The Diabetes Prevention Program (DPP) has been shown to prevent type 2 diabetes through lifestyle modification. The purpose of this study was to describe the literature on DPP translation, synthesizing studies using cultural adaptation and implementation research. A systematic search was conducted. Original studies evaluating DPP implementation and/or cultural adaptation were included. Data about cultural adaptation, implementation outcomes, and translation strategies was abstracted. A total of 44 were included, of which 15 reported cultural adaptations and 38 explored implementation. Many studies shortened the program length and reported a group format. The most commonly reported cultural adaptation (13 of 15) was with content. At the individual level, the most frequently assessed implementation outcome (n=30) was adoption. Feasibility was most common (n=32) at the organization level. The DPP is being tested in a variety of settings and populations, using numerous translational strategies and cultural adaptations. Implementation research that identifies, evaluates, and reports efforts to translate the DPP into practice is crucial.
Keywords
Diabetes prevention, Translation, Cultural adaptation, Implementation
INTRODUCTIONNearly 26 million people in the USA-8.3 % of the population-have diabetes, and 90-95 % have type 2 diabetes [1]. Diabetes in adults is the leading cause of new cases of blindness, kidney failure, and non-injury amputations of the feet and legs. In 2007, the cost associated with diabetes was $174 billion [1]. Diabetes and its complications are largely preventable [2,3]; obesity, physical inactivity, and unhealthy eating account for over half of new cases [4,5].Racial/ethnic minorities are at substantially higher risk for type 2 diabetes and continue to experience greater rates of hospitalization due to diabetes-related complications and 50-100 % higher morbidity and mortality than their white counterparts [6][7][8]. To address such health disparities effectively, interventions need to attend to cultural factors to increase engagement of ethnic minority populations in prevention