{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:10:26Z","timestamp":1789186226395,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Small Steps for Big Changes (SSBC) is a 4\u2010week, evidence\u2010based diabetes prevention program delivered by non\u2010medical personnel in community settings. This study explored changes in type 2 diabetes risk factors and health behaviours over 12\u2009months following SSBC program completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010arm pragmatic trial with repeated measures was conducted in three urban locations in Canada and was delivered virtually during COVID\u201019. Participants were adults at risk of developing type 2 diabetes (HbA1c 39\u201046\u2009mmol\/mol[5.7\u20136.4%]). SSBC consists of 6 one\u2010hour sessions involving behavioural counselling and exercise. The primary outcome was HbA1c at 12\u2010month post\u2010program. Secondary outcomes included weight, waist circumference, functional exercise capacity, diet and physical activity behaviour at 12\u2010month post\u2010program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three hundred and eighty\u2010nine individuals at risk of developing type 2 diabetes were enrolled (mean age\u2009=\u200958.8(8.7) years, 61% White, 68% women), with a 93% session attendance rate. Of 389 enrolled, 172 completed 12\u2010month assessments, of whom 117 had HbA1c at baseline and the 12\u2010month follow\u2010up. At 12 months, participants had significant reductions in HbA1c (\u22121.91\u2009mmol\/mol; \u22120.19% [95% CI: \u22122.57, \u22121.36\u2009mmol\/mol; \u22120.25, \u22120.13%]), weight (\u22123.03 [\u22124.15, \u22121.93] kg), waist circumference (\u22124.07 [\u22125.27, \u22122.91] cm) and improved distance walked on the six\u2010minute walk test (37.55 [28.58, 46.75] m). Favourable changes in diet and physical activity were also sustained at 12\u2010month post\u2010program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SSBC participation was associated with improvements in key diabetes risk factors at 12\u2010month post\u2010program. These findings suggest that brief, community\u2010based, lay\u2010led programs may have potential for supporting diabetes prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70387","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:12:08Z","timestamp":1781759528000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A 4\u2010week community\u2010implemented diabetes prevention program is associated with improved metabolic outcomes at 12\u2009months after participation"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8213-5376","authenticated-orcid":false,"given":"J. 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