Healthy Living Partnerships to Prevent Diabetes (HELP PD)

Updated: Nov 21, 2017
Evidence Rating:
Near Top Tier

Highlights

  • Program:

    A community-based lifestyle weight-loss program for overweight or obese adults with prediabetes.

  • Evaluation Methods:

    A well-conducted randomized controlled trial (RCT) with a sample of 301 adults.

  • Key Findings:

    Two years after random assignment, a 7.5-pound reduction in body weight, a 4% decrease in fasting blood glucose (a test used to diagnose prediabetes and diabetes), and a promising but not yet definitive reduction in incidence of diabetes – from 8% to 3%.

  • Other:

    A study limitation is that its sample was relatively small and geographically concentrated in the Winston-Salem, North Carolina area. Replication of these findings in a second trial, in another setting, would be desirable to confirm the initial results and establish that they generalize to other settings where the program might be implemented.

Healthy Living Partnerships to Prevent Diabetes (HELP PD) is a community-based lifestyle weight-loss program designed for overweight or obese adults with prediabetes.1 The goal is for participants to lose 5-7% of their body weight over six months – through increased physical activity (at least 180 minutes/week) and limited caloric intake (approximately 1,500 calories/day) – and to maintain the weight loss for an additional 18 months.

The program is delivered over 24 months. For the first six months (the intensive phase), participants attend 24 weekly group sessions (8-12 participants per group), each of which is led by a trained community health worker. The sessions take place at community sites, such as recreation centers or parks. The sessions focus on reducing caloric intake (e.g., reducing portion sizes), increasing aerobic physical activity (e.g., brisk walking), and adopting behavioral self-management strategies (e.g., controlling negative emotions). Participants also receive three personalized consultations with a registered dietitian. During the next 18 months (the maintenance phase), participants have two contacts each month with the community health worker – one group session and one telephone call – to reinforce the strategies described above and help participants address barriers to weight loss. The community health workers were recruited specifically for the study described below, and all have well-controlled type 2 diabetes and a history of healthy eating and physical activity. They each received brief training (36 hours) from registered dietitians, who also monitored their delivery of the program. The program’s cost is $961 per participant (in 2017 dollars).2

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References

1HELP PD is designed as a low-cost, group-based adaptation of the Diabetes Prevention Program (DPP) – a more expensive, individualized lifestyle program delivered by specialized personnel. DPP has previously been found in a large, well-conducted RCT to produce sizable and sustained effects on weight loss and incidence of diabetes.

2This amount includes all costs of delivering the program except for training of the community health workers and dietitians (which is likely to be modest when spread over the many participants they work with).

Main Study:

Pedley, Carolyn F., L. Douglas Case, Caroline S. Blackwell, Jeffrey A. Katula, Mara Z. Vitolins. “The 24-Month Metabolic Benefits of the Healthy Living Partnerships to Prevent Diabetes: A Community-Based Translational Study.” Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2018, vol. 12, pp. 215-220.

Katula, Jeffrey A., Mara Z. Vitolins, Timothy M. Morgan, Michael S. Lawlor, Caroline S. Blackwell, Scott P. Isom, Carolyn F. Pedley, and David C. Goff, Jr. “The Healthy Living Partnerships to Prevent Diabetes Study: 2-Year Outcomes of a Randomized Controlled Trial.” American Journal of Preventive Medicine, 2013, vol. 44, no. 4S4, pp. S324-S332.

Lawlor, Michael S., Caroline S. Blackwell, Scott P. Isom, Jeffrey A. Katula, Mara Z. Vitolins, Timothy M. Morgan, and David C. Goff Jr. “Cost of a Group Translation of the Diabetes Prevention Program: Healthy Living Partnerships to Prevent Diabetes.” American Journal of Preventive Medicine, 2013, vol. 44, no. 4S4, pp. S381–S389.

Katula, Jeffrey A., Mara Z. Vitolins, Erica L. Rosenberger, Caroline S. Blackwell, Timothy M. Morgan, Michael S. Lawlor, and David C. Goff, Jr. “One-Year Results of a Community-Based Translation of the Diabetes Prevention Program.” Diabetes Care, 2011, vol. 34, no. 7 pp. 1451-1457.

Other Reference:

American Diabetes Association. “Standards of Medical Care in Diabetes – 2013.” Diabetes Care, 2013, vol. 36, supplement 1, pp. S11-S66.

 

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