Effectiveness of a culturally adapted group-based lifestyle intervention in reducing cardiovascular risk factors in a high-risk Latin American population.

Authors

Rosario Suárez, Yoredy Sarmiento-Andrade, Karem Carrión, Martha Montalvan, Milenka Zhindón, Jorge Ramirez, Sebastián Chapela, Evelyn Frias-Toral

Published in

Translational behavioral medicine. Volume 16. Issue 1. Jan 07, 2026.

Abstract

Type 2 diabetes (T2D) is a global public health challenge globally. Effective prevention programs must be tailored to cultural and logistical contexts.
This study evaluated the comparative efficacy of a culturally adapted diabetes prevention program (DPP) intervention versus usual care in reducing T2D risk factors in Ecuadorian institutional settings.
This quasi-experimental study included adults with high T2D risk (FINDRISC score ≥12). Participants voluntarily enrolled to an experimental group (EG, N = 192) receiving a 16-week, 10 session culturally adapted DPP, or a control group (CG, N = 91), receiving usual care. Primary comparative efficacy was assessed using analysis of covariance (ANCOVA), adjusting for key baseline imbalances.
Intragroup analysis showed that EG achieved significant reductions in weight (average loss of 1.06%), BMI, and body fat mass (P < .05). However, the primary outcome reduction in FINDRISC score (P = .013) did not retain significance after Holm-Bonferroni correction. The comparative ANCOVA analysis revealed no significant difference between EG and CG for the primary outcomes of weight (P = .330) or FINDRISC score (P = .291). The intervention showed a reduction in systolic blood pressure (SBP) that was statistically significant in the per-protocol analysis (adjusted Δ = -3.338 mmHg; F = 5.160, P = .024), although this effect was attenuated to a trend (P = .079) in a multiply imputed intention-to-treat sensitivity analysis.
The short-term, culturally adapted DPP intervention failed to demonstrate superior comparative efficacy in achieving the primary goals of T2D risk reduction or weight loss compared to usual care. Nevertheless, the per-protocol analysis identified a promising reduction in SBP, whose robustness was supported by inverse probability of treatment weighting but attenuated under intention-to-treat multiple imputation. These findings suggest partial efficacy of the short-term adaptation on cardiovascular health and underscore the critical need for longer program duration and strategies to reduce attrition in similar institutional settings.

PMID:
42479756
Bibliographic data and abstract were imported from PubMed on 22 Jul 2026.

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