PilAm Go4Health: A Feasible Effective Diabetes Prevention Program for Filipinos with Type 2 Diabetes
Melinda Sarmiento Bender, RN, PhD, PNP-Bc; Bruce Cooper, PhD; Carissa Villanueva, BS; Shoshana Arai, RN PhD
UCSF School of Nursing
Problem: Filipino Americans have greater Type 2 diabetes prevalence and subsequent cardiometabolic complications compared to other racial/ethnic groups. Effective interventions are needed to reduce health disparities in Filipinos. The Diabetes Prevention Program lifestyle interventions can significantly reduce diabetes risks, yet untested in Filipinos. Thus, PilAm Go4Health intervention study (a culturally adapted DPP with mobile technology) was conducted in 2014-2016.
Objective: Assess PilAm Go4Health feasibility and potential efficacy.
Hypothesis: 1) participant recruitment/retention > 80%; 2) Compared to the control, intervention group will have significantly greater reduction in: % weight loss, waist circumference, fasting plasma glucose, and HbA1; and greater increase in steps.
Methods: Two-arm (intervention + control groups) randomized controlled trial compared a 3-month PilAm Go4Health with Fitbit accelerometer, app/diary and Facebook; and control (Fitbit only). N=45, Filipino overweight adults with T2D recruited in Northern California. Between group differences in baseline to 3-months were analyzed using: 1) multilevel regression for within-person change in weight and step-counts using a nonparametric bias-corrected bootstrapped 95%CI for the multilevel models, and 2) T-tests, ANOVA for waist circumference, fasting plasma glucose, and HbA1c (significance =p<0.05).
Results: N=45 Filipinos (intervention=22 and control=23); mean age=58+10 years, 62% women with100% recruitment/retention. Intervention group compared to control had significantly greater: % weight (2.3%greater decrease, d=0.46); waist circumference (-2.68cm; d=0.88); fasting plasma glucose (-18.52mg/dl; d= -0.86), step-counts (3432 steps; d=1.44); but HbA1c had no group difference (-0.34%; p<0.19).
Conclusion/Implications: PilAm Go4Health was feasibility with potential efficacy for reducing Filipino cardiometabolic risks. PilAm Go4Health warrants further testing for effectiveness with Filipinos.
AHA Award Number: 14CRP19560008
NHLBI grant R25HL126146
Keywords: Filipinos, diabetes prevention interventions, randomized trial