***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: ABSTRACT Lifestyle interventions can prevent diabetes through weight loss , but they are rarely translated for use in underserved communities . The aim of this study was to describe how a community – academic partnership formed and developed a program to address local health disparities by developing a low-cost , culturally and economically appropriate , peer-led community-based diabetes prevention program . Using a participatory approach , the partnership chose to focus on diabetes prevention , and co-developed all intervention , recruitment , research , and evaluation strategies . The partnership 's philosophy to maintain high clinical and scientific st and ards paired with their ability to represent and engage the community facilitated the development of a r and omized controlled trial that achieved statistically significant and sustained weight loss , and the recruitment of a largely Spanish-speaking , low income , uninsured population . The success of this intervention lies in the partnership 's commitment to the community , co-ownership of research , and a careful balance between academic rigor and community engagement and relevance BACKGROUND Since the Diabetes Prevention Project ( DPP ) demonstrated that lifestyle weight-loss interventions can reduce the incidence of diabetes by 58 % , several studies have translated the DPP methods to public health-friendly context s. Although these studies have demonstrated short-term effects , no study to date has examined the impact of a translated DPP intervention on blood glucose and adiposity beyond 12 months of follow-up . PURPOSE To examine the impact of a 24-month , community-based diabetes prevention program on fasting blood glucose , insulin , insulin resistance as well as body weight , waist circumference , and BMI in the second year of follow-up . DESIGN An RCT comparing a 24-month lifestyle weight-loss program ( LWL ) to an enhanced usual care condition ( UCC ) in participants with prediabetes ( fasting blood glucose=95 - 125 mg/dL ) . Data were collected in 2007 - 2011 ; analyses were conducted in 2011 - 2012 . SETTING / PARTICIPANTS 301 participants with prediabetes were r and omized ; 261 completed the study . The intervention was held in community-based sites . INTERVENTION The LWL program was led by community health workers and sought to induce 7 % weight loss at 6 months that would be maintained over time through decreased caloric intake and increased physical activity . The UCC received two visits with a registered dietitian and a monthly newsletter . MAIN OUTCOME MEASURES The main measures were fasting blood glucose , insulin , insulin resistance , body weight , waist circumference , and BMI . RESULTS Intent-to-treat analyses of between-group differences in the average of 18- and 24-month measures of outcomes ( controlling for baseline values ) revealed that the LWL participants experienced greater decreases in fasting glucose ( -4.35 mg/dL ) ; insulin ( -3.01 μU/ml ) ; insulin resistance ( -0.97 ) ; body weight ( -4.19 kg ) ; waist circumference ( -3.23 cm ) ; and BMI ( -1.40 ) , all p-values < 0.01 . CONCLUSIONS A diabetes prevention program administered through an existing community-based system and delivered by community health workers is effective at inducing significant long-term reductions in metabolic indicators and adiposity Purpose The objective was to take prevention from the clinic to the community by including a high-risk group and working with the community to tailor , enhance , deliver , and evaluate a community-based version of the Diabetes Prevention Program ’s ( DPP ) clinic-based lifestyle intervention . Methods This was a nonr and omized prospect i ve study using a single-group design . Study eligibility included a screening glucose value in the normal to prediabetes range with no current diagnosis of diabetes , overweight , not pregnant nor planning to become pregnant during study period , aged 18 to 65 , Latino , living in the study target communities , and no reported medical restrictions related to the program goals . A total of 69 individuals participated . The Healthy Living Program ( HLP ) was based on the DPP ’s 1-year intensive lifestyle program , was tailored and enhanced for a Latino community , and was delivered by community health workers . Anthropometric and paper and pencil measures were administered to examine program outcome at 6 months and 12 months . Results In general , results indicate statistically significant improvements in anthropometrics and many behavioral outcomes , particularly at 6 months . Participants demonstrated forward movement through the stages of change during the program . Conclusions Results support the effectiveness of the intervention and show that delivery of the translated version of the DPP ’s lifestyle intervention in the community by community residents holds promise as one strategy to reach people at increased risk of developing diabetes . Use of this translation model , including collaboration with community health workers , offers diabetes educators an opportunity to extend their reach into underserved communities Introduction Hispanics are at increased risk of developing type 2 diabetes . Lifestyle interventions are effective in preventing diabetes and restoring glucose regulation . Methods We recruited Hispanic men and women ( N = 320 ) who were residents of the Lower Yakima Valley , Washington , aged 18 years or older with hemoglobin A1c ( HbA1c ) levels higher than 6 % to a parallel 2-arm r and omized-controlled trial conducted from 2008 through 2012 . The trial compared participants in the intervention arm , who received an immediate educational curriculum ( n = 166 ) , to participants in the control arm , who received a delayed educational curriculum ( n = 154 ) . The home-based curriculum consisted of 5 sessions led by community health workers and was design ed to inform participants about diabetes , diabetes treatment , and healthy dietary and physical activity behaviors . Participants were r and omly assigned to the intervention and control arms , and analysts were blinded as to participant arm . We evaluated intervention effects on HbA1c levels ; frequency ( times per week ) of fruit and vegetable consumption ; and frequency ( times per week ) of mild , moderate , and strenuous leisure-time physical activity . At baseline , 3 months , and 6 months after r and omization , participants completed a question naire and provided a blood sample . Analysts were blinded to intervention arm . Results The immediate intervention group ( −0.64 % [ st and ard error ( SE ) 0.10 ] ) showed a significant improvement in HbA1c scores ( –37.5 % , P = .04 ) compared with the delayed intervention group ( –0.44 % , P = .14 ) . No significant changes were seen for dietary end points or changes in physical activity . We did observe a trend of greater increases in frequency of moderate and vigorous physical activity and a smaller increase in mild physical activity in the immediate intervention group than in the delayed intervention group . Conclusion This home-based intervention delivered by CHWs was associated with a clinical ly and statistically significant reduction in HbA1c levels in Hispanic adults with HbA1c levels higher than 6 % Asian Americans experience diabetes at a higher rate than non-Hispanic whites . Diabetes prevention programs using lifestyle interventions have been shown to produce beneficial results , yet there have been no culturally-tailored programs for diabetes prevention in the Korean community . We explore the impact and feasibility of a pilot Community Health Worker ( CHW ) intervention to improve health behaviors and promote diabetes prevention  among Korean Americans using a r and omized controlled trial . Between 2011 and 2012 , a total of 48 Korean Americans at risk for diabetes living in New York City ( NYC ) participated in the intervention . Participants were allocated to treatment or control groups . A community-based participatory research approach guided development of the intervention , which consisted of 6 workshops held by CHWs on diabetes prevention , nutrition , physical activity , diabetes complications , stress and family support , and access to health care . Changes over 6 months were examined for clinical measurements ( weight , BMI , waist circumference , blood pressure , glucose , and cholesterol ) ; health behaviors ( physical activity , nutrition , food behaviors , diabetes knowledge , self-efficacy , and mental health ) ; and health access ( insurance and self-reported health ) . In this small pilot study , changes were seen in weight , waist circumference , diastolic blood pressure , physical activity nutrition , diabetes knowledge , and mental health . Qualitative findings provide additional context ual information that inform ways in which CHWs may influence health outcomes . These findings demonstrate that a diabetes prevention program can be successful among a Korean American population in NYC , and important insight is provided for ways that programs can be tailored to meet the needs of vulnerable population Purpose . To evaluate the effectiveness of FUEL Your Life , a translation of the Diabetes Prevention Program for worksites . Design . A r and omized control group design was conducted in five worksites of a large transportation company . Measures were collected pretest , posttest ( 6 months ) , and follow-up ( 12 months ) . Setting . Railroad maintenance facilities of Union Pacific Railroad . Subjects . Participants consisted of 362 workers ( 227 treatment , 135 control ) . Intervention . FUEL Your Life was translated from the Diabetes Prevention Program to better fit within the context of the worksite . The primary difference was the use of peer health coaches to provide social support and reinforcement and an occupational nurse to provide lesson content ( six sessions of 10 minutes ) to participants instead of the lifestyle coaches employed by the Diabetes Prevention Program , result ing in a less structured meeting schedule . Measures . The primary outcomes were weight and body mass index ( BMI ) , with secondary outcomes including eating behaviors , physical activity , and social support . Analysis . Latent growth modeling was used to measure changes in the outcomes over time . Results . Participants in the intervention group maintained weight/ BMI ( –.1 pounds/–.1 BMI ) , whereas the control participants gained weight/ BMI ( + 2.6 pounds/+.3 BMI ) , result ing in a statistically significant difference between groups . Fifty-five percent of intervention participants lost some weight , whereas only 35 % of the control group lost weight . Conclusions . FUEL Your Life , a low intensity intervention , was not effective for promoting weight loss , but was effective for helping workers maintain weight over a 12-month period OBJECTIVE The progression from impaired glucose tolerance (IGT)/impaired fasting glucose ( IFG ) to type 2 diabetes can be prevented or delayed through intensive lifestyle changes . How to translate this to implementation across whole communities remains unclear . We now describe the results to a pilot of a personal trainer ( Maori Community Health Worker , MCHW ) approach among Maori in New Zeal and . DESIGN , SETTING AND SUBJECTS A r and omised cluster-controlled trial of intensive lifestyle change was commenced among 5,240 non-pregnant Maori family members without diabetes from 106 rural and 106 urban geographical clusters . Baseline assessment s included lifestyle question naires , anthropometric measurements and venesection . A pilot study ( Vanguard Study ) cohort of 160 participants were weighed before and during MCHW intervention , and compared with fifty-two participants weighed immediately before intervention and with 1,143 participants from the same geographical area . Interactions between participants and the MCHW were reported using personal digital assistants with a programmed detailed structured approach to each interview . RESULTS During the Vanguard Study , participants and MCHW found the messages , toolkit and delivery approach acceptable . Those with IGT/IFG diagnosed ( n 27 ) experienced significant weight loss after screening and during the Vanguard Study ( 5.2 ( sd 6.6 ) kg , paired t test P < 0.01 ) . Significant weight loss occurred during the Vanguard Study among all participants ( -1.3 ( sd 3.6 ) kg , P < 0.001 ) . CONCLUSIONS Comparable initial weight loss was shown among those with IGT/IFG and those from existing trials . Community-wide prevention programmes are feasible among Maori and are likely to result in significant reductions in the incidence of diabetes Purpose The purpose of this study was to describe the feasibility of using a community-based participatory research ( CBPR ) approach to implement the Power to Prevent ( P2P ) diabetes prevention education curriculum  in rural African American ( AA ) setting s. Methods Trained community health workers facilitated the 12-session P2P curriculum across 3 community setting s. Quantitative ( based on the pre- and post-curriculum question naires and changes in blood glucose , blood pressure [ BP ] , and weight at baseline and 6 months ) and qualitative data ( based on semi-structured interviews with facilitators ) were collected . Indicators of feasibility included : dem and , acceptability , implementation fidelity , and limited efficacy testing . Results Across 3 counties , 104 AA participants were recruited ; 43 % completed ≥ 75 % of the sessions . There was great dem and for the program . Fifteen community health ambassadors ( CHAs ) were trained , and 4 served as curriculum facilitators . Content and structure of the intervention was acceptable to facilitators but there were challenges to implementing the program as design ed . Improvements were seen in diabetes knowledge and the impact of healthy eating and physical activity on diabetes prevention , but there were no significant changes in blood glucose , BP , or weight . Conclusion While it is feasible to use a CBPR approach to recruit participants and implement the P2P curriculum in AA community setting s , there are significant challenges that must be overcome Background India currently has more than 60 million people with Type 2 Diabetes Mellitus ( T2DM ) and this is predicted to increase by nearly two-thirds by 2030 . While management of those with T2DM is important , preventing or delaying the onset of the disease , especially in those individuals at ‘ high risk ’ of developing T2DM , is urgently needed , particularly in re source -constrained setting s. This 
    Output:
    
Overall the training was culturally sensitive and /or appropriate , covering topics such as the importance of good nutrition and the benefits of increased physical activity , communication and leadership .
CHWs delivered a variety of interventions and also screened or recruited participants .
The shared culture and language between CHWs and participants likely contributed to better programme implementation and successful outcomes .
The complexity of DPPs and the diverse CHW roles preclude attributing specific outcomes to CHW involvement .