A Cluster Randomized Controlled Trial Comparing Diabetes Prevention Program Interventions for Overweight/Obese...

Area of Science:

• Public Health
• Chronic Disease Prevention
• Health Disparities

Background:

• Overweight and obesity are significant health concerns within the Marshallese population.
• The Diabetes Prevention Program (DPP) has shown success in other populations but requires adaptation for diverse cultural groups.
• Faith-based and family-focused adaptations may enhance engagement and effectiveness in community settings.

Purpose of the Study:

• To compare the effectiveness of a faith-based DPP adaptation versus a family-focused DPP adaptation on weight loss in overweight/obese Marshallese adults.
• To evaluate the impact of these interventions on secondary outcomes including Hemoglobin A1c, blood pressure, diet, and physical activity.
• To identify culturally relevant strategies for chronic disease prevention in this specific at-risk population.

Main Methods:

• A two-arm cluster randomized controlled trial involving 380 Marshallese adults across 30 churches in Arkansas and Oklahoma.
• Participants received either a faith-based or family-focused DPP intervention over 24 weeks.
• Weight change was the primary outcome, assessed longitudinally using general linear mixed effects regression models.

Main Results:

• Both interventions resulted in small, statistically non-significant differences in weight loss between the two arms at 6 and 12 months.
• Only 7.1% of participants achieved a clinically significant 5% weight loss.
• Significant improvements were observed in systolic and diastolic blood pressure, sugar-sweetened beverage consumption, and family support for healthy behaviors in both arms.

Conclusions:

• While both adapted DPP interventions led to modest improvements in some health indicators, they did not achieve significant weight loss differences between groups.
• Culturally tailored interventions are crucial, but further research is needed to develop effective weight reduction strategies for the Marshallese population.
• Addressing weight management remains critical for preventing chronic diseases in this vulnerable community.