title: Diabetes prevention in Hispanics: report from a randomized controlled trial.
abstract: BACKGROUND
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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%.
authors.affiliation: Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, N Seattle, WA 98109. E-mail: cduggan@fhcrc.org.
authors.forename: Catherine
authors.initials: C
authors.lastname: Duggan
authors.affiliation: Fred Hutchinson Cancer Research Center, N Seattle, Washington.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Carosso
authors.affiliation: Fred Hutchinson Cancer Research Center, N Seattle, Washington.
authors.forename: Norma
authors.initials: N
authors.lastname: Mariscal
authors.affiliation: Fred Hutchinson Cancer Research Center, N Seattle, Washington.
authors.forename: Ilda
authors.initials: I
authors.lastname: Islas
authors.affiliation: Fred Hutchinson Cancer Research Center, N Seattle, Washington.
authors.forename: Genoveva
authors.initials: G
authors.lastname: Ibarra
authors.affiliation: Fred Hutchinson Cancer Research Center, N Seattle, Washington.
authors.forename: Sarah
authors.initials: S
authors.lastname: Holte
authors.affiliation: Fred Hutchinson Cancer Research Center, N Seattle, Washington.
authors.forename: Wade
authors.initials: W
authors.lastname: Copeland
authors.affiliation: Sunnyside Community Hospital, Sunnyside, Washington.
authors.forename: Sandra
authors.initials: S
authors.lastname: Linde
authors.affiliation: Fred Hutchinson Cancer Research Center and University of Washington, Seattle, Washington.
authors.forename: Beti
authors.initials: B
authors.lastname: Thompson
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000517:prevention & control*; D004032:Diet; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human