Table 3

Modifications to the US Diabetes Prevention Programme (DPP) for the SHAPE Programme

US DPP curriculumSHAPE curriculumReason for change
Individual lessons led by a trained lifestyle coachGroup-based lessons led by a trained lifestyle coachIncrease social support among participants
Diet examples in class reflected the wider US populationExamples were modified to better reflect South Asian foods and holidaysImprove cultural appropriateness
Portion size recommendations were included in one lessonPortion sizes were discussed during several lessons and focused on foods often eaten in excess (eg, rice, breads)Portion sizes were identified as a major contributor to overeating
Participants were taught to overcome barriers to activity, with a large focus on internally derived barriersDiscussions of barriers included several exercises to practice talking to family and friends about the programme and helping them be more supportiveFamily and social support are important barriers—and motivators—for lifestyle choices
Coach and participant worked one on one to discuss the programme information, overcoming barriers, and building social supportEach class included a group activity and ample interaction and discussion timeBuild social support among the class and identify and find solutions for culturally specific barriers
Only the participant attended each classParticipants were encouraged to invite family members to classesBuild social support and make family members a source of motivation (and not a barrier) for behaviour change
Lifestyle coach is the main source of programme supportParticipants were divided into small groups of 4–5 participants. Groups worked together in class and were encouraged to interaction outside of class timeBuild social support
Exercise (overcoming barriers, increasing amount and exertion level, safety) was discussed during sessions with lifestyle coachAdded more basic exercise training (eg, exercise safety, stretching, basic strength training and increasing level of exertion), invited an exercise trainer to come to some classes, and offered optional group walks after most lessonsBuild a strong foundation for exercise within a population with less exercise experience or working knowledge
  • SHAPE, South Asian Health and Prevention Education.