Translating Lifestyle Programs for Diabetes Prevention inSouth Asian Communities
2012
Translating Lifestyle Programs for Diabetes Prevention
in South Asian Communities South Asians, people from the Indian
subcontinent, are at increased risk for developing diabetes.
Translating successful diabetes prevention programs to create
culturally appropriate lifestyle interventions for South Asian
populations worldwide is a prudent method for preventing diabetes
in this population. The aims of this dissertation are to understand
the determinants of lifestyle behaviors and excess weight and
evaluate the ability of a culturally tailored lifestyle
intervention to improve anthropometric measures related to diabetes
risk in the South Asian population. This dissertation describes
research using data from two different studies which seek to plan,
implement, and evaluate lifestyle programs for diabetes prevention
in South Asian populations: the formative research phase of the
US-based South Asian Health and Prevention Education (SHAPE) study
and cross-sectional and longitudinal data from the Diabetes
Community Lifestyle Improvement Program (D-CLIP) in Chennai, India.
A thematic analysis of verbatim transcripts from seventeen focus
group discussions conducted with US South Asians showed that
immigration to the US and gender expectations, particularly the
desire to ensure the comfort and happiness of family members, were
barriers to healthy lifestyle behaviors. Conversely, family can
also be a motivator and a source of social support for healthy
lifestyles. A cross-sectional analysis of D-CLIP screening data
(N=1,281) assessed the relationship between factors associated with
healthy weight maintenance (fruit and vegetable intake, weekly
exercise, weight loss history, and weight loss and exercise
self-efficacy) and BMI and waist circumference. Weekly fruit
consumption, past weight loss experience, and weight loss
self-efficacy, along with gender, age, and marital status,
explained 13.7% and 25.8% of the variation in BMI and waist
circumference, respectively, in this population. Finally, changes
in BMI, weight, and waist circumference during the first six months
of the D-CLIP randomized controlled intervention trial were
compared in intervention (n=294) and control (n=304) participants.
Intervention participants showed significantly greater reductions
(p<0.0001 for all) in weight, BMI, and waist circumference (2.86
kg, 1.05 kg/m2, and 3.72 cm) compared to controls (0.73 kg, 0.31
kg/m2, and 1.58 cm). Based on the results of this research,
recommendations for diabetes prevention in South Asian populations
are proposed.
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