Topic: Obesity, Nutrition/Diet, Physical Activity
Target Population: Adults
Sector: Community-Based
This program is for adults who are overweight or obese and have prediabetes.
Healthy Living Partnerships to Prevent Diabetes (HELP PD), a community-based program, is designed to help participants lose a modest amount of body weight through increased physical activity and limited caloric intake and intends to teach participants how to maintain this weight loss.
One randomized controlled trial was conducted in 301 adults living in Winston-Salem, North Carolina, from 2007 to 2011. Participants in the intervention group experienced significantly greater decreases in blood glucose, insulin, weight, body mass index (BMI), and waist circumference at 12 months compared to the control group. Additionally, 2 years after beginning the program, participants had maintained their weight loss with evidence for significantly greater decreases in fasting glucose, insulin, weight, BMI, and waist circumference in the intervention group when compared to the control group. Participants in the intervention group were more likely to experience clinically meaningful weight loss at both 12 and 24 months when compared to the control group. Intervention participants continued with group maintenance (GM) sessions or self-maintenance (SM) sessions, and the control group continued as usual for an additional 4 years. Outcomes for body weight, BMI, and waist circumference remained relatively stable over time for those in the control group; those in the GM group maintained improvements in these outcomes; and those in the SM group had significant increases in these outcomes.
HELP PD is a lifestyle change and weight-loss program that is adapted from the Diabetes Prevention Program curriculum. The program includes two phases, an intensive phase and a maintenance phase.
During the intensive phase, participants meet in small groups. These sessions are led by a community health worker, and participants learn about the following:
Participants also complete three individual sessions with a registered dietitian. The goals for phase one include the following:
During the maintenance phase, the focus is on weight maintenance and continued weight loss (if needed), and participants continue to meet in small groups and receive a phone call from the community health worker.
The program has been tested in 301 adults in the Winston-Salem, North Carolina, area from 2007 to 2011. The extent to which the program has been used outside of this is unknown.
The program is delivered by registered dietitians and community health workers. Program staff train registered dietitians to train the community health workers. The registered dietitian training consists of 16 hours of instruction, interaction, and role playing. Community health workers are required to have well-controlled Type 2 Diabetes and a history of healthy eating, physical activity, and weight loss. Community health workers are required to complete 36 hours of training over 6 to 9 weeks. The training includes experiential learning, didactic instruction, peer mentoring, and observation.
Considerations for implementing this program include recruiting dietitians and community health workers who have a suitable background, understanding funds will need to be procured to pay community health workers, realizing funds may be needed to compensate dietitians, ensuring dietitians and community health workers receive training, locating a community space to hold program sessions, and understanding that the program requires a 24-month commitment.
The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email clearinghouse@psu.edu
If you are interested in implementing HELP PD, the Clearinghouse is interested in helping you! Please call 1-877-382-9185 or email clearinghouse@psu.edu
The program lasts 24 months and includes two phases. Phase one lasts 6 months, and, during this phase, participants meet weekly for 1-hour group sessions. Phase two includes 1 monthly group session and 1 monthly phone call. Participants also attend three individual meetings with a dietitian in months 1, 3, and 6.
Community health workers are paid $100/week for the first phase and $200/month for the second phase. Additional information on implementation costs of the program was not located.
To move HELP PD to the Effective category on the Clearinghouse Continuum of Evidence at least one external evaluation must be conducted that demonstrates sustained, positive outcomes. This study must be conducted independently of the program developer.
The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email clearinghouse@psu.edu
Contact the Clearinghouse with any questions regarding this program. Phone: 1-877-382-9185 Email: clearinghouse@psu.edu
You may also contact Jeffery Katula by mail Wake Forest University, Department of Health & Exercise Science, PO Box 7868 Reynolds Station, Winston-Salem, NC 27109, phone 1-336-758-3612, fax 1-336-758-4680, or email katulaj@wfu.edu
https://evidencebasedprograms.org/programs/healthy-living-partnerships-to-prevent-diabetes-help-pd/ and Pedley, Case, Blackwell, Katula, and Vitolins (2017)
Katula, J. A., Vitolins, M. Z., Morgan, T. M., Lawlor, M. S., Blackwell, C. S., Isom, S. P., ... Goff, D. C. (2013). The Healthy Living Partnerships to Prevent Diabetes study: 2-year outcomes of a randomized controlled trial. American Journal of Preventive Medicine, 44(4), S324-S332. https://doi.org/10.1016/j.amepre.2012.12.015
Katula, J. A., Vitolins, M. Z., Rosenberger, E. L., Blackwell, C. S., Morgan, T. M., Lawlor, M. S., & Goff, D. C. (2011). One-year results of a community-based translation of the diabetes prevention program: Healthy-Living Partnerships to Prevent Diabetes (HELP PD) project. Diabetes Care, 34(7), 1451-1457. https://doi.org10.2337/dc10-2115
Pedley, C. F., Case, L. D., Blackwell, C. S., Katula, J. A., & Vitolins, M. Z. (2018). The 24-month metabolic benefits of the Healthy Living Partnerships to Prevent Diabetes: A community-based translational study. Diabetes & Metabolic Syndrome Clinical Research & Reviews, 12(3), 215-220. https://doi.org/10.1016/j.dsx.2017.09.011
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Beavers, K. M., Case, L. D., Blackwell, C. S., Katula, J. A., Goff Jr, D. C., & Vitolins, M. Z. (2015). Effects of weight regain following intentional weight loss on glucoregulatory function in overweight and obese adults with pre-diabetes. Obesity Research & Clinical Practice, 9(3), 266-273.
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Katula, J. A., Vitolins, M. Z., Rosenberger, E. L., Blackwell, C., Espeland, M. A., Lawlor, M. S., ... Goff, D. C. (2010). Healthy Living Partnerships to Prevent Diabetes (HELP PD): Design and methods. Contemporary Clinical Trials, 31(1), 71-81. https://doi.org/10.1016/j.cct.2009.09.002
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Lawlor, M. S., Blackwell, C. S., Isom, S. P., Katula, J. A., Vitolins, M. Z., Morgan, T. M., & Goff, D. C. (2013). Cost of a group translation of the diabetes prevention program: Healthy Living Partnerships to Prevent Diabetes. American Journal of Preventive Medicine, 44(4), S381-S389. https://doi.org/10.1016/j.amepre.2012.12.016
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