Team Members: J. Steven Cramer, MD, MS, Ralph F. Sibley, PhD, MS, Nicole Scouras, MPH, Donald P. Bartlett, PhD, Lisa Loffredo, RN,.

Background:
Recent work has confirmed the power of lifestyle interventions in reducing the incidence of diabetes in high-risk individuals. The Diabetes Prevention Program (DPP) demonstrated that the introduction of a healthy low fat diet and physical activity of moderate intensity for at least 150 minutes a week produced a weight loss of 7% and a 58% reduction in the progression to diabetes when compared to the usual care group.

Purpose:
A case management project was developed using modifications of the DPP teaching plan to treat a high risk minority diabetic population. The goals of the intervention were to achieve increased exercise levels, a weight loss of 7% and an appropriate modification of the patient’s diet. Components of the DPP program were modified to address this focus and to allow for completion in nine visits.

The DPP Participant Notebook originally consisted of a core curriculum of 16 modules to be implemented over a 24 week period with monthly follow-ups. The edited version consists of a 7-module (51 page) participant handbook and appropriately modified provider script. The edited version focuses on the following core areas: provision of basic knowledge regarding diabetes and its complications, individual goal setting for diet and exercise, basic education regarding the calorie and fat content of various foods, guidance in choosing exercises appropriate to age and physical condition, techniques for self-monitoring, specific strategies for shopping and eating out, relapse prevention, and individual coaching to monitor progress, address obstacles and increase motivation.

We wish to thank Dr. Anne Tilghman Brenneman, Project Coordinator for The Diabetes Prevention Program, for permission to publish this abbreviated version of the DPP manual.