Modifications to the US Diabetes Prevention Programme (DPP) for the SHAPE Programme
| US DPP curriculum | SHAPE curriculum | Reason for change |
| Individual lessons led by a trained lifestyle coach | Group-based lessons led by a trained lifestyle coach | Increase social support among participants |
| Diet examples in class reflected the wider US population | Examples were modified to better reflect South Asian foods and holidays | Improve cultural appropriateness |
| Portion size recommendations were included in one lesson | Portion 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 barriers | Discussions of barriers included several exercises to practice talking to family and friends about the programme and helping them be more supportive | Family 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 support | Each class included a group activity and ample interaction and discussion time | Build social support among the class and identify and find solutions for culturally specific barriers |
| Only the participant attended each class | Participants were encouraged to invite family members to classes | Build 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 support | Participants were divided into small groups of 4–5 participants. Groups worked together in class and were encouraged to interaction outside of class time | Build social support |
| Exercise (overcoming barriers, increasing amount and exertion level, safety) was discussed during sessions with lifestyle coach | Added 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 lessons | Build a strong foundation for exercise within a population with less exercise experience or working knowledge |
SHAPE, South Asian Health and Prevention Education.