant cardiometabolic improvements after 6 months and 12 months of intervention.

Conclusions:

• An adapted Diabetes Prevention Program (DPP) appears effective in improving cardiometabolic health within a correctional environment.
• High attrition rates, primarily due to participant transfers and releases, impacted study findings and necessitate consideration in future implementations.
• Further research with larger sample sizes is recommended to confirm these promising outcomes and refine intervention strategies for incarcerated populations.