Outcomes of the Sustainable Culturally Adapted Nutrition Program (SCAN) and food supplement program to improve engagement with the National Diabetes Prevention Program (NDPP)

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Purpose: The National Diabetes Prevention Program (National DPP) is an evidence-based lifestyle program for patients with prediabetes, but low attendance and retention hinder its effectiveness. To improve adherence, we developed the Sustainable Culturally Adapted Nutrition (SCAN) program. SCAN includes 4 group cooking technique lessons and group motivational interviewing counseling to reinforce participants' ability to adapt and sustain the dietary recommendations discussed in the National DPP. The study aims were to assess 1) the feasibility of incorporating SCAN into the National DPP and 2) health related outcomes for SCAN + National DPP compared to National DPP only. Methods: We employed a pragmatic quasi-experimental approach for this pilot. 37 National DPP participants were recruited from a Federally Qualified Health Center in Houston, Texas, and were randomized to participate in the intervention or control arms. The primary outcome was National DPP attendance, and the secondary outcomes were weight and body mass index (BMI). Chi-square and Fisher's exact tests compared baseline characteristics. Linear regression assessed the association between weight and National DPP attendance. Results: At 12 months, the intention-to-treat and per-protocol analyses found no significant difference in attendance. There was a greater dose-response association between National DPP attendance and average weight loss in the intervention group. Among the SCAN cohort, there were improvements in confidence in assessing personal risk for diabetes and ability to reach healthcare providers. Conclusion: SCAN's integration into the National DPP has shown potential in improving attendance and was well received. Larger scale implementation is necessary to understand the long-term impact of SCAN.

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