Effectiveness of a cluster-randomized controlled trial community-based lifestyle intervention program to control prehypertension and/or prediabetes in Thailand

Abstract

Lifestyle intervention is recommended as the primary management for prehypertension and prediabetes. The aim of the study was to examine the effect of a community-based lifestyle intervention on glucose and blood pressure levels in Nakhon Pathom Province, Thailand. We conducted a cluster-randomized community trial in 12 Buddhist temples, enrolling 443 members, aged 35–65 years, with prediabetes and/or prehypertension. The temple (and their members) was randomized to six 2-h group session of lifestyle intervention (physical activity and nutrition) over 6 months guided by the Health Action Process Approach model or receiving a healthy lifestyle pamphlet. Physical outcomes (glucose, blood pressure, lipid profiles, and anthropometric measures) were assessed at 6 and/or 12 months following baseline assessments. The effects of the lifestyle intervention were assessed with generalized linear mixed models. The study recruited 443 participants in 12 temples (220 in the intervention and 223 in the control group), and 89% completed the 12-month evaluation. At 12-month follow-up, mixed modeling found significant interaction effects on fasting plasma glucose (p = 0.017) and diastolic blood pressure (p = 0.002). Improvements were found for systolic blood pressure, but no significant interaction effect was detected. In conclusion, the lifestyle intervention was only partially effective. More research is needed to investigate lifestyle interventions in this community-based setting. Trial registration number: TCTR20170721001