Preventing Chronic Disease | Diabetes Prevention in Hispanics: Report From a Randomized Controlled Trial - CDC
Diabetes Prevention in Hispanics: Report From a Randomized Controlled Trial
Catherine Duggan, PhD; Elizabeth Carosso; Norma Mariscal; Ilda Islas; Genoveva Ibarra; Sarah Holte, PhD; Wade Copeland, MS; Sandra Linde; Beti Thompson, PhD
Suggested citation for this article: Duggan C, Carosso E, Mariscal N, Islas I, Ibarra G, Holte S, et al. Diabetes Prevention in Hispanics: Report From a Randomized Controlled Trial. Prev Chronic Dis 2014;11:130119. DOI: http://dx.doi.org/10.5888/pcd11.130119
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Abstract
Introduction
Hispanics are at increased risk of developing type 2 diabetes. Lifestyle interventions are effective in preventing diabetes and restoring glucose regulation.
Hispanics are at increased risk of developing type 2 diabetes. Lifestyle interventions are effective in preventing diabetes and restoring glucose regulation.
Methods
We recruited Hispanic men and women (N = 320) who were residents of the Lower Yakima Valley, Washington, aged 18 years or older with hemoglobin A1c (HbA1c) levels higher than 6% to a parallel 2-arm randomized-controlled trial conducted from 2008 through 2012. The trial compared participants in the intervention arm, who received an immediate educational curriculum (n = 166), to participants in the control arm, who received a delayed educational curriculum (n = 154). The home-based curriculum consisted of 5 sessions led by community health workers and was designed to inform participants about diabetes, diabetes treatment, and healthy dietary and physical activity behaviors. Participants were randomly assigned to the intervention and control arms, and analysts were blinded as to participant arm. We evaluated intervention effects on HbA1c levels; frequency (times per week) of fruit and vegetable consumption; and frequency (times per week) of mild, moderate, and strenuous leisure-time physical activity. At baseline, 3 months, and 6 months after randomization, participants completed a questionnaire and provided a blood sample. Analysts were blinded to intervention arm.
We recruited Hispanic men and women (N = 320) who were residents of the Lower Yakima Valley, Washington, aged 18 years or older with hemoglobin A1c (HbA1c) levels higher than 6% to a parallel 2-arm randomized-controlled trial conducted from 2008 through 2012. The trial compared participants in the intervention arm, who received an immediate educational curriculum (n = 166), to participants in the control arm, who received a delayed educational curriculum (n = 154). The home-based curriculum consisted of 5 sessions led by community health workers and was designed to inform participants about diabetes, diabetes treatment, and healthy dietary and physical activity behaviors. Participants were randomly assigned to the intervention and control arms, and analysts were blinded as to participant arm. We evaluated intervention effects on HbA1c levels; frequency (times per week) of fruit and vegetable consumption; and frequency (times per week) of mild, moderate, and strenuous leisure-time physical activity. At baseline, 3 months, and 6 months after randomization, participants completed a questionnaire and provided a blood sample. Analysts were blinded to intervention arm.
Results
The immediate intervention group (−0.64% [standard error (SE) 0.10]) showed a significant improvement in HbA1c scores (–37.5%, P = .04) compared with the delayed intervention group (–0.44%, P = .14). No significant changes were seen for dietary end points or changes in physical activity. We did observe a trend of greater increases in frequency of moderate and vigorous physical activity and a smaller increase in mild physical activity in the immediate intervention group than in the delayed intervention group.
The immediate intervention group (−0.64% [standard error (SE) 0.10]) showed a significant improvement in HbA1c scores (–37.5%, P = .04) compared with the delayed intervention group (–0.44%, P = .14). No significant changes were seen for dietary end points or changes in physical activity. We did observe a trend of greater increases in frequency of moderate and vigorous physical activity and a smaller increase in mild physical activity in the immediate intervention group than in the delayed intervention group.
Conclusion
This home-based intervention delivered by CHWs was associated with a clinically and statistically significant reduction in HbA1c levels in Hispanic adults with HbA1c levels higher than 6%.
This home-based intervention delivered by CHWs was associated with a clinically and statistically significant reduction in HbA1c levels in Hispanic adults with HbA1c levels higher than 6%.
Author Information
Corresponding Author: Catherine Duggan, PhD, Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, N Seattle, WA 98109. Telephone: 206-667-2323. E-mail: cduggan@fhcrc.org.
Author Affiliations: Elizabeth Carosso, Norma Mariscal, Ilda Islas, Genoveva Ibarra, Sarah Holte, Wade Copeland, Fred Hutchinson Cancer Research Center, N Seattle, Washington; Sandra Linde, Sunnyside Community Hospital, Sunnyside, Washington; Beti Thompson, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, Washington.
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