Evaluation of a Diabetes Prevention Program Implementation in a Student-Run Free Clinic Setting

Meredith Huszagh, Jeremy B Hatcher, C. Grimaldi, N. Kloosterman, D. Carranza-León, Xuanyi Li, Lina M. Sulieman, Rosette Chakkalakal, K. Niswender
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Abstract

Introduction: The Diabetes Prevention Program (DPP) can prevent or delay the development of type 2 diabetes in at-risk individuals. Although low-resource and minority communities have higher rates of type 2 diabetes, these communities often have limited DPP participation due to cost and program accessibility. We evaluated whether a high-fidelity, reduced-cost 16-week DPP could feasibly be implemented by student volunteers and be effective in facilitating the target 5% weight loss goal among participants.  Methods: Uninsured, Spanish-speaking participants and their invited guests were recruited from Vanderbilt University Medical Center’s student-run clinic. Weekly DPP sessions were conducted using the CDC’s Prevent T2 curriculum in Spanish, delivered in-person for 6 weeks and virtually for the remaining 10 weeks due to the Coronavirus Disease 2019 pandemic. Participant attendance and weight data were collected. Pre- and post-program health-related quality of life was assessed using the EuroQoL 5D5L tool, and qualitative program feedback surveys were administered. Changes in weight and quality of life as a function of program session attendance and patient demographics were determined primarily using Wilcoxon tests. Results: Of the 17 participants actively engaged in the student-led DPP, 13 were clinic patients and 4 were invited guests. The median weight loss achieved by participants was 5.90% of their total body weight. 13 of the 17 participants (76.50%) achieved the 5% weight loss goal. Age, sex, pre-program body mass index, and English proficiency were not associated with the achievement of the 5% weight loss goal. Though not statistically significant, patients’ average self-scored general health rating (0-100) improved from 72.30 to 81.50 (p=0.12), and the greatest reductions in health limitations were reported with regards to pain (1.94 to 1.70, p=0.28) and daily activities (1.53 to 1.35, p=0.36). Conclusion: A student-run DPP implementation among low-resource participants is feasible and appears capable of achieving the target 5% weight loss.
糖尿病预防计划在学生经营的自由诊所实施的评估
引言:糖尿病预防计划(DPP)可以预防或延缓高危人群2型糖尿病的发展。尽管低资源和少数民族社区的2型糖尿病发病率较高,但由于成本和项目可及性,这些社区的DPP参与度往往有限。我们评估了学生志愿者是否可以实施高保真、低成本的16周DPP,并有效促进参与者实现5%的减肥目标。方法:从范德比尔特大学医学中心的学生诊所招募未参保的西班牙语参与者及其受邀嘉宾。每周的DPP课程使用美国疾病控制与预防中心的西班牙语预防T2课程进行,面授6周,由于2019冠状病毒病大流行,实际上在剩余的10周内面授。收集参与者的出勤率和体重数据。使用EuroQoL 5D5L工具评估项目前和项目后与健康相关的生活质量,并进行定性项目反馈调查。主要使用Wilcoxon检验确定了体重和生活质量随项目出勤率和患者人口统计的变化。结果:在积极参与学生主导的DPP的17名参与者中,13名是诊所患者,4名是受邀嘉宾。参与者体重减轻的中位数为其总体重的5.90%。17名参与者中有13人(76.50%)达到了5%的减肥目标。年龄、性别、项目前体重指数和英语水平与5%减肥目标的实现无关。尽管没有统计学意义,但患者的平均自我评分(0-100)从72.30提高到81.50(p=0.12),据报道,在疼痛(1.94至1.70,p=0.28)和日常活动(1.53至1.35,p=0.36)方面,健康限制的减少幅度最大。结论:在低资源参与者中实施学生管理的DPP是可行的,似乎能够实现5%的减肥目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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