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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