Project 459789

More than 6 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, mainly 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 in diverse urban communities across Canada, where T2D rates are high and diabetes prevention programs remain inaccessible. In partnership with 9 regional YMCAs in Canada, we are well-positioned to evaluate the implementation and effectiveness of Small Steps for Big Changes across 29 distinct municipalities. In Year 1, the program will be adapted through our provincial delivery teams and YMCA staff will receive virtual training to deliver program. Small Steps for Big Changes will be delivered to patients in-person or virtually, in Years 2 and 3. 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 3-5. YMCA staff 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.