title: Community-based lifestyle interventions to prevent type 2 diabetes.
abstract: OBJECTIVE
  To conduct a literature review of community-based interventions intended to prevent or delay type 2 diabetes.
  
  
  METHODS
  Recently published findings about the potential to prevent or delay type 2 diabetes with intensive lifestyle interventions prompted a literature search for community-based diabetes prevention interventions. The literature review design was a search of databases for publications in 1990-2001 that identified reports on community-based interventions designed to prevent or modify risk factors for type 2 diabetes.
  
  
  RESULTS
  The search revealed 16 published interventions, 8 of which were conducted in the U.S. and involved populations disproportionately burdened by diabetes (e.g., American Indians, Native Hawaiians, Mexican Americans, and African Americans). Of the studies reporting results among youth, there were posttest improvements in intervention groups in knowledge, preventive behaviors, and self-esteem. Among studies reporting results among adults, most reported improvements in intervention groups in knowledge or adoption of regular physical activity. Several investigators offered important reflections about the process of engaging communities and sharing decision making in participatory research approaches, as well as insights about the expectations and limitations of community-based diabetes prevention research. Many of the studies reported limitations in their design, including the lack of control or comparison groups, low response rates or lack of information on nonresponders, or brief intervention periods.
  
  
  CONCLUSIONS
  There is a critical need to conduct and publish reports on well-designed community-based diabetes prevention research and share information on the process, results, and lessons learned. Armed with recent positive findings about diabetes prevention and literature documenting community-based efforts, advocates at local, state, and national levels can collaborate to stem the rising tide of diabetes in communities.
authors.affiliation: Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia. Westat, Atlanta, Georgia 30341-4002, USA. dxs9@cdc.gov
authors.forename: Dawn W
authors.initials: DW
authors.lastname: Satterfield
authors.forename: Michele
authors.initials: M
authors.lastname: Volansky
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Caspersen
authors.forename: Michael M
authors.initials: MM
authors.lastname: Engelgau
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Bowman
authors.forename: Ed W
authors.initials: EW
authors.lastname: Gregg
authors.forename: Linda S
authors.initials: LS
authors.lastname: Geiss
authors.forename: Gwen M
authors.initials: GM
authors.lastname: Hosey
authors.forename: Jeannette
authors.initials: J
authors.lastname: May
authors.forename: Frank
authors.initials: F
authors.lastname: Vinicor
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D005006:Ethnicity; D006801:Humans; D008019:Life Style; D015995:Prevalence; D044469:Racial Groups; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology