Pre-diabetes
Conditions
Brief summary
In this pilot trial participants will be randomized 1:1 to participate in either standard Diabetes Prevention Program (DPP) vs. DPP plus a novel cooking skills intervention (DPP Cooks). The researchers hypothesize that participants randomized to DPP Cooks will have greater weight loss, better diet quality at 4 months, and greater confidence in their cooking skills and ability to implement dietary changes recommended in the DPP.
Detailed description
This study is a randomized pilot trial testing a novel cooking skills intervention (DPP Cooks) vs. the standard Diabetes Prevention Program (DPP). The DPP is a widely disseminated evidenced-based lifestyle behavior change program to help adults with pre-diabetes lose weight and prevent type-2 diabetes. In this trial the investigators will test whether the addition of food-agency based cooking skills classes improves the effectiveness of the DPP. This trial will take place in Baltimore, MD in collaboration with community partner DPP providers. The trial has been informed by formative work with prior DPP participants and has used a Community Based Participatory Research (CBPR) approach to developing the DPP Cooks intervention. Participants will be randomized 1:1 to participate in either standard DPP vs. DPP Cooks. The length of the trial will be 12 months and outcomes will be measured at baseline, 4 months, and 12 months.
Interventions
BEHAVIORALDPP Cooks
6 'food agency' based cooking skills classes during the first 4 months of the DPP
BEHAVIORALDPP
Standard DPP
Sponsors
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Johns Hopkins Bloomberg School of Public Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults in Baltimore City * eligible for DPP based on Centers for Disease Control guidelines * possession of a smart phone with camera * can commit to 12 month study participation
Exclusion criteria
* current or prior diagnosis of type 1- or type 2 diabetes * non-English speaker * participating in another research study that may effect diabetes, diet, or weight loss * currently pregnant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Absolute Body Weight (Kilograms (kg)) | baseline, 4 months and 12 months | Weight change will be measured in absolute kg. Weight will be measured at baseline, 4 months and 12 months. Weight will be measured by DPP coaches at weekly meetings (or, if DPP groups are meeting virtually, weight will be reported by participants to their DPP coaches in weekly virtual meetings). |
| Change From Baseline in Percentage of Baseline Bodyweight | baseline, 4 months and 12 months | Weight change will be measured in the percent of body weight change. Weight will be measured at baseline, 4 months and 12 months. Weight will be measured by DPP coaches at weekly meetings (or, if DPP groups are meeting virtually, weight will be reported by participants to their DPP coaches in weekly virtual meetings). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Food Agency Measured Via the Cooking and Food Provisioning Action Scale (CAFPAS) | baseline, 4 months and 12 months | The Cooking and Food Provisioning Action Scale (CAFPAS) is a 28 question scale in which higher scores indicate higher Food Agency. All questions in the CAFPAS are measured on 7-point Likert Scales (strongly agree to strongly disagree). The CAFPAS has 3 sub-scales which are scored by summing the scores on each individual question (after reverse coding negative items) and are then standardized. Then the 3 standardized sub-scale scores are summed to generate an overall CAFPAS score in which higher scores indicate better Food Agency. In this sample scores range from 10.48- 22.25 points with higher scores indicating better Food Agency. |
| Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | baseline, 4 months and 12 months | The USDA Adult Food Security Survey Module is a 10-item progressive survey instrument in which individuals are asked about the food situation in their household over the last 30 days. Scores are summed and generate the following categories: High food security status (raw score: 0), Marginal food security status (raw score: 1-2), Low food security status (raw score 3-5), Very low food security status (raw score: 6-10). |
| Change From Baseline in Cooking Attitudes | baseline, 4 months and 12 months | Cooking confidence, attitudes and behaviors will be measured via online survey (7- point Likert Scale (strongly agree to strongly disagree) questions) at baseline, 4 months and 12 months. Survey items were based on prior literature, but there is not a formal named scale that was used. Attitudes were assessed by 11 questions all scored on a 7 point Likert scale. Negative attitudes were reverse coded, then scores were summed across all 11 items to create an overall Attitudes score (range: 7-77) with higher scores indicating more positive attitudes about cooking. |
| Change From Baseline in Cooking Behavior (Days Cooking Dinner) | baseline, 4 months and 12 months | Cooking confidence, attitudes and behaviors will be measured via online survey (7- point Likert Scale (strongly agree to strongly disagree) questions) at baseline, 4 months and 12 months. To assess behavior change, an item from the National Health an Nutrition Examination Survey (NHANES) assessing frequency of cooking dinner was used. Change in number of days (0-7) cooking is reported with higher numbers indicating more frequent cooking dinner at home. |
| Difference From Baseline in Diet Quality (Healthy Eating Index- 2015) Score | Baseline and at 4 months | Dietary intake and diet quality (Healthy Eating Index (HEI-2015) as measured by the Remote Food Photography Method (RFPM) over 3 days of dietary intake at baseline and 4 months. The HEI-2015 is a score from 0-100 with high score indicating better diet quality. The HEI-2015 measures how well an individuals dietary intake aligns with the 2015 US Dietary Guidelines. |
| Change From Baseline in Cooking Confidence | baseline, 4 months and 12 months | Cooking confidence, attitudes and behaviors will be measured via online survey (7- point Likert Scale (strongly agree to strongly disagree) questions) at baseline, 4 months and 12 months. Survey items were based on prior literature, but there is not a formal named scale that was used. Cooking confidence was assessed by 7 items all measured on a 7 point Likert scale. Negative items were reverse coded, then 7 confidence items were summed to create a overall confidence score (range 7-49) with higher values indicating higher confidence. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Program Attendance Among DPP and DPP Cooks Participants | 12 months | DPP coaches will report weekly session attendance for all trial participants. Attendance at a higher number of sessions will be a favorable result. |
| Program Satisfaction Among DPP Cooks Participants (Qualitative) | 12 months | Investigators will use interviews or focus groups with DPP Cooks participants to gather qualitative feedback about program satisfaction among participants |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Standard DPP Standard DPP (over 12 months)
DPP: Standard DPP | 16 |
| DPP Cooks Standard DPP plus DPP Cooks (over 12 months, with 6 active cooking sessions during the first 4 months)
DPP Cooks: 6 'food agency' based cooking skills classes during the first 4 months of the DPP | 20 |
| Total | 36 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| 12 Month Data Collection | Lost to Follow-up | 3 | 1 |
| 12 Month Data Collection | Withdrawal by Subject | 1 | 0 |
| 4 Month Data Collection | Lost to Follow-up | 1 | 0 |
| 4 Month Data Collection | Withdrawal by Subject | 1 | 5 |
| Baseline Data Collection | Lost to Follow-up | 0 | 3 |
| Baseline Data Collection | Protocol Violation | 2 | 0 |
| Baseline Data Collection | Withdrawal by Subject | 1 | 0 |
| Randomized | Lost to Follow-up | 2 | 0 |
| Randomized | Withdrawal by Subject | 1 | 0 |
Baseline characteristics
| Characteristic | Standard DPP | DPP Cooks | Total |
|---|---|---|---|
| Age, Continuous | 55.1 years STANDARD_DEVIATION 12.8 | 56.5 years STANDARD_DEVIATION 17.2 | 55.9 years STANDARD_DEVIATION 15.2 |
| Education college graduate | 6 Participants | 12 Participants | 18 Participants |
| Education high school | 6 Participants | 2 Participants | 8 Participants |
| Education some college | 3 Participants | 6 Participants | 9 Participants |
| Education some high school | 1 Participants | 0 Participants | 1 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 1 Participants | 0 Participants | 1 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 15 Participants | 20 Participants | 35 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Income #35,000-$59,000/ year | 6 Participants | 5 Participants | 11 Participants |
| Income <$35,000/ year | 6 Participants | 7 Participants | 13 Participants |
| Income $60,000-$85,000/ year | 1 Participants | 5 Participants | 6 Participants |
| Income >$85,000/ year | 3 Participants | 3 Participants | 6 Participants |
| Marital Status divorced, separated, widowed | 6 Participants | 6 Participants | 12 Participants |
| Marital Status living with partner | 1 Participants | 3 Participants | 4 Participants |
| Marital Status married | 3 Participants | 7 Participants | 10 Participants |
| Marital Status single | 6 Participants | 4 Participants | 10 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 12 Participants | 14 Participants | 26 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants | 3 Participants | 4 Participants |
| Race (NIH/OMB) White | 3 Participants | 3 Participants | 6 Participants |
| Region of Enrollment United States | 16 Participants | 20 Participants | 36 Participants |
| Sex: Female, Male Female | 12 Participants | 17 Participants | 29 Participants |
| Sex: Female, Male Male | 4 Participants | 3 Participants | 7 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 22 | 0 / 23 |
| other Total, other adverse events | 0 / 22 | 0 / 23 |
| serious Total, serious adverse events | 0 / 22 | 0 / 23 |
Outcome results
Primary
Change From Baseline in Absolute Body Weight (Kilograms (kg))
Weight change will be measured in absolute kg. Weight will be measured at baseline, 4 months and 12 months. Weight will be measured by DPP coaches at weekly meetings (or, if DPP groups are meeting virtually, weight will be reported by participants to their DPP coaches in weekly virtual meetings).
Time frame: baseline, 4 months and 12 months
Population: Change from baseline to 4 months includes the 29 individuals who completed 4 month data collection. Change from baseline to 12 months includes the 24 individuals who completed 12 month data collection.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard DPP | Change From Baseline in Absolute Body Weight (Kilograms (kg)) | change from baseline to 4 months | -2.12 kg | Standard Error 1.61 |
| Standard DPP | Change From Baseline in Absolute Body Weight (Kilograms (kg)) | change from baseline to 12 months | -5.27 kg | Standard Error 1.67 |
| DPP Cooks | Change From Baseline in Absolute Body Weight (Kilograms (kg)) | change from baseline to 4 months | -1.00 kg | Standard Error 1.55 |
| DPP Cooks | Change From Baseline in Absolute Body Weight (Kilograms (kg)) | change from baseline to 12 months | -4.15 kg | Standard Error 1.57 |
Primary
Change From Baseline in Percentage of Baseline Bodyweight
Weight change will be measured in the percent of body weight change. Weight will be measured at baseline, 4 months and 12 months. Weight will be measured by DPP coaches at weekly meetings (or, if DPP groups are meeting virtually, weight will be reported by participants to their DPP coaches in weekly virtual meetings).
Time frame: baseline, 4 months and 12 months
Population: Change from baseline to 4 months includes the 29 individuals who completed 4 month data collection. Change from baseline to 12 months includes the 24 individuals who completed 12 month data collection.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard DPP | Change From Baseline in Percentage of Baseline Bodyweight | change from baseline to 4 months | -1.96 percentage of body weight | Standard Error 1.49 |
| Standard DPP | Change From Baseline in Percentage of Baseline Bodyweight | change from baseline to 12 months | -5.12 percentage of body weight | Standard Error 1.55 |
| DPP Cooks | Change From Baseline in Percentage of Baseline Bodyweight | change from baseline to 4 months | -0.95 percentage of body weight | Standard Error 1.44 |
| DPP Cooks | Change From Baseline in Percentage of Baseline Bodyweight | change from baseline to 12 months | -4.11 percentage of body weight | Standard Error 1.46 |
Secondary
Change From Baseline in Cooking Attitudes
Cooking confidence, attitudes and behaviors will be measured via online survey (7- point Likert Scale (strongly agree to strongly disagree) questions) at baseline, 4 months and 12 months. Survey items were based on prior literature, but there is not a formal named scale that was used. Attitudes were assessed by 11 questions all scored on a 7 point Likert scale. Negative attitudes were reverse coded, then scores were summed across all 11 items to create an overall Attitudes score (range: 7-77) with higher scores indicating more positive attitudes about cooking.
Time frame: baseline, 4 months and 12 months
Population: Change from baseline to 4 months includes the 29 individuals who completed 4 month data collection. Change from baseline to 12 months includes the 24 individuals who completed 12 month data collection.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard DPP | Change From Baseline in Cooking Attitudes | change from baseline to 4 months | 1.57 units on a scale | Standard Error 1.85 |
| Standard DPP | Change From Baseline in Cooking Attitudes | change from baseline to 12 months | 3.92 units on a scale | Standard Error 1.89 |
| DPP Cooks | Change From Baseline in Cooking Attitudes | change from baseline to 4 months | -0.28 units on a scale | Standard Error 1.76 |
| DPP Cooks | Change From Baseline in Cooking Attitudes | change from baseline to 12 months | 2.07 units on a scale | Standard Error 1.77 |
Secondary
Change From Baseline in Cooking Behavior (Days Cooking Dinner)
Cooking confidence, attitudes and behaviors will be measured via online survey (7- point Likert Scale (strongly agree to strongly disagree) questions) at baseline, 4 months and 12 months. To assess behavior change, an item from the National Health an Nutrition Examination Survey (NHANES) assessing frequency of cooking dinner was used. Change in number of days (0-7) cooking is reported with higher numbers indicating more frequent cooking dinner at home.
Time frame: baseline, 4 months and 12 months
Population: Change from baseline to 4 months includes the 29 individuals who completed 4 month data collection. Change from baseline to 12 months includes the 24 individuals who completed 12 month data collection.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard DPP | Change From Baseline in Cooking Behavior (Days Cooking Dinner) | change from baseline to 4 months | 0.80 days | Standard Error 0.39 |
| Standard DPP | Change From Baseline in Cooking Behavior (Days Cooking Dinner) | change from baseline to 12 months | 0.86 days | Standard Error 0.41 |
| DPP Cooks | Change From Baseline in Cooking Behavior (Days Cooking Dinner) | change from baseline to 4 months | 0.43 days | Standard Error 0.38 |
| DPP Cooks | Change From Baseline in Cooking Behavior (Days Cooking Dinner) | change from baseline to 12 months | 0.49 days | Standard Error 0.38 |
Secondary
Change From Baseline in Cooking Confidence
Cooking confidence, attitudes and behaviors will be measured via online survey (7- point Likert Scale (strongly agree to strongly disagree) questions) at baseline, 4 months and 12 months. Survey items were based on prior literature, but there is not a formal named scale that was used. Cooking confidence was assessed by 7 items all measured on a 7 point Likert scale. Negative items were reverse coded, then 7 confidence items were summed to create a overall confidence score (range 7-49) with higher values indicating higher confidence.
Time frame: baseline, 4 months and 12 months
Population: Change from baseline to 4 months includes the 29 individuals who completed 4 month data collection. Change from baseline to 12 months includes the 24 individuals who completed 12 month data collection.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard DPP | Change From Baseline in Cooking Confidence | change from baseline to 4 months | 0.84 units on a scale | Standard Error 1.37 |
| Standard DPP | Change From Baseline in Cooking Confidence | change from baseline to 12 months | 1.84 units on a scale | Standard Error 1.44 |
| DPP Cooks | Change From Baseline in Cooking Confidence | change from baseline to 4 months | 0.47 units on a scale | Standard Error 1.31 |
| DPP Cooks | Change From Baseline in Cooking Confidence | change from baseline to 12 months | 1.46 units on a scale | Standard Error 1.33 |
Secondary
Change From Baseline in Food Agency Measured Via the Cooking and Food Provisioning Action Scale (CAFPAS)
The Cooking and Food Provisioning Action Scale (CAFPAS) is a 28 question scale in which higher scores indicate higher Food Agency. All questions in the CAFPAS are measured on 7-point Likert Scales (strongly agree to strongly disagree). The CAFPAS has 3 sub-scales which are scored by summing the scores on each individual question (after reverse coding negative items) and are then standardized. Then the 3 standardized sub-scale scores are summed to generate an overall CAFPAS score in which higher scores indicate better Food Agency. In this sample scores range from 10.48- 22.25 points with higher scores indicating better Food Agency.
Time frame: baseline, 4 months and 12 months
Population: Change from baseline to 4 months includes the 29 individuals who completed 4 month data collection. Change from baseline to 12 months includes the 24 individuals who completed 12 month data collection.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard DPP | Change From Baseline in Food Agency Measured Via the Cooking and Food Provisioning Action Scale (CAFPAS) | change from baseline to 4 months | 0.16 change in score on a scale | Standard Error 0.42 |
| Standard DPP | Change From Baseline in Food Agency Measured Via the Cooking and Food Provisioning Action Scale (CAFPAS) | change from baseline to 12 months | 0.93 change in score on a scale | Standard Error 0.44 |
| DPP Cooks | Change From Baseline in Food Agency Measured Via the Cooking and Food Provisioning Action Scale (CAFPAS) | change from baseline to 4 months | -0.53 change in score on a scale | Standard Error 0.41 |
| DPP Cooks | Change From Baseline in Food Agency Measured Via the Cooking and Food Provisioning Action Scale (CAFPAS) | change from baseline to 12 months | 0.24 change in score on a scale | Standard Error 0.41 |
Secondary
Difference From Baseline in Diet Quality (Healthy Eating Index- 2015) Score
Dietary intake and diet quality (Healthy Eating Index (HEI-2015) as measured by the Remote Food Photography Method (RFPM) over 3 days of dietary intake at baseline and 4 months. The HEI-2015 is a score from 0-100 with high score indicating better diet quality. The HEI-2015 measures how well an individuals dietary intake aligns with the 2015 US Dietary Guidelines.
Time frame: Baseline and at 4 months
Population: all individuals with data at baseline and 4 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Standard DPP | Difference From Baseline in Diet Quality (Healthy Eating Index- 2015) Score | 1.52 score on a scale | Standard Error 3.5 |
| DPP Cooks | Difference From Baseline in Diet Quality (Healthy Eating Index- 2015) Score | -2.81 score on a scale | Standard Error 3.37 |
Secondary
Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module
The USDA Adult Food Security Survey Module is a 10-item progressive survey instrument in which individuals are asked about the food situation in their household over the last 30 days. Scores are summed and generate the following categories: High food security status (raw score: 0), Marginal food security status (raw score: 1-2), Low food security status (raw score 3-5), Very low food security status (raw score: 6-10).
Time frame: baseline, 4 months and 12 months
Population: Analyzed among all participants enrolled and at each time point. One participant still enrolled at 12 months was missing data for food insecurity.
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Standard DPP | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | Baseline | High food security | 9 Participants |
| Standard DPP | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | Baseline | Marginal food security | 5 Participants |
| Standard DPP | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | Baseline | Low food security | 1 Participants |
| Standard DPP | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | Baseline | Very low food security | 1 Participants |
| Standard DPP | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 4 months | High food security | 10 Participants |
| Standard DPP | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 4 months | Marginal food security | 3 Participants |
| Standard DPP | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 4 months | Low food security | 1 Participants |
| Standard DPP | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 4 months | Very low food security | 0 Participants |
| Standard DPP | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 12 months | High food security | 8 Participants |
| Standard DPP | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 12 months | Marginal food security | 2 Participants |
| Standard DPP | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 12 months | Low food security | 0 Participants |
| Standard DPP | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 12 months | Very low food security | 0 Participants |
| DPP Cooks | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 12 months | Low food security | 2 Participants |
| DPP Cooks | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | Baseline | High food security | 11 Participants |
| DPP Cooks | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 4 months | Low food security | 3 Participants |
| DPP Cooks | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | Baseline | Marginal food security | 4 Participants |
| DPP Cooks | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 12 months | Marginal food security | 3 Participants |
| DPP Cooks | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | Baseline | Low food security | 5 Participants |
| DPP Cooks | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 4 months | Very low food security | 4 Participants |
| DPP Cooks | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | Baseline | Very low food security | 0 Participants |
| DPP Cooks | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 12 months | Very low food security | 3 Participants |
| DPP Cooks | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 4 months | High food security | 6 Participants |
| DPP Cooks | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 12 months | High food security | 5 Participants |
| DPP Cooks | Participant Food Security Status Over the Past 30 Days Using the 10-item United States Department of Agriculture (USDA) Adult Food Security Survey Module | 4 months | Marginal food security | 2 Participants |
Other Pre-specified
Program Attendance Among DPP and DPP Cooks Participants
DPP coaches will report weekly session attendance for all trial participants. Attendance at a higher number of sessions will be a favorable result.
Time frame: 12 months
Other Pre-specified
Program Satisfaction Among DPP Cooks Participants (Qualitative)
Investigators will use interviews or focus groups with DPP Cooks participants to gather qualitative feedback about program satisfaction among participants
Time frame: 12 months