Grant: Project Grant

In the past 15 years, type 2 diabetes (T2D) rates have risen faster in the British Columbia Interior compared to the rest of the Canadian population. A recent environmental scan conducted in Interior British Columbia demonstrated a lack of capacity to deliver diabetes prevention services, particularly in rural towns. Small Steps for Big Changes (SSBC) is a diet and exercise counselling intervention that has been effective as a community-based program for lowering T2D risk in individuals with prediabetes. SSBC has been delivered in two urban city sites in Interior BC. The next phase is to expand delivery of SSBC to five rural community sites where T2D rates are high and no prediabetes programs exist. Partnerships from different sectors, and community-delivery are necessary for successful uptake and meaningful healthcare impact. Having established a formal partnership with the YMCA of Okanagan in 2017, we are well-positioned to deliver and evaluate the implementation and effectiveness of the SSBC program adapted to rural sites. In Year 1, the program will be adapted through partnership with site-level implementation teams, and YMCA staff will receive training for program delivery. Delivery of SSBC to community members (60/site; total = 300) will begin in Year 2. To evaluate the implementation of SSBC, we will examine number of staff trained and patients enrolled in the program, patient attendance, sessions delivered as planned, delivery costs, and number of sites continuing to deliver the program in Years 3 and 4. YMCA staff and SSBC patients will also be interviewed on how well they receive the program. To evaluate program effectiveness, changes in patient health (e.g., blood glucose, weight, physical activity, diet) will be measured over two years following program completion. Evaluating the implementation and effectiveness of SSBC will result in a template for scaling-out a diabetes prevention program that can service the many rural communities of Canada.