Grant: Team Grant: HCIS - Type 2 diabetes prevention

Six million Canadians are at risk for developing type 2 diabetes (T2D). Laboratory-based diabetes prevention programs have not been effective when translated into community settings due to their low-quality delivery and inability to reach people in the community who need it most. Small Steps for Big Changes is a diet and exercise counselling intervention that significantly reduces the risk of developing T2D. Designed for feasible, scalable, and sustainable implementation into communities, Small Steps for Big Changes is delivered by community-dwelling peers to ensure the content is ethnoculturally relevant. Small Steps for Big Changes can now be delivered virtually through a state-of-the-art online platform. The next phase of research is to test the implementation of this program where T2D rates are high and diabetes prevention programs remain inaccessible. In partnership with YMCAs in Canada and Australia spanning 8 provinces and the state of Queensland, we are well-positioned to evaluate the implementation and effectiveness of Small Steps for Big Changes across 16 urban municipalities. In Year 1, the program will be adapted through our regional delivery teams and YMCA staff will receive virtual training to deliver program. Small Steps for Big Changes will be delivered to patients in Years 2, 3 and 4. To evaluate implementation, we will examine number of staff trained/patients enrolled, attendance, sessions delivered as planned, delivery costs, and number of sites continuing to deliver the program in Years 4-6. YMCA staff, municipality stakeholders, and patients will also be interviewed on program receptivity. To evaluate program effectiveness, changes in patient health (e.g., blood glucose, weight, exercise, diet) will be measured over 2 years following program completion. This research offers an innovative, cost-saving, and sustainable solution for the prevention of T2D in traditionally underserved, at-risk populations by partnering with communities.