The HITS Diabetes with Prevention Project

Principal Investigator: Juan Pablo González Rivas

Hybridized Three Steps (HITS) Intervention to Prevent Diabetes in Venezuela. HITS Diabetes with Prevention, An EVESCAM lifestyle intervention study.

Intensive lifestyle intervention (LSI) programs in patients with increased weight and prediabetes have demonstrated to prevent or delay the incidence of type 2 diabetes, however, its effectiveness in daily clinical practice is lower compared with pragmatic trials. Because the effectiveness in the reduction of type 2 diabetes incidence is directly proportional to the weight reduced during the program, we aim

• To compare the weight loss achieved with two LSI programs in a community health center of Venezuela: a) A hybrid LSI including rapid weight loss with total diet replacement (TDR), followed by medical nutrition therapy (MNT), and the Diabetes Prevention Program (DPP) protocol, vs b) only the DPP.
• To compare the change of cardiometabolic risk factors between groups.
• To evaluate the implementation process.

Cross-Cultural Adaptation for Venezuela of the Lifestyle Balance Group Program

The adaptation included: Change of data from the United States to data from Venezuela. Ex. Prevalence of metabolic syndrome. Change of units. Ex. From pounds to kilograms. Changes in wording or style. Spelling and grammar corrections. Ex. Subject verb agreement. Change to foods available and common in the country. Change of recipes according to the time of day. For example, the main course in the United States is during dinner, in Venezuela it is lunch. Change to recipes for foods frequently consumed in the country. Eg. Empanadas and arepas. Physical activities that are not usually carried out in the region were modified. Ex. Ice skating, skiing. Some protection recommendations in extreme climates were omitted. Ex. Symptoms of frostbite due to snowfall during physical activity. Modifications of metaphors for local metaphors. Changing the names of the characters in the examples to locally common names. Some recommendations and guidelines were adapted according to the
current guides.

Project Funded by the Lown Scholar in Cardiovascular Health Program of the Harvard School of Public Health, Boston, USA

Publications

Feasibility and Effectiveness of a Preventive Care Program during the Compound Humanitarian Crisis and COVID-19 Pandemic in Venezuelaa

Juan P. González-Rivas, María M. Infante-García, Ramfis Nieto-Martinez, Jeffrey I. Mechanick and Goodarz Danaei.

Nutrients 2022, 14, 939