title: Translating the Diabetes Prevention Program into American Indian and Alaska Native communities: results from the Special Diabetes Program for Indians Diabetes Prevention demonstration project.
abstract: OBJECTIVE
  The landmark Diabetes Prevention Program (DPP) showed that lifestyle intervention can prevent or delay the onset of diabetes for those at risk. We evaluated a translational implementation of this intervention in a diverse set of American Indian and Alaska Native (AI/AN) communities.
  
  
  METHODS
  The Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented the DPP lifestyle intervention among 36 health care programs serving 80 tribes. A total of 2,553 participants with prediabetes were recruited and started intervention by 31 July 2008. They were offered the 16-session Lifestyle Balance Curriculum and underwent a thorough clinical assessment for evaluation of their diabetes status and risk at baseline, soon after completing the curriculum (postcurriculum), and annually for up to 3 years. Diabetes incidence was estimated. Weight loss, changes in blood pressure and lipid levels, and lifestyle changes after intervention were also evaluated.
  
  
  RESULTS
  The completion rates of SDPI-DP were 74, 59, 42, and 33% for the postcurriculum and year 1, 2, and 3 assessments, respectively. The crude incidence of diabetes among SDPI-DP participants was 4.0% per year. Significant improvements in weight, blood pressure, and lipid levels were observed immediately after the intervention and annually thereafter for 3 years. Class attendance strongly correlated with diabetes incidence rate, weight loss, and change in systolic blood pressure.
  
  
  CONCLUSIONS
  Our findings demonstrate the feasibility and potential of translating the lifestyle intervention in diverse AI/AN communities. They have important implications for future dissemination and institutionalization of the intervention throughout the Native American health system.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Rural Public Health, Texas A&M Health Science Center, College Station, Texas, USA. ljiang@srph.tamhsc.edu
authors.forename: Luohua
authors.initials: L
authors.lastname: Jiang
authors.forename: Spero M
authors.initials: SM
authors.lastname: Manson
authors.forename: Janette
authors.initials: J
authors.lastname: Beals
authors.forename: William G
authors.initials: WG
authors.lastname: Henderson
authors.forename: Haixiao
authors.initials: H
authors.lastname: Huang
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Acton
authors.forename: Yvette
authors.initials: Y
authors.lastname: Roubideaux
mesh_terms: D000328:Adult; D000413:Alaska / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007198:Indians, North American; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology* / Q000628:therapy*; D015431:Weight Loss; D055815:Young Adult