Formative research to adapt the 'Diabetes Prevention Program- Power to Prevent' for implementation in Bamako, Mali

Area of Science:

• Public Health
• Health Behavior Interventions
• Global Health

Background:

• Increasing rates of type 2 diabetes and cardiovascular diseases in Africa.
• Limited community-level behavior change interventions for diabetes and hypertension risk in Africa.
• Need for culturally adapted health programs for low-income, low-literacy populations.

Purpose of the Study:

• To adapt the US Centers for Disease Control and Prevention's "Diabetes Prevention Program Power to Prevent" (DPP-P2P) for urban communities in Bamako, Mali.
• To develop a culturally appropriate and accessible diabetes prevention program for a low-literacy population.
• To assess the feasibility and initial impact of the adapted program.

Main Methods:

• Iterative adaptation of DPP-P2P guidelines through stakeholder feedback and focus groups with community health workers (CHWs).
• Development of French PowerPoint presentations with visual aids, role plays, and group discussions.
• Pilot testing of a 14-session program with 45 at-risk individuals and assessment of dietary and exercise habit changes.

Main Results:

• Successful adaptation of DPP-P2P for low-literacy CHWs in Bamako, Mali.
• Inclusion of family-oriented components based on CHW recommendations.
• Significant improvements in participants' daily exercise frequency, reduced fat intake, and healthier diet/exercise goals.

Conclusions:

• The iterative adaptation process resulted in a culturally appropriate and well-received diabetes prevention program.
• The adapted DPP-P2P shows promise for effectively reaching low-income, low-literacy populations at risk for diabetes in Bamako.
• Culturally tailored health interventions are crucial for addressing non-communicable diseases in diverse African settings.