Table 3.

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.