Small Steps for Big Changes: Implementing an Evidence-Based Diabetes Prevention Program Into Diverse Urban Communities

What this Trial Is About

Researchers are evaluating the implementation and effectiveness of the Small Steps for Big Changes (SSBC) program, an evidence-based diabetes prevention program aimed at reducing the risk of developing Type 2 Diabetes (T2D) among adults with prediabetes. This study partners with YMCAs across 8 Canadian provinces to deliver and assess the program in diverse urban communities. The study uses a hybrid type 2 implementation-effectiveness design to examine clinical outcomes such as T2D status, blood glucose levels, weight, exercise, and diet, along with program adoption and sustainability metrics. The SSBC program consists of a 4-week behavior change intervention delivered at YMCA locations by community facility trainers. It includes six supervised exercise sessions combined with brief counseling to teach self-regulatory skills for healthy lifestyle changes, plus three independent exercise sessions outside the YMCA. The counseling focuses on promoting regular exercise and dietary improvements like reducing sugar and processed carbohydrates while increasing vegetable intake. Program delivery and adaptations will be monitored from the start through sustainment planning up to 208 weeks. Participants will be involved in assessments over two years following the intervention, including evaluations of T2D status, changes in HbA1c, fitness, body measurements, and health behaviors. Data on program reach, attendance, delivery fidelity, adaptations, patient and staff receptivity, costs, and membership rates will also be collected. The study aims to provide comprehensive insights into the clinical effectiveness, implementation success, and cost-effectiveness of the SSBC program in real-world community settings.

Small Steps for Big Changes - Healthy Cities Implementation Science