Publications (4)3.88 Total impact

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    ABSTRACT: Objective The purpose of this study was to assess if group size is associated with weight loss outcomes among participants in an adapted diabetes prevention program. Methods Adults at high-risk (N = 841) for CVD and diabetes were enrolled in the lifestyle intervention in 2011. Multiple logistic regression analyses were used to identify if group size (smaller group < 16 participants; larger group ≥16 participants) was independently associated with weight loss outcomes among participants. Results In the bivariate analyses, participants in the smaller groups compared to those in the larger groups were significantly more likely to have a higher baseline body mass index, to attend fewer intervention sessions, and less likely to self-monitor their fat intake for ≥14 weeks, and to have lost less weight during the core intervention (5.1 kg [SD 4.7] versus 5.8 kg [4.5]). However, analysis adjusting for age, sex, baseline BMI, achievement of the physical activity goal, number of weeks self-monitoring fat intake, and group size, found only two factors to be independently associated with achievement of the 7% weight loss goal: frequency of self-monitoring of fat intake and achievement of the physical activity goal. Conclusions Our findings indicate that intensive lifestyle intervention goals can be achieved as effectively with large or small groups.
    12/2014; 8(4). DOI:10.1016/j.pcd.2014.02.002
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    ABSTRACT: This study evaluated weight loss and cardiometabolic risk reduction achieved through an adapted Diabetes Prevention Program lifestyle intervention among adults at high risk for cardiovascular disease (CVD) and diabetes. A 16-session lifestyle intervention was delivered through a partnership between a diabetes self-management education (DSME) program and the Young Men's Christian Association (YMCA). Overweight adults with ≥ 1 additional risk factors for CVD or diabetes were enrolled (n = 265). Lifestyle coaches from the DSME program coordinated intervention delivery and taught the curriculum. YMCA staff delivered the physical activity component of the intervention. Two-hundred and nineteen participants (83%) completed the program. Seventy-five percent of participants achieved the physical activity goal (≥ 150 minutes/week), 34% achieved the 7% weight loss goal, and 60% achieved weight loss ≥ 5%. There were significant improvements in cardiometabolic risk factors among participants completing the intervention. Our findings suggest that an adapted lifestyle intervention can be successfully implemented through collaboration between a DSME program and a YMCA. Implementation of effective prevention programs in multiple settings throughout the United States will be needed to ensure that the large subpopulation of adults at high risk for CVD and diabetes have access to this prevention service.
    Diabetes Spectrum 08/2011; 24(3):138-143. DOI:10.2337/diaspect.24.3.138
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    ABSTRACT: To identify the key elements that enabled the Greater Green Triangle Diabetes Prevention Project (GGT DPP) and the Montana Cardiovascular Disease and Diabetes Prevention (CDDP) programs successful establishment and implementation in rural areas, as well as identifying specific challenges or barriers for implementation in rural communities. Focus groups were held with the facilitators who delivered the GGT DPP in Australia and the Montana CDDP programs in the USA. Interview questions covered the facilitators' experiences with recruitment, establishing the program, the components and influence of rurality on the program, barriers and challenges to delivering the program, attributes of successful participants, and the influence of community resources and partnerships on the programs. Four main themes emerged from the focus groups: establishing and implementing the diabetes prevention program in the community; strategies for recruitment and retention of participants; what works in lifestyle intervention programs; and rural-centred issues. The results from this study have assisted in determining the factors that contribute to developing, establishing and implementing successful diabetes prevention programs in two rural areas. Recommendations to increase the likelihood of success of programs in rural communities include: securing funding early for the program; establishing support from community leaders and developing positive relationships with health care providers; creating a professional team with passion for the program; encouraging participants to celebrate their small and big successes; and developing procedures for providing post-intervention support to help participants maintain their success.
    Australian Journal of Rural Health 06/2011; 19(3):125-34. DOI:10.1111/j.1440-1584.2011.01197.x · 1.23 Impact Factor
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    ABSTRACT: This study evaluated factors associated with achievement or maintenance of a 7% weight loss goal post intervention among adults at high-risk for cardiovascular disease (CVD) and diabetes who participated in an adapted Diabetes Prevention Program (DPP) intervention. High-risk adults completed the intervention in 2008 or 2009 (N=466). In 2010, we conducted a follow-up survey of participants to assess characteristics, behaviors and barriers associated with the maintenance or achievement of the weight loss goal. Thirty-nine percent of respondents (73/188) maintained or achieved the goal post intervention. Participants who achieved the goal were more likely to have attended more intervention sessions, and to have lost more weight during the intervention compared to participants who did not achieve the goal. Participants who achieved or maintained the goal post intervention were more likely to engage in behaviors related to weight loss maintenance. Our findings suggest maintenance or achievement of a weight loss goal post intervention among participants in an adapted lifestyle intervention is consistent with the original DPP. Our findings also highlight the relationship between maintaining or achieving a weight loss goal post intervention and behaviors that can be reinforced and barriers that can be mitigated.
    Diabetes research and clinical practice 12/2010; 91(2):141-7. DOI:10.1016/j.diabres.2010.12.001 · 2.54 Impact Factor