# Addressing Social Determinants of Health to Improve Diabetes Prevention Program Outcomes Among Underserved African Americans

> **NIH NIH R01** · UNIVERSITY OF MISSOURI KANSAS CITY · 2022 · $663,387

## Abstract

PROJECT SUMMARY
African Americans (AAs) are disproportionately burdened by diabetes mellitus (DM) with rates twice as high as
Whites (13% vs 7.5%), and increased rates of DM-related complications and comorbidities (e.g. amputations,
cardiovascular disease). A key pre-DM risk factor is overweight/obesity. Nearly 70% of AAs are overweight or
obese, with higher rates among AAs with low-income. A critical component of national efforts to reduce
growing obesity rates and prevent DM is the Diabetes Prevention Program (DPP), a lifestyle intervention
proven to reduce or delay DM onset with diet change, exercise, and modest weight loss (5-7%) in a rigorously
evaluated national trial. A group-based version of the DPP has been widely disseminated and numerous
community-based trials support its efficacy. In spite of these successes, there are significant health disparities
in DPP attendance and outcomes and considerable room exists for improving success rates among AAs, a
population that tends to experience half the amount of DPP weight loss compared to Whites. We aim to build
on our promising pilot studies by tailoring the DPP via a social determinants (SD) of health lens to achieve
optimal DPP attendance and clinically meaningful weight loss with pre-DM AAs. This includes tailoring on
cultural and socioeconomic SD mechanisms that are associated with improving health outcomes and align with
predisposing needs among AAs who are primarily of low-income and live in low-resource AA communities.
We propose a randomized controlled trial of 360 pre-DM AA patients from a safety net hospital (SNH) to test a
standard DPP (S-DPP) against a culturally tailored DPP (TC-DPP; e.g., tailoring of language, foods, values,
religiosity, norms, values) alone and a culturally tailored DPP enhanced to address access and support related
economic barriers (TCE-DPP; hybrid group/online/text DPP; community health worker support to improve
access to DPP classes, healthy food, exercise, and other community and health resources; and financial
incentives) over 12 months. We will: 1) examine effects of TC-DPP and TCE-DDP on percent weight loss and
attendance (primary outcomes) and on secondary outcomes (physical activity, completion of physician follow-
up visit, hbA1c, and blood pressure) at 6 and 12 months with SNH AAs, 2) evaluate potential mediators/
moderators related to weight loss and attendance among AA SNH patients at 6 and 12 months to determine
modifiable facilitators and barriers, and 3) conduct a process evaluation to examine TCE-DPP acceptability,
feasibility, and fidelity, and relationships between delivery dose, exposure, costs, and outcomes to identify and
improve essential intervention components. Our multidimensional DPP interventions are guided by our past
pilots, and based on components that, all together, were used to help drive clinically important outcomes in the
original DPP trial – and are certainly needed to achieve similar outcomes with AA primarily of low-inco...

## Key facts

- **NIH application ID:** 10380677
- **Project number:** 5R01DK124664-03
- **Recipient organization:** UNIVERSITY OF MISSOURI KANSAS CITY
- **Principal Investigator:** Jannette Yvonne Berkley-Patton
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $663,387
- **Award type:** 5
- **Project period:** 2020-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10380677

## Citation

> US National Institutes of Health, RePORTER application 10380677, Addressing Social Determinants of Health to Improve Diabetes Prevention Program Outcomes Among Underserved African Americans (5R01DK124664-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10380677. Licensed CC0.

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