{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:07:42Z","timestamp":1786122462249,"version":"build-2736575974"},"reference-count":75,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":201,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019349","name":"Universidad T\u00e9cnica Particular de Loja","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Type 2 diabetes (T2D) is a global public health challenge globally. Effective prevention programs must be tailored to cultural and logistical contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study evaluated the comparative efficacy of a culturally adapted diabetes prevention program (DPP) intervention versus usual care in reducing T2D risk factors in Ecuadorian institutional settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This quasi-experimental study included adults with high T2D risk (FINDRISC score \u226512). Participants voluntarily enrolled to an experimental group (EG, N\u2009=\u2009192) receiving a 16-week, 10 session culturally adapted DPP, or a control group (CG, N\u2009=\u200991), receiving usual care. Primary comparative efficacy was assessed using analysis of covariance (ANCOVA), adjusting for key baseline imbalances.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Intragroup analysis showed that EG achieved significant reductions in weight (average loss of 1.06%), BMI, and body fat mass (P\u2009&amp;lt;\u2009.05). However, the primary outcome reduction in FINDRISC score (P\u2009=\u2009.013) did not retain significance after Holm\u2013Bonferroni correction. The comparative ANCOVA analysis revealed no significant difference between EG and CG for the primary outcomes of weight (P\u2009=\u2009.330) or FINDRISC score (P\u2009=\u2009.291). The intervention showed a reduction in systolic blood pressure (SBP) that was statistically significant in the per-protocol analysis (adjusted \u0394\u2009=\u2009\u22123.338 mmHg; F\u2009=\u20095.160, P\u2009=\u2009.024), although this effect was attenuated to a trend (P\u2009=\u2009.079) in a multiply imputed intention-to-treat sensitivity analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The short-term, culturally adapted DPP intervention failed to demonstrate superior comparative efficacy in achieving the primary goals of T2D risk reduction or weight loss compared to usual care. Nevertheless, the per-protocol analysis identified a promising reduction in SBP, whose robustness was supported by inverse probability of treatment weighting but attenuated under intention-to-treat multiple imputation. These findings suggest partial efficacy of the short-term adaptation on cardiovascular health and underscore the critical need for longer program duration and strategies to reduce attrition in similar institutional settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/tbm\/ibag038","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T16:32:37Z","timestamp":1784651557000},"source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of a culturally adapted group-based lifestyle intervention in reducing cardiovascular risk factors in a high-risk Latin American population"],"prefix":"10.1093","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0419-030X","authenticated-orcid":false,"given":"Rosario","family":"Su\u00e1rez","sequence":"first","affiliation":[{"name":"School of Medicine, Universidad T\u00e9cnica Particular del Loja Health Sciences Department, , Loja, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4343-7793","authenticated-orcid":false,"given":"Yoredy","family":"Sarmiento-Andrade","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad T\u00e9cnica Particular del Loja Health Sciences Department, , Loja, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8443-1550","authenticated-orcid":false,"given":"Karem","family":"Carri\u00f3n","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad T\u00e9cnica Particular del Loja Health Sciences Department, , Loja, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9550-2772","authenticated-orcid":false,"given":"Martha","family":"Montalvan","sequence":"additional","affiliation":[{"name":"Universidad Cat\u00f3lica Santiago de Guayaquil, Av. 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Carlos Julio Arosemena Tola Escuela de Medicina, , Guayaquil, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9315-129X","authenticated-orcid":false,"given":"Milenka","family":"Zhind\u00f3n","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad T\u00e9cnica Particular del Loja Health Sciences Department, , Loja, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2802-8569","authenticated-orcid":false,"given":"Jorge","family":"Ramirez","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad T\u00e9cnica Particular del Loja Health Sciences Department, , Loja, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8083-1714","authenticated-orcid":false,"given":"Sebasti\u00e1n","family":"Chapela","sequence":"additional","affiliation":[{"name":"Departamento de Bioqu\u00edmica Humana, Facultad de Medicina, Universidad de Buenos , Aires, Buenos Aires,","place":["Argentina"]},{"name":"Departamento de Medicina Interna, Hospital Brit\u00e1nico de Buenos Aires Equipo de Soporte Nutricional, , Buenos Aires,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2228-0141","authenticated-orcid":false,"given":"Evelyn","family":"Frias-Toral","sequence":"additional","affiliation":[{"name":"Universidad Esp\u00edritu Santo, Escuela de Medicina Escuela de Medicina, , Samborond\u00f3n, Ecuador"},{"name":"Texas State University Division of Research, , San Marcos, TX,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"2026080705431790000_ibag038-B1","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.jdiacomp.2015.02.007","article-title":"Functional mechanisms for type 2 diabetes-associated genetic variants","volume":"29","author":"Zhu","year":"2015","journal-title":"J Diabet Compl"},{"key":"2026080705431790000_ibag038-B2","doi-asserted-by":"publisher","first-page":"110195","DOI":"10.1016\/j.diabres.2022.110195","article-title":"Two decades of diabetes prevention efforts: A call to innovate and revitalize our approach to lifestyle change","volume":"198","author":"Golovaty","year":"2023","journal-title":"Diabetes Res Clin Pract"},{"key":"2026080705431790000_ibag038-B3","volume-title":"Diabetes Atlas","author":"International Diabetes Federation","year":"2025"},{"key":"2026080705431790000_ibag038-B4","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.dsx.2017.12.002","article-title":"Prevalence of prediabetes and diabetes among older adults in Ecuador: analysis of the SABE survey","volume":"12","author":"Orces","year":"2018","journal-title":"Diabetes Metab Syndr"},{"key":"2026080705431790000_ibag038-B5","doi-asserted-by":"crossref","first-page":"e0332159","DOI":"10.1371\/journal.pone.0332159","article-title":"The burden of non-communicable disease risk factors in a low-income population: findings from a cross-sectional study highlighting the prevalence of obesity, hypertension, and metabolic disorders in the South of Quito, Ecuador","volume":"20","author":"Morales-Garz\u00f3n","year":"2025","journal-title":"PLoS One"},{"key":"2026080705431790000_ibag038-B6","doi-asserted-by":"crossref","first-page":"e0254812","DOI":"10.1371\/journal.pone.0254812","article-title":"Prevalence of metabolic syndrome and diabetes mellitus type-2 and their association with intake of dairy and legume in Andean communities of Ecuador","volume":"16","author":"Balde\u00f3n","year":"2021","journal-title":"PLoS One"},{"key":"2026080705431790000_ibag038-B7","doi-asserted-by":"crossref","first-page":"e0307403","DOI":"10.1371\/journal.pone.0307403","article-title":"Cardiometabolic diseases and associated risk factors in transitional rural communities in tropical coastal Ecuador","volume":"19","author":"Gualan","year":"2024","journal-title":"PLoS One"},{"key":"2026080705431790000_ibag038-B8","first-page":"7","article-title":"Is type 2 diabetes mellitus a behavioural disorder? 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