Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

A Randomized-Controlled, Pilot Intervention on Diabetes Prevention and Healthy Lifestyles in the New York City Korean Community


Asian Americans experience diabetes at a higher rate than non-Hispanic whites. Diabetes prevention programs using lifestyle interventions have been shown to produce beneficial results, yet there have been no culturally-tailored programs for diabetes prevention in the Korean community. We explore the impact and feasibility of a pilot Community Health Worker (CHW) intervention to improve health behaviors and promote diabetes prevention among Korean Americans using a randomized controlled trial. Between 2011 and 2012, a total of 48 Korean Americans at risk for diabetes living in New York City (NYC) participated in the intervention. Participants were allocated to treatment or control groups. A community-based participatory research approach guided development of the intervention, which consisted of 6 workshops held by CHWs on diabetes prevention, nutrition, physical activity, diabetes complications, stress and family support, and access to health care. Changes over 6 months were examined for clinical measurements (weight, BMI, waist circumference, blood pressure, glucose, and cholesterol); health behaviors (physical activity, nutrition, food behaviors, diabetes knowledge, self-efficacy, and mental health); and health access (insurance and self-reported health). In this small pilot study, changes were seen in weight, waist circumference, diastolic blood pressure, physical activity nutrition, diabetes knowledge, and mental health. Qualitative findings provide additional contextual information that inform ways in which CHWs may influence health outcomes. These findings demonstrate that a diabetes prevention program can be successful among a Korean American population in NYC, and important insight is provided for ways that programs can be tailored to meet the needs of vulnerable populations.

This is a preview of subscription content, log in to check access.

Fig. 1


  1. 1.

    Centers for Disease Control and Prevention. (2011). National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Available from: http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.

  2. 2.

    Knowler, W. C., Barrett-Connor, E., Fowler, S. E., et al. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6), 393–403.

  3. 3.

    Barnes, P. M., Adams, P. F., & Powell-Griner, E. (2008). Health characteristics of the Asian adult population: United States, 2004–2006. Adv Data (394), 1–22.

  4. 4.

    Oza-Frank, R., Ali, M. K., Vaccarino, V., & Narayan, K. M. (2009). Asian Americans: Diabetes prevalence across US and World Health Organization weight classifications. Diabetes Care, 32(9), 1644–1646.

  5. 5.

    Ye, J., Rust, G., Baltrus, P., & Daniels, E. (2009). Cardiovascular risk factors among Asian Americans: Results from a National Health Survey. Annals of Epidemiology, 19(10), 718–723.

  6. 6.

    Islam, N., Wyatt, L., Kapadia, S., Rey, M., Trinh-Shevrin, C., & Kwon, S. (2013). Diabetes and associated risk factors among Asian American subgroups in New York City. Diabetes Care, 36(1), e5.

  7. 7.

    Kim, D. J. (2011). The epidemiology of diabetes in Korea. Diabetes & Metabolism Journal, 35(4), 303–308.

  8. 8.

    Ramachandran, A., & Snehalatha, C. (2011). Diabetes prevention programs. Med Clin North Am, 95(2), 353–372, viii.

  9. 9.

    Kim, M. T., Han, H. R., Song, H. J., et al. (2009). A community-based, culturally tailored behavioral intervention for Korean Americans with type 2 diabetes. The Diabetes Educator, 35(6), 986–994.

  10. 10.

    American Diabetes Association. American Diabetes Association unveils new diabetes risk test. 2012 March, 2013. Available from: http://www.diabetes.org/for-media/2012/american-diabetes-association-new-risk-test.html.

  11. 11.

    National Heart, L., & Blood Institute. Healthy heart, healthy family: A community health worker’s manual for the filipino community. 1999 March, 2013. Available from: http://www.nhlbi.nih.gov/health/prof/heart/other/chdfilipino/intro.htm.

  12. 12.

    Diabetes Prevention Program Research G. (2002). The diabetes prevention program (DPP): Description of lifestyle intervention. Diabetes Care, 25(12), 2165–2171.

  13. 13.

    National Diabetes Education Program. The road to health toolkit resource guide. Available from: http://www.ndep.nih.gov/media/road-to-health-toolkit-resources-guide.pdf.

  14. 14.

    National Diabetes Education Program. Power to prevent: A family lifestyle approach to diabetes prevention. Available from: http://ndep.nih.gov/media/power-to-prevent-508.pdf.

  15. 15.

    Islam, N. S., Tandon, D., Mukherji, R., et al. (2012). Understanding barriers to and facilitators of diabetes control and prevention in the New York City Bangladeshi community: A mixed-methods approach. American Journal of Public Health, 102(3), 486–490.

  16. 16.

    Ruiz, Y., Matos, S., Kapadia, S., et al. (2012). Lessons learned from a community-academic initiative: The development of a core competency-based training for community-academic initiative community health workers. American Journal of Public Health, 102(12), 2372–2379.

  17. 17.

    United States Census: American community survey. 2011. Available from: http://www.census.gov/acs/www/methodology/questionnaire_archive/.

  18. 18.

    CDC: Behavioral risk factor surveillance system. 2011. Available from: http://www.cdc.gov/brfss/questionnaires/english.htm.

  19. 19.

    Bandura, A. (2006). Guide for constructing self-efficacy scales. In Self-efficacy beliefs of adolescents. Information Age Publishing.

  20. 20.

    Nothwehr, F., Dennis, L., & Wu, H. (2007). Measurement of behavioral objectives for weight management. Health Education & Behavior, 34(5), 793–809.

  21. 21.

    American Diabetes Association. Diabetes basics: Your risk. 2013 1/9/2013. Available from: http://www.diabetes.org/diabetes-basics/prevention/risk-factors/.

  22. 22.

    Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.

  23. 23.

    Kroenke, K., Spitzer, R. L., Williams, J. B., Monahan, P. O., & Lowe, B. (2007). Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146(5), 317–325.

  24. 24.

    Consultation, W. H. O. E. (2004). Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 363(9403), 157–163.

  25. 25.

    Parikh, P., Simon, E. P., Fei, K., Looker, H., Goytia, C., & Horowitz, C. R. (2010). Results of a pilot diabetes prevention intervention in East Harlem, New York City: Project HEED. American Journal of Public Health, 100(Suppl 1), S232–S239.

  26. 26.

    Islam, N., Wyatt, L., Patel, S., et al. Evaluation of a community health worker pilot intervention to improve diabetes management in Bangladeshi immigrants with type 2 diabetes in New York City. Diabetes Educ (in press).

  27. 27.

    D’Eramo-Melkus, G., Spollett, G., Jefferson, V., et al. (2004). A culturally competent intervention of education and care for black women with type 2 diabetes. Applied Nursing Research, 17(1), 10–20.

  28. 28.

    Mauldon, M., Melkus, G. D., & Cagganello, M. (2006). Tomando control: A culturally appropriate diabetes education program for Spanish-speaking individuals with type 2 diabetes mellitus–evaluation of a pilot project. The Diabetes Educator, 32(5), 751–760.

Download references


This study was supported by Grant 1U48DP001904-01 from the Centers for Disease Control and Prevention, Grants P60MD000538 and MD001786 from the National Institutes of Health, Grant R24MD001786 from the National Insitutes of Health National Institute on Minority Health and Health Disparities, and Grant UL1 TR000038 from the National Center for Advancing Translational Sciences, National Institutes of Health. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the funding organizations. The authors would also like to thank the following individuals for their guidance and support on the project: Mariano J. Rey at the New York University School of Medicine, Sunhi Shin at the New York University Langone Medical Center, Miyong Kim and Hae-Ra Han at Johns Hopkins University School of Nursing, Kim B. Kim at Korean Resource Center, Ashwini Rao at Columbia University Medical Center, Darius Tandon at Johns Hopkins University School of Medicine, Tazuko Shibusawa at the New York University Silver School of Social Work, the Project RICE community health workers Christina Choi and Hyunjae Yim, and the staff at Korean Community Services for their service and dedication in implementing this project.

Author information

Correspondence to Nadia S. Islam.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Islam, N.S., Zanowiak, J.M., Wyatt, L.C. et al. A Randomized-Controlled, Pilot Intervention on Diabetes Prevention and Healthy Lifestyles in the New York City Korean Community. J Community Health 38, 1030–1041 (2013). https://doi.org/10.1007/s10900-013-9711-z

Download citation


  • Asian Americans
  • Korean Americans
  • Community health workers
  • Community-based participatory research
  • Diabetes prevention