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other·endocrinology, public health, nutrition, dietetics, internal medicine·PMC10002357

Adapting and Developing A Diabetes Prevention Intervention Programme for South Africa: Curriculum and Tools

International Journal of Environmental Research and Public Health · 6 authors, 4 centres

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TL;DR

This paper describes the mixed-methods, staged process of developing a culturally adapted diabetes prevention lifestyle intervention curriculum and tools for South Africa, including needs assessment, expert input, and pilot testing. The main finding is that the developed curriculum and tools were deemed acceptable and feasible by the target population in a pilot study, with participants reporting positive experiences and some lifestyle changes. The most important limitation is that the findings are specific to resource-poor communities in Cape Town and may not be generalizable to other contexts.

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The South African Diabetes Prevention Programme (SA-DPP) aimed to develop a context-specific lifestyle intervention curriculum and tools for adults at high risk of T2DM in low-resource communities. Methods: A qualitative, mixed-method staged approach was followed, involving 11 steps: literature review, needs assessment via focus group discussions (FGDs) with 68 participants, expert input, curriculum and tool development, expert content evaluation, design/layout refinement, participant readability/acceptability evaluation, translation into Xhosa, and a pilot suitability evaluation. The pilot study involved 10 participants in a 6-week accelerated version of the planned intervention. Key Results: The needs assessment revealed that participants had limited knowledge of T2DM causes, identified financial constraints as the major barrier to healthy eating, and preferred group sessions in their community. The developed curriculum and tools (participant and facilitator workbooks) received high acceptability scores (mean 94.3% and 89.3% respectively). The pilot study showed high satisfaction, with participants reporting learning new information, feeling excited to make lifestyle changes, and sharing knowledge with family and community. Some participants reported positive changes, such as a spouse's improved diabetes control. Limitations: The development process was specific to resource-poor communities in Cape Town, South Africa, and the pilot study had a small sample size (n=10) and was accelerated due to COVID-19, which may limit generalizability. Implications: The study demonstrates a successful process for developing a culturally tailored diabetes prevention intervention in an African context, which may serve as a model for other low- and middle-income countries. The next step is a full evaluation of the intervention's effectiveness.

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other

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endocrinology

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ORIGINAL PAPER

PMC10002357

Adapting and Developing A Diabetes Prevention Intervention Programme for South Africa: Curriculum and Tools

International Journal of Environmental Research and Public Health

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ABSTRACT

Abstract The South African Diabetes Prevention Programme (SA-DPP) is a lifestyle intervention targeting individuals at high risk of developing type 2 diabetes mellitus (T2DM). In this paper we describe the mixed-method staged approach that was used to develop and refine the SA-DPP intervention curriculum and the appropriate tools for local resource-poor communities. During the preparation phase, existing evidence on similar DPP interventions was reviewed, focus group discussions with individuals from the target population were conducted as part of a needs assessment, and experts were consulted. The curriculum booklet, a participant workbook and facilitator workbook were developed, and the content was evaluated by experts in the field. The design and layout of the booklet and workbooks needed to be culturally and contextually appropriate. The printed material was evaluated for readability and acceptability by participants of the target population; based on their feedback, the design and layout were refined and the printed material was translated. The suitability of the intervention was tested in a pilot study; based on feedback from the participants and facilitator, the curriculum was revised where needed and finalised. Through this process a context specific intervention and printed materials were developed. A complete evaluation of this culturally relevant model for T2DM prevention in South Africa is pending. Keywords: diabetes prevention, intervention, healthy lifestyle curriculum, health education, South Africa

CITATION EXPORT

Jillian Hill, Mieke Faber, Nasheeta Peer et al.. Adapting and Developing A Diabetes Prevention Intervention Programme for South Africa: Curriculum and Tools. International Journal of Environmental Research and Public Health. (2023). https://doi.org/10.3390/ijerph20054463

AUTHORS

6 · 4 CENTRES

Jillian Hill, Mieke Faber, Nasheeta Peer, Cindy George, Brian Oldenburg, Andre P Kengne

1Non-Communicable Diseases Research Unit, South African Medical Research Council (SAMRC), Cape Town 7505, South Africa
2Center of Excellence for Nutrition, North-West University, Potchefstroom 2531, South Africa
3Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
4Baker Heart and Diabetes Institute, School of Psychology and Public Health, La Trobe University, Victoria 3004, Australia