Public Health Nurs. 2017;1–7. wileyonlinelibrary.com/journal/phn
|
1 © 2017 Wiley Periodicals, Inc.
DOI: 10.1111/phn.12379
SPECIAL FEATURES: EDUCATION
Application of a modified diabetes prevention program with
adolescents
Kimberly Geria DNP, AGPCNP-BC, APN
1
| Janice M. Beitz PhD, RN, CS, CNOR, CWOCN,
CRNP, MAPWCA, ANEF, FAAN
2
1
Complete Care Health Network, Wildwood,
NJ, USA
2
School of Nursing Camden, Rutgers
University, Camden, NJ, USA
Correspondence
Kimberly Geria, Advanced Practice Nurse
Practitioner, Complete Care Health Network,
Wildwood, NJ, USA.
Email: kimberlygeria23@gmail.com
Abstract
Objective: The purpose of this study was to increase type 2 diabetes (T2DM) aware-
ness and decrease T2DM risk factors by examining effectiveness of a modified version
of the Centers for Disease Control and Prevention (CDC) Diabetes Prevention Program
(DPP) with adolescents.
Design and Sample: A quasi-experimental one-group, pretest/posttest design was
used to determine impact of the modified DPP on adolescents. Study intervention was
incorporated into the health education curriculum at a public charter school and imple-
mented over 11 weeks. Study sample included primarily African-American and
Hispanic adolescents (N = 101) aged 13–18 attending the public charter school in a
New Jersey urban community.
Measures: Instrumentation included valid, reliable measures of self-efficacy for
healthy eating, physical activity, food knowledge, and healthy food choices.
Participants’ pretest/posttest waist circumference and body mass index (BMI) were
collected.
Results: Outcomes revealed significant (p < .001) increase in participants’ food knowl-
edge, self-efficacy for choosing healthy foods and performing physical activity, healthy
food choices, and amount of weekly aerobic exercise. Reductions in BMI and waist
circumference were statistically significant (p < .05).
Conclusions: A modified DPP adapted for adolescents’ learning needs lowered risk for
T2DM. Implications for clinical practice, education, and research are posed.
KEYWORDS
adolescent, diabetes prevention, school-based interventions, type 2 diabetes mellitus
1 | BACKGROUND
In the United States, currently, 9.4% of Americans (30.3 million per-
sons) have been diagnosed with diabetes and 37% of adults have
prediabetes for a total of 100 million affected Americans (Centers
for Disease Control and Prevention [CDC], 2017). Yearly, 1.7 million
adults 20 years of age or older are diagnosed with diabetes, and 5,089
persons under the age of 20 are diagnosed with T2DM (American
Diabetes Association (ADA) (2015); CDC, 2017). Between the years
of 1980 to 2014, people diagnosed with diabetes in the United States
increased from 5.6 to 22 million (CDC, 2015a). Economic cost of T2DM
was $192 billion in 2007 (Zhang et al., 2009) and rose to $245 billion
in 2015 (ADA, 2015). Projected costs for 2017 are $312 billion (ADA,
2017).
Onset of T2DM is most commonly seen in adult populations.
As childhood obesity rates continue to rise, diagnosis of T2DM has
become more frequent in children (Mayo Clinic Staff, 2014). Annual
incidence rate of T2DM among children and adolescents has increased
by 4.8% from 2002 to 2012 (Mayer-Davis et al., 2017). As of 2009,
the SEARCH for Diabetes in Youth Study estimated a total of 20,262