Abstract
India has one of the highest burdens of diabetes worldwide, and rates of diabetes are also high among Asian Indian immigrants that have migrated into the United States (U.S.). Sikhs represent a significant portion of Asian Indians in the U.S. Diabetes prevention programs have shown the benefits of using lifestyle intervention to reduce diabetes risk, yet there have been no culturally-tailored programs for diabetes prevention in the Sikh community. Using a quasi-experimental two-arm design, 126 Sikh Asian Indians living in New York City were enrolled in a six-workshop intervention led by community health workers. A total of 108 participants completed baseline and 6-month follow-up surveys between March 2012 and October 2013. Main outcome measures included clinical variables (weight, body mass index (BMI), waist circumference, blood pressure, glucose, and cholesterol) and health behaviors (changes in physical activity, food behaviors, and diabetes knowledge). Changes were significant for the treatment group in weight, BMI, waist circumference, blood pressure, glucose, physical activity, food behaviors, and diabetes knowledge, and between group differences were significant for glucose, diabetes knowledge, portion control, and physical activity social interaction. Retention rates were high. Findings demonstrate that a diabetes prevention program in the Sikh community is acceptable, feasible, and efficacious.
Highlights
Diabetes, a group of diseases marked by high levels of blood glucose, can lead to serious complications and morbidity
Recruitment was facilitated by building on strong relationships with respected Sikh organizations in the community and by the principles of “seva”, which is a call for volunteerism and community service in the Sikh religion, which enabled community health worker (CHW) to benefit from help provided by volunteers at recruitment events and in getting the word out about the project
The main challenges to recruitment that CHW and focus group discussion revealed were: (1) Community members felt that if they were free of symptoms of diabetes, they did not need to take steps to prevent the disease; and (2) community members felt that diabetes was a natural part of aging and could not be prevented
Summary
A group of diseases marked by high levels of blood glucose, can lead to serious complications and morbidity. DPP studies that have been translated into community settings have included various modifications to the original DPP protocol in order to address feasibility and sustainability challenges associated with the program, and to address the specific needs of the target communities in which studies are implemented Examples of these modifications have included a reduced number of group sessions [11,20,22,28,29], culturally-adapted curricula [15,20,21,28,30,31], and allocation of the intervention by site rather than at the individual level for experimental study designs [12,23,32,33]. In the U.S, the DPP has been undertaken in few Asian American communities [28], none of which have been South Asian
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