THE MICROCLINIC HEALTH PROGRAM: A SOCIAL NETWORK-BASED INTERVENTION FOR WEIGHT LOSS AND DIABETES RISK MANAGEMENT.
AUTHORS: *Marta Prescott, Daniel Zoughbie, Katie Watson, Nancy Bui, Rami Farraj, Nadia Elkarra (Mailman School of Public Health, Columbia University, New York NY 10032)
Obesity and behavioral risk factors have been shown to aggregate and propagate via social networks. We aimed to examine the ability of a program, the Microclinic Health Program, to harness organic social structures by determining the extent to which change in clinical markers that occurred during the program was clustered within social layers. The program was conducted among 720 individuals who participated in the 4-month type-2 diabetes education program in Amman, Jordan. All subjects participated with 2-8 friends or family members (a microclinic) and had diabetes, were at-risk for diabetes, or had a loved one with diabetes. Clinical markers (weight, Body Mass Index [BMI], and Hemoglobin A1c [HbA1c]) were measured at baseline and at the end of the program. We used multivariable multi-level linear regression to examine the change in clinical markers as well as examine the clustering of change within social layers (microclinics, classes, or cohorts). At the end of the program, results indicated decreased weight (Beta [B]:-1.38 kg; 95% confidence interval [CI]: -1.73, -1.04), BMI (B:-0.55 kg/m2; 95% CI -0.69, -0.41), and HbA1c (B:-0.48%; 95% CI -0.61, -0.34). Additionally, the trajectories of change in these risk factors were clustered in the social layer within microclinic groups (Intraclass corre-lation [ICC] = 57.7% weight loss, ICC = 52.5% for BMI decrease, and ICC = 35.3% for HbA1c). Based on the clustering of change, our results suggest that the program successfully harness an organic social-network to promote improvements in diabetes management. Such a social network-based intervention may be a promising tool to propagate healthy behaviors for diabetes and obesity prevention throughout a community.
* = Presenter;