Reducing Environmental Risks to Modify Lifestyle Behaviors

摘要: It has been more than 10 years since the Diabetes Prevention Program (DPP) reported that changes in diet and physical activity resulted a larger reduction incidence of type 2 diabetes medication alone (1). We have acquired abundant well-replicated scientific evidence from national international multisite, multiyear intervention trials showing benefits lifestyle change for health, yet prevention programs healthier behaviors are not being widely adopted translated to reach population at large. Consequently, prevalence associated risk factors continued increase. Between 1999 2010, hyperglycemia increased 12.9 19.9%. The portion having waist size above recommended threshhold also 45.4 56.1%, indicating rise rate abdominal obesity (2). Among U.S. elderly Medicare population, is estimated by 1.69% per year between 2005 (3). co-occurrence two or lifestyle-related chronic conditions 2002 2009 2% (4). Successfully disseminating interventions requires over-coming many challenges—screening recruiting individuals, providing instruction, promoting adherence, supporting maintenance. When long complex, as was case with DPP, which had core curriculum 16 weekly education sessions, these challenges costs can be overwhelming. Group developed reduce may able replicate magnitude impact original DPP. For example, community-based program Pennsylvania yielded <20% no complications rates (5). Even if efficacy DPP maintained disseminated, …