Lessons learned from the development and implementation of culturally-tailored diabetes prevention interventions in the South Asian and Korean communities of New York City

Asian Americans have higher rates of diabetes than Non-Hispanic Whites. There are few community-based, culturally-tailored interventions to promote diabetes prevention in Asian subgroups. In a 5-year project to develop, implement, and evaluate a community health worker (CHW) program to promote diabetes prevention in NYC South Asian and Korean communities, a community-based participatory research (CBPR) approach was used to ensure active engagement by target communities in the development of a culturally-tailored program. 

Using a CBPR approach, a coalition of academic and community partners designed and implemented a formative study to understand health needs, access, and behaviors, knowledge, and perceptions related to diabetes prevention. The coalition adapted existing diabetes prevention program curricula to create culturally-tailored intervention protocols and curricula for the target communities. Approximately 500 participants were enrolled in multiple rounds of a 6-month intervention; treatment groups received 6 CHW-led educational workshops and 10 follow-up phone calls. Baseline and follow-up surveys were administered to capture diabetes knowledge, behavioral change, and clinical outcomes. A process evaluation was conducted, including focus groups with study participants and discussions with key project staff. Outcomes, challenges, and lessons learned were assessed and reviewed by the coalition in a continuous process to adapt and refine the intervention.

Challenges, facilitators and lessons learned across the South Asian and Korean interventions will be discussed. Findings will also be discussed in relation to how the interventions were tailored and targeted to meet the context and factors specific to each target community.   

Using a CBPR approach and building in a process evaluation and assessment as well as time to review and collectively discuss outcomes to refine and tailor the intervention resulted in meaningful, relevant interventions for target communities. Overall, the project demonstrated high feasibility, acceptability, and efficacy of a CHW-led intervention to promote diabetes prevention in NYC South Asian and Korean communities.