Diabetes Prevention in Chinese Americans: Online Adaptation of Diabetes Prevention Program

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ABSTRACT Asians comprise a rapidly increasing proportion of immigrants in the United States with Chinese immigrants comprising the fastest growing Asian subgroup. Despite relatively low obesity prevalence, prior research showed that Asians had comparable, if not higher, diabetes or impaired fasting glucose prevalence compared with other ethnic groups. Results from the Diabetes Prevention Program (DPP) have shown that an intensive lifestyle intervention focusing on increasing physical activity and decreasing fat intake demonstrated a significant reduction in the incidence of type 2 diabetes compared with a metformin medication group or a control group. As a result, the DPP curriculum has been successfully translated and piloted in different populations and settings. However, there are unique challenges inherent in adapting the DPP lifestyle intervention for implementation in Chinese populations. For instance, low-income Chinese Americans often live in insular communities with limited exposure to the dominant mainstream culture. Although the YMCA DPP has widespread community-based implementation, it has not been tailored to address the cultural and linguistic needs of Chinese-speaking Americans. In addition, similar to other immigrant groups, Chinese Americans often work long hours with multiple jobs and do not have much free time to participate in health promotion programs. Finding new strategies, such as delivering diabetes prevention programs online, could potentially overcome the time barrier immigrants often face. Therefore, the aims of the SCORE SC3 project are to: 1) adapt and translate the DPP curriculum using formative evaluation to refine strategies to promote healthy dietary habits and increase physical activity in high-risk Chinese Americans, 2) develop an electronic version of the adapted Chinese DPP curriculum and test its feasibility and acceptability, and 3) develop plans for transition to non-SCORE support. The proposed project has high potential for scalability to other hard-to-reach populations. This translation model can be easily transferred and readily adapted for use in other underserved minority communities to prevent or reduce diabetes. In addition, with this SCORE SC3 funding support, the PI will be able to gather needed preliminary data to generate robust applications and to transition to non-SCORE sources of support such as NIH R01 funding mechanism.