# Using Peer Support To Aid in PRevention and Treatment in Prediabetes (UPSTART)

> **NIH NIH R18** · KAISER FOUNDATION RESEARCH INSTITUTE · 2020 · $647,491

## Abstract

Project Abstract
An estimated 86 million adults in the United States have prediabetes, and low-income Latino and African
American adults have disproportionately high rates compared to non-Hispanic adults. Structured lifestyle
interventions can prevent or delay type 2 diabetes in these at-risk populations and now are widely offered at
community organizations and health systems. Yet, uptake of and engagement in available formal programs is
very low. Low-income racial and ethnic minority adults in particular face multiple barriers to navigating,
engaging in, and sustaining involvement in available programs and lifestyle behaviors found to decrease
progression to diabetes. It is critically important to develop and evaluate innovative approaches to increase
uptake, engagement, and maintenance of gains in diabetes prevention activities. Peer support has been
shown in ours and others' effectiveness trials to be a sustainable, effective approach for positive behavior
change and improved outcomes in adults with diabetes and other chronic conditions. Our pilot work suggests
such approaches are feasible and acceptable among low-income Latino and African American patients with
prediabetes to prevent chronic disease and better navigate their health care systems to obtain healthy lifestyle
counseling and support. However, such peer support models among Latino, African American, and other low-
income adults with prediabetes have not yet been rigorously evaluated. Accordingly, we propose a parallel,
two-arm randomized controlled trial in primary care centers in two different health systems that serve multi-
ethnic communities with a high concentration of Latinos and African Americans and diverse socio-economic
backgrounds. We will compare enhanced usual care (providing referrals to diabetes prevention programs and
resources) with a model of a structured behavioral change intervention supplementing enhanced referral to
programs and resources with peer support to help link adults with prediabetes to existing health system and
community diabetes prevention programs, to support their engagement in formal programs, maintain achieved
gains, and support participants to initiate and sustain healthy behaviors to prevent diabetes.

## Key facts

- **NIH application ID:** 9980886
- **Project number:** 5R18DK113403-04
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** MARY ELLEN MICHELE HEISLER
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $647,491
- **Award type:** 5
- **Project period:** 2017-09-14 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9980886

## Citation

> US National Institutes of Health, RePORTER application 9980886, Using Peer Support To Aid in PRevention and Treatment in Prediabetes (UPSTART) (5R18DK113403-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9980886. Licensed CC0.

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