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Int Health. 2014 Jun;6(2):118-24. doi: 10.1093/inthealth/iht039. Epub 2014 Feb 3.

Impact of a novel community-based lifestyle intervention program on type 2 diabetes and cardiovascular risk in a resource-poor setting in the Dominican Republic.

Author information

1
University of Virginia Health System, 1215 Lane Street, Hospital Expansion Building, Box 800158 Charlottesville, VA, USA, 22908.
2
CEDIMAT Plaza de la Salud, Dr Juan Manuel Taveras Rodriguez, Calle Pepillo Salcedo, Ensanche La Fe, Santo Domingo, República Dominicana.
3
University of Virginia Health System, 1215 Lane Street, Hospital Expansion Building, Box 800158 Charlottesville, VA, USA, 22908 amt6b@virginia.edu.

Abstract

BACKGROUND:

The prevalence of type 2 diabetes is increasing at an alarming rate in Latin America and in the Caribbean. We present evidence that a cost-effective and sustainable approach to lifestyle modification in underdeveloped countries can be implemented using community members as healthcare champions.

METHODS:

Of 222 community members screened in the impoverished community of Villa Juana, Santo Domingo, 69% had prediabetes or diabetes and 79 of these were enrolled. In a 1-day session, trained lifestyle educators from the USA trained ten lay community members to lead groups oriented to lifestyle change. Community leaders met with assigned patient groups monthly for 1 year. Glycated hemoglobin (HbA1c; average plasma glucose concentration), blood pressure, weight and waist circumference were measured at baseline, 6 months and 1 year.

RESULTS:

59 individuals completed follow-up. Patients showed significant improvements after 6 months in systolic blood pressure (p=0.001), diastolic blood pressure (p=0.000002) and HbA1c (p=0.015). HbA1c improved further at 1 year (p=0.005).

CONCLUSION:

Our pilot experience demonstrates the efficacy and feasibility of a novel, low-cost, community-based educational initiative to improve blood glucose control and reduce cardiovascular risk in individuals with type 2 diabetes or prediabetes. Replication of our model in other underserved areas could have a substantial impact on global health.

KEYWORDS:

Behavior modification; Cardiovascular disease; Community-based participatory research; Hypertension, Lifestyle; Type 2 diabetes mellitus

PMID:
24497608
DOI:
10.1093/inthealth/iht039
[Indexed for MEDLINE]

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