Translational behavioral medicine · 2026
Effectiveness of a culturally adapted group-based lifestyle intervention in reducing cardiovascular risk factors in a high-risk Latin American population.
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Suárez Rosario, Sarmiento-Andrade Yoredy, Carrión Karem, Montalvan Martha, Zhindón Milenka, Ramirez Jorge, Chapela Sebastián, Frias-Toral Evelyn
Аннотация
BACKGROUND: Type 2 diabetes (T2D) is a global public health challenge globally. Effective prevention programs must be tailored to cultural and logistical contexts.
PURPOSE: This study evaluated the comparative efficacy of a culturally adapted diabetes prevention program (DPP) intervention versus usual care in reducing T2D risk factors in Ecuadorian institutional settings.
METHODS: This quasi-experimental study included adults with high T2D risk (FINDRISC score ≥12). Participants voluntarily enrolled to an experimental group (EG, N = 192) receiving a 16-week, 10 session culturally adapted DPP, or a control group (CG, N = 91), receiving usual care. Primary comparative efficacy was assessed using analysis of covariance (ANCOVA), adjusting for key baseline imbalances.
RESULTS: Intragroup analysis showed that EG achieved significant reductions in weight (average loss of 1.06%), BMI, and body fat mass (P < .05). However, the primary outcome reduction in FINDRISC score (P = .013) did not retain significance after Holm-Bonferroni correction. The comparative ANCOVA analysis revealed no significant difference between EG and CG for the primary outcomes of weight (P = .330) or FINDRISC score (P = .291). The intervention showed a reduction in systolic blood pressure (SBP) that was statistically significant in the per-protocol analysis (adjusted Δ = -3.338 mmHg; F = 5.160, P = .024), although this effect was attenuated to a trend (P = .079) in a multiply imputed intention-to-treat sensitivity analysis.
CONCLUSION: The short-term, culturally adapted DPP intervention failed to demonstrate superior comparative efficacy in achieving the primary goals of T2D risk reduction or weight loss compared to usual care. Nevertheless, the per-protocol analysis identified a promising reduction in SBP, whose robustness was supported by inverse probability of treatment weighting but attenuated under intention-to-treat multiple imputation. These findings suggest partial efficacy of the short-term adaptation on cardiovascular health and underscore the critical need for longer program duration and strategies to reduce attrition in similar institutional settings.
PURPOSE: This study evaluated the comparative efficacy of a culturally adapted diabetes prevention program (DPP) intervention versus usual care in reducing T2D risk factors in Ecuadorian institutional settings.
METHODS: This quasi-experimental study included adults with high T2D risk (FINDRISC score ≥12). Participants voluntarily enrolled to an experimental group (EG, N = 192) receiving a 16-week, 10 session culturally adapted DPP, or a control group (CG, N = 91), receiving usual care. Primary comparative efficacy was assessed using analysis of covariance (ANCOVA), adjusting for key baseline imbalances.
RESULTS: Intragroup analysis showed that EG achieved significant reductions in weight (average loss of 1.06%), BMI, and body fat mass (P < .05). However, the primary outcome reduction in FINDRISC score (P = .013) did not retain significance after Holm-Bonferroni correction. The comparative ANCOVA analysis revealed no significant difference between EG and CG for the primary outcomes of weight (P = .330) or FINDRISC score (P = .291). The intervention showed a reduction in systolic blood pressure (SBP) that was statistically significant in the per-protocol analysis (adjusted Δ = -3.338 mmHg; F = 5.160, P = .024), although this effect was attenuated to a trend (P = .079) in a multiply imputed intention-to-treat sensitivity analysis.
CONCLUSION: The short-term, culturally adapted DPP intervention failed to demonstrate superior comparative efficacy in achieving the primary goals of T2D risk reduction or weight loss compared to usual care. Nevertheless, the per-protocol analysis identified a promising reduction in SBP, whose robustness was supported by inverse probability of treatment weighting but attenuated under intention-to-treat multiple imputation. These findings suggest partial efficacy of the short-term adaptation on cardiovascular health and underscore the critical need for longer program duration and strategies to reduce attrition in similar institutional settings.