title: Development of a diabetes prevention program for Surinamese South Asians in the Netherlands.
abstract: Type 2 diabetes is highly prevalent among South Asian origin groups around the world. Not only is prevalence higher than in other ethnic groups, age at presentation is lower and these groups are more likely to experience complications. Evidence suggests that lifestyle interventions may prevent or delay the onset of diabetes. However, little is known about diabetes prevention in South Asians (SA). DH!AAN is a diabetes prevention program designed for Surinamese SA in The Netherlands. In this paper, we describe the theoretical frameworks and formative research that guided the development and cultural adaptation of DH!AAN. Cultural adaptation was based on analysis of the determinants of diet and physical activity, including socio-cultural factors, within our study population. This led to the incorporation of surface and deep structure elements in the intervention. One-to-one counseling by dieticians using motivational interviewing (MI) was the basis for the intervention. Additionally, we aimed to generate social support by including family members in parts of the intervention and group sessions to address issues relating to traditional food habits. We discuss our reflections on the development process and the choices made in developing this intervention. The results of DH!AAN will provide insight into the use of MI for this population group. Moreover, DH!AAN will provide evidence regarding the feasibility of diabetes prevention among South Asian populations.
authors.affiliation: Department of Public Health, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100DD Amsterdam, The Netherlands m.nicolaou@amc.nl.
authors.forename: Mary
authors.initials: M
authors.lastname: Nicolaou
authors.affiliation: Department of Public Health, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100DD Amsterdam, The Netherlands.
authors.forename: Evalina
authors.initials: E
authors.lastname: Vlaar
authors.affiliation: Department of Public Health, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100DD Amsterdam, The Netherlands.
authors.forename: Irene
authors.initials: I
authors.lastname: van Valkengoed
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Barend
authors.initials: B
authors.lastname: Middelkoop
authors.affiliation: Department of Public Health, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100DD Amsterdam, The Netherlands.
authors.forename: Karien
authors.initials: K
authors.lastname: Stronks
authors.affiliation: Department of Public Health, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100DD Amsterdam, The Netherlands.
authors.forename: Vera
authors.initials: V
authors.lastname: Nierkens
mesh_terms: D044466:Asian People; D054521:Cultural Competency; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000517:prevention & control*; D004032:Diet / Q000208:ethnology; D015444:Exercise; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008019:Life Style / Q000208:ethnology*; D008297:Male; D062405:Motivational Interviewing; D009426:Netherlands / Q000453:epidemiology; D010865:Pilot Projects; D015995:Prevalence; D016730:Program Development; D012307:Risk Factors; D013177:Sports; D013532:Suriname / Q000208:ethnology
keywords: South Asian; cultural sensitivity; motivational interviewing; type 2 diabetes