ArticleTranslational behavioral medicine2026
Closing the Hispanic/Latino engagement gap in diabetes prevention: feasibility of a community co-designed, participate-to-lead program.
Article in Translational behavioral medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHispanic/Latino (H/L) adults show lower engagement and smaller weight-loss outcomes than non-Hispanic White (NHW) participants in the National Diabetes Prevention Program (NDPP), a gap driven by delivery rather than biological differences. PURPOSE: To evaluate the feasibility, engagement, and preliminary clinical outcomes of Paso a Paso, a community co-designed, culturally relevant diabetes prevention program for Spanish-speaking H/L adults, across two cohorts: instructor-trainees (Cohort 1) and community participants (Cohort 2).
methodsSingle-arm feasibility pilot guided by RE-AIM, EPIS, and ERIC frameworks. Cohort 1 (n = 18 H/L community leaders) completed 16 weekly in-person sessions; Cohort 2 (n = 30 at two sites) completed 13-15 weekly sessions, both led by a registered dietitian. Participants were classified into three engagement tiers: high-dose (≥50% sessions), low-dose community-connected (<50% but retained at the final session), and discontinued. Body mass index (BMI), waist circumference, and HbA1c were assessed at baseline and 4 months.
resultsCohort 1 achieved 100% retention and a median attendance rate of 93.8% (range 31.2%-100.0%). Cohort 2 achieved 73% 4-month retention and a median attendance rate of 61.5% (range 0.0%-93.3%). Among 21 paired participants, mean % body weight change was -1.5% (SD, 2.3) and 81% achieved any weight reduction; participants with overweight and obesity, the primary target population, lost -1.7% (SD, 1.5) and -1.9% (SD, 2.6) respectively.
conclusionsPaso a Paso suggests feasibility, with engagement and retention exceeding NDPP benchmarks for H/L participants and preliminary, clinically meaningful weight reductions observed across the winter holiday season. These hypothesis-generating findings support advancement to a powered hybrid effectiveness-implementation trial.
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