Diabetes Prevention Program (DPP) Executive Summary
Asian Center – Southeast Michigan (AC-SE MI) was awarded a grant to offer a Diabetes Prevention Program to Asian Americans, more specifically, to the high risk Asian groups in Southeast Michigan, which included: Asian Indians, Chinese, Filipinos and Koreans. The grant period was set for July 1, 2016 to June 30, 2018.
This “Diabetes Prevention Program” (DPP) used the curriculum from the CDC website: https://www.cdc.gov/diabetes/prevention/lifestyle-program/curriculum.html. This is a yearlong program that starts with weekly sessions of an hour for the first 16 weeks, and then follows up with monthly maintenance sessions, also an hour long, for 8 months. The goals of the program are:
- Lose 7% of body weight through healthy eating
- Do 150 minutes of brisk physical activity each week
For the low BMI Asian Americans, mainly referring to Chinese and Koreans, we had to waive the first goal since there was nobody even in the overweight range. So instead, we added a hemoglobin A1c test for all participants at the beginning of the program and at the last session of the program to see if there is any substantial change in their A1c data after the intervention. The CDC program is mainly targeted to pre-diabetes patients; we accepted a few diabetes patients because they really wanted to learn how to control their disease.
In two years, AC-SE MI conducted 4 diabetes prevention workshops, recruiting 74 participants, with 53 of them completing the program and receiving certificates. For a yearlong program, 30% attrition is acceptable (our past health workshops ranged from 10-40% attrition). We expected to have higher attrition, so we requested workshop coaches and assistants to put extra effort into retention by helping participants, to make their learning of new skills easier and more effective.
The following table is a simple summary of the four workshops conducted:
|#||Ethnic Group||Location||Period||# of recruited participants||# of certified at class end|
|1||Chinese||Assoc of Chinese Americans in Madison Heights||10/18/16 – 10/17/17||17||11|
|2||Koreans||Korean Cultural Center in Southfield||3/27/17 – 3/26/18||16||14|
|3||Asian Indians||Asian Indian ISSO temple in Pontiac||4/23/17- 4/22/18||22||13|
|4||Filipinos||PNC Bldg, Troy||5/17/17 – 5/16/18||19||15|
For a very heavy 2-year program, there were a lot of data generated and recorded, including:
- Workshop weekly attendance plus weight record
Every participant had to be weighted at the beginning of every workshop
- Individual weekly weight chart & exercise record
Every participant received a “weekly diet and exercise journal” book to record their food and calculate their calories and jot down their exercise duration”
- A1c data (at the 1st and last workshop)
- Pre-/post- questions on health knowledge and self-assessment on health
(at the 1st and last workshop)
- Workshop evaluation (at the last workshop)
There were massive data collected from 74 participants. For those who are interested, please contact us at 248-227-4374.
The following are some written feedback from participants on their final workshop evaluation:
- Many thanks to the teacher’s efforts in the past year. I went from knowing nothing about diabetes to understanding the damage of this disease. I learned to evaluate food I eat and to increase my activities. Now I do a better job identifying food of high fat and high calorie and figuring out ways to improve my food consumption. I can make myself healthier.
- Learned about the right foods to eat and importance of physical exercise.
- I truly appreciate the teacher’s hard work in the year. I have learned a lot in medical science. The material was easy to understand, and the knowledge that I have learned will benefit me in my life. I can also pass the knowledge to the younger generation so they can have a healthier life style. I really appreciate this learning opportunity. Thank you very much.
- I am thankful for the friendship and learning from others aside from the handouts and teachers.
- This diabetes prevention program has been very helpful to me. Dr. Lee is very knowledgeable and friendly. In the past, we had some wrong behavior due to the lack of proper knowledge. This program has been very helpful in teaching us information of food, calorie, fat, sugar and salt intake. I appreciate the teacher’s instruction which has allowed us to gradually understand and maintain a good weight and a positive attitude. I hope there will be similar programs soon.
- I learned a lot and used what I learned with family and friends.
- I really enjoyed my educational opportunity to learn how to prevent diabetes. Many thanks to coaches who prepared many references and examples for us to understand better. It was a very good workshop. Learning gave me happy moments.
Result & Conclusion
Everyone in the program reached their goals of weight control and exercise. About 4-5 people who started at the overweight level (among Asian Indian and Filipino groups) lost more than 10 lbs and moved to a normal BMI range. Every participant did more than 150 minutes of brisk exercise weekly. Actually most of them did 60-minute daily exercise. The more direct biomarker data, A1c, showed the most encouraging results. A1c was offered to all participants, but not everyone took both before/after for comparison; only 45 out of 53 participants have comparison data, shown below:
|Average A1c Drop|
|Pre-diabetes Participants (30)||0.14|
|Diabetes Participants (15)||0.60|
|Total Participants (45)||0.25|
Since the number of diabetes patients is low, we cannot claim its merit from a statistical point. Also we did not ask for their medication regimen, nor did we know if there was any change of their medication during the year. But it is certainly a worthy report and perhaps provides interest for future study that can reach a better intervention for diabetes patients. A1c data can definitely prove the effectiveness of this program for diabetes prevention.
The general overall program evaluation also scored very high: 4.5 out of 5, with all positive feedback. We received nothing but words of appreciation from participants. Overall, this is a successful program and a very good intervention for diabetes prevention.