title: Feasibility and effectiveness of a targeted diabetes prevention program for 18 to 60-year-old South Asian migrants: design and methods of the DH!AAN study.
abstract: BACKGROUND
  South Asian migrants are at particularly high risk of type 2 diabetes. Previous studies have shown that intensive lifestyle interventions may prevent the onset of diabetes. Such interventions have not been culturally adapted and evaluated among South Asians in industrialized countries. Therefore, we have set up a randomized controlled trial to study the effectiveness of a targeted lifestyle intervention for the risk of type 2 diabetes and cardiovascular risk factors among 18 to 60-year-old Hindustani Surinamese (South Asians) in The Hague, the Netherlands. Here we present the study design and describe the characteristics of those recruited.
  
  
  METHODS
  Between May 18, 2009 and October 11, 2010, we screened 2307 Hindustani Surinamese (18-60 years old) living in The Hague. We sent invitations to participate to those who had an impaired fasting glucose of 5.6-6.9 mmol/l, an impaired glucose tolerance of 7.8-11.0 mmol/L, a glycated hemoglobin level of 6.0% or more and/or a value of 2.39 or more for the homeostasis model assessment of estimated insulin resistance. In total, 536 people (56.1% of those eligible) participated. People with a higher level of education and a family history of type 2 diabetes were more likely to participate. The control and intervention groups were similar with regard to important background characteristics. The intervention group will receive a culturally targeted intervention consisting of dietary counseling using motivational interviewing and a supervised physical activity program. The control group will receive generic lifestyle advice. To determine the effectiveness, a physical examination (anthropometrics, cardiorespiratory test, lipid profile, and measures of oral glucose tolerance, glycated hemoglobin, and insulin) and interview (physical activity, diet, quality of life, and intermediate outcomes) were carried out at baseline and will be repeated at 1 year and 2 years. The process and the costs will be evaluated.
  
  
  CONCLUSIONS
  This trial will provide insight into the feasibility and effectiveness of a targeted, intensive, lifestyle intervention for the risk of type 2 diabetes and cardiovascular risk factors among 18 to 60-year-old South Asians.
  
  
  BACKGROUND
  Dutch Trial Register: NTR1499.
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. E.M.Vlaar@amc.uva.nl
authors.forename: Everlina M A
authors.initials: EM
authors.lastname: Vlaar
authors.forename: Irene G M
authors.initials: IG
authors.lastname: van Valkengoed
authors.forename: Vera
authors.initials: V
authors.lastname: Nierkens
authors.forename: Mary
authors.initials: M
authors.lastname: Nicolaou
authors.forename: Barend J C
authors.initials: BJ
authors.lastname: Middelkoop
authors.forename: Karien
authors.initials: K
authors.lastname: Stronks
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D002318:Cardiovascular Diseases / Q000097:blood / Q000208:ethnology* / Q000517:prevention & control*; D035061:Control Groups; D003920:Diabetes Mellitus / Q000097:blood / Q000208:ethnology* / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010043:Outcome and Process Assessment, Health Care / Q000592:standards* / Q000706:statistics & numerical data; D010358:Patient Participation / Q000706:statistics & numerical data; D015397:Program Evaluation; D018570:Risk Assessment / Q000379:methods*; D012959:Socioeconomic Factors; D013532:Suriname / Q000208:ethnology; D011795:Surveys and Questionnaires; D014171:Transients and Migrants / Q000523:psychology / Q000706:statistics & numerical data*