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Table 3 Kerala Diabetes Prevention Program Components and focal areas of influence on different stages of intervention

From: Cultural adaptation of a peer-led lifestyle intervention program for diabetes prevention in India: the Kerala diabetes prevention program (K-DPP)

  Engagement (0-2 months) Preparation and adoption of changes (3-5 months) Adoption and maintenance of changes (6-12 months) Community empowerment (>9 months)
Overall objective • Increasing willingness to participate
• Rapport building
• Establishing personal relevance
• Increasing awareness of T2DM prevention and K-DPP
• Increasing personal relevance
• Preparing for changes
• Increasing self-efficacy
• Making and assessing changes on personal and family level
• Assessing and sustaining changes on personal and family level
• Supporting community change
K-DPP Components • Recruitment of LRPs
• Small group sessions (1-2)
• DPES 1
• Peer-leaders selection and training
• Small group sessions 3-5
• Pre- and post-session telephone contact with PLs and LRPs
• DPES II
• PLs training
• Small group sessions 6-12
• Pre- and post-session telephone contact with PLs and LRPs
• Extra-curricular activities (yoga training, kitchen garden cultivation, etc.)Workshops for PL and LRP and support for planning extra-curricular activities in the community (E.g. healthy snack preparation, sports, painting competition on behavior change themes)
• Linkage with other services for health care and promotion
• Linkage with other community organizations
Peer Leader (PL) • Selection,
• Commitment
• PL leader skill-building and support for self-efficacy
• Benefits of being a PL
• Supporting PL self-efficacy and perception of benefits
• Enabling and promoting peer support among peer-leaders
• Supporting peer-leader self-efficacy, autonomy and perception of benefits.
• Promoting linkages with community organisations.
Participants (and family) • Recruitment
• Retention: participatory methods and benefits from participation (for participant and family)
• Building peer support and self-efficacy in behavior change in participant and family • Promoting maintenance of peer support and behavior change
• Supporting participants in becoming change agents in their families
• Promoting maintenance of peer support and behavior change in participant and family
• Supporting participants in becoming change agents in their community
Community • Increasing community awareness of K-DPP
• Encouraging community support of K-DPP
• Encouraging community support of K-DPP • How can K-DPP groups support health in their communities: extra-curricular activities and linkages with community organizations • Support for community rollout