Adapting the Diabetes Prevention Program for a Developing World Context
Adapting the Diabetes Prevention Program for a Developing World Context
This study will examine whether an adapted version of ]he Diabetes Prevention Program (DPP)
 can be effective when delivered by community health workers (CHWs) in a poor urban community
 in South Africa. We will randomize existing groups that are part of an non-governmental
 organization's (NGO) chronic disease management program (anticipated cluster N = 54;
 anticipated individual N=540), to receive either the program or usual care (wait-list). The
 primary outcome analysis will compare percentage of baseline weight loss at Y1 between the
 program and usual care; however, after Y1 usual care participants will also receive the
 program and both groups will be followed for another year.
Inclusion Criteria:

 -  member of participating partner NGO "health club" (members are medically stabilized
 individuals with diabetes mellitus or hypertension referred for disease and lifestyle
 management)

 -  BMI greater than or equal to 25 kg per meter squared

 Exclusion Criteria:

 -  unsafe level of blood pressure (greater than or equal to 160 (systolic) and greater
 than equal to 100 mm (diastolic)) at screening

 -  elevated blood sugar (A1C greater than 11) at screening

 -  being pregnant, breast-feeding or planning pregnancy within 2 years

 -  chronic use of oral steroid medication

 -  intellectual disabilities that would prevent ability to understand the program

 -  not intending to stay in the health club over the next 2 years