A Randomized Comparative Effectiveness Trial for Preventing Type 2 Diabetes

Am J Public Health. 2015 Nov;105(11):2328-34. doi: 10.2105/AJPH.2015.302641. Epub 2015 Sep 17.


Objectives: We evaluated the weight loss effectiveness of a YMCA model for the Diabetes Prevention Program (DPP) lifestyle intervention.

Methods: Between July 2008 and November 2010, we individually randomized 509 overweight or obese, low-income, nondiabetic adults with elevated blood glucose in Indianapolis, Indiana, to receive standard care plus brief lifestyle counseling or be offered a group-based YMCA adaptation of the DPP (YDPP). Primary outcome was mean weight loss difference at 12 months. In our intention-to-treat analyses, we used longitudinal linear or logistic regression, multiply imputing missing observations. We used instrumental variables regression to estimate weight loss effectiveness among participants completing 9 or more intervention lessons.

Results: In the YDPP arm, 161 (62.6%) participants attended ≥ 1 lesson and 103 (40.0%) completed 9 or more lessons. In intention-to-treat analysis, mean 12-month weight loss was 2.3 kilograms (95% confidence interval [CI] = 1.1, 3.4 kg) more for the YDPP arm than for standard care participants. In instrumental variable analyses, persons attending 9 or more lessons had a 5.3-kilogram (95% CI = 2.8, 7.9 kg) greater weight loss than did those with standard care alone.

Conclusions: The YMCA model for DPP delivery achieves meaningful weight loss at 12 months among low-income adults.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose
  • Body Mass Index
  • Counseling / organization & administration*
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Female
  • Health Behavior
  • Humans
  • Indiana
  • Life Style
  • Male
  • Middle Aged
  • Obesity / therapy
  • Overweight / therapy*
  • Poverty*
  • Single-Blind Method
  • Weight Loss
  • Weight Reduction Programs / organization & administration*


  • Blood Glucose