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