Preliminary effectiveness of a promotora-led diabetes prevention program for high-risk Latinas: A pilot study

Background:  The purpose of this pilot study was to test the feasibility, acceptability, and preliminary effectiveness of a Promotora-Led Diabetes Prevention Program (PL-DPP) in Hispanic women (Latinas). This is an adaptation of the Diabetes Prevention Program lifestyle intervention delivered by lay health workers, or promotoras. And it is the first to enroll only Latinas, the demographic group with the highest lifetime diabetes risk.

Methods: Twenty Latina adults with prediabetes were enrolled in this single-arm trial of PL-DPP. Participants underwent a year-long lifestyle intervention consisting of 24 sessions divided into 14 weekly core sessions and 10 post-core sessions offered either biweekly or monthly. Each session was led by one promotora in Spanish. The primary outcome was weight change over the 12-month study period.

Results:  Eighteen participants (90%) completed at least 10 sessions and one was lost to follow-up. Overall, patients reported high levels of satisfaction with PL-DPP. At 12 months, the participants achieved a clinically meaningful and statistically significant mean change in body weight of 10.8lbs (4.9kg), which corresponded to 5.6% of initial body weight. Forty-two percent of participants achieved the 7% weight loss goal. Significant pre-post reductions in waist circumference, diastolic blood pressure, LDL cholesterol, and insulin levels were also observed. Modest reductions in A1C and fasting plasma glucose were not significant.

Conclusions:  The PL-DPP demonstrated feasibility, acceptability, and preliminary effectiveness in a high-risk population of Latinas. Future research examining this intervention in a randomized clinical trial should explore factors impacting its effects using both qualitative and quantitative methods.