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Effectiveness of the Diabetes Prevention Program in Urban Bamako, Mali: Small Steps, Big Rewards

Award Number: R21TW011736
ORGANIZATION: FOGARTY INTERNATIONAL CENTER
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2020
PERIOD OF PERFORMANCE END DATE: 04/30/2023

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Effectiveness of the Diabetes Prevention Program in Urban Bamako, Mali: Small Steps, Big Rewards - Project Abstract As African countries rapidly urbanize, they face new service delivery challenges to address the rapid rise of non- communicable diseases in cities, where women bear an exceptional portion of this burden. While access to medical management of these conditions is receiving attention, culturally appropriate approaches are needed to address the behavioral components including changes to diet and physical activity habits. We propose an innovative adaptation of the Centers for Disease Control and Prevention’s Diabetes Prevention Program “Power to Prevent” program, which we will develop and pilot in the low-income peri-urban neighborhoods of Bamako, Mali. This program is well-suited to delivery by the city’s community health workers already supporting families in improving maternal and child health outcomes. First, we will use participatory research methods to engage them and community residents in making adaptations to the community health worker’s guidelines and tools for recommended activities so that they are linguistically and culturally appropriate, including guidelines for food consumption using locally available foods. These adaptations will use more graphics and photographs, so they are appropriate for low-literacy participants. Second, another key innovation is the explicit orientation to couples, where only one may have a diagnosed cardiovascular disease. Our adaptation will provide tools the women can use in negotiating for changes to the family’s meals and her daily routine. Third, we will conduct a comparative effectiveness study at 6 community health centers with high rates of CVD, recruiting adults recently diagnosed with diabetes or hypertension. Based on the random allocation of their community health center, participants will be assigned to one of three groups of 150 each: Couples, with at least one meeting the eligibility criteria; Individuals, men and women, both eligible; Comparison, men and women with CVD. Trained community health workers and diabetic peer educators will use the adapted DPP materials with the Couples and Individuals groups over a period of 12 months. At the conclusion of this pilot we will assess the levels of adoption of recommended cardiovascular risk reduction behaviors and changes in obesity, hypertension, and diabetes control, comparing differences in outcomes between the three groups. Our work will enable Mali to incorporate diabetes and hypertension risk reduction into their already deployed networks of community health workers. A successful pilot will be followed by a larger scale study with full integration into the Malian health care system, potentially then reaching women and their families. The Malian DPP adaptation will also be suitable for Francophone West Africa, where customs and lifestyles are similar among the millions of families confronting the burdens of cardiovascular disease.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = -$4 )
2024	2021	UNIVERSITE DES SCIENCES, DES TECHNIQUES ET DES TECHNOLOGIES DE BAMAKO (USTTB)	HAMDALLAYE ACI 2000	BAMAKO				MLI	International Research and Research Training	000	2	2/15/2024	NON-COMPETING CONTINUATION	-$4
														Subtotal = -$4

Issue Date FY: 2021 ( Subtotal = $141,607 )
2021	2021	UNIVERSITE DES SCIENCES, DES TECHNIQUES ET DES TECHNOLOGIES DE BAMAKO USTTB	HAMDALLAYE ACI 2000	BAMAKO				MLI	International Research and Research Training	000	2	4/20/2021	NON-COMPETING CONTINUATION	$141,607
														Subtotal = $141,607

Issue Date FY: 2020 ( Subtotal = $187,012 )
2020	2020	UNIVERSITE DES SCIENCES, DES TECHNIQUES ET DES TECHNOLOGIES DE BAMAKO USTTB	HAMDALLAYE ACI 2000	BAMAKO				MLI	International Research and Research Training	000	1	8/12/2020	NEW	$187,012
														Subtotal = $187,012

Grand Total All Awards = $328,615

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Effectiveness of the Diabetes Prevention Program in Urban Bamako, Mali: Small Steps, Big Rewards

Award Number: R21TW011736

ORGANIZATION: FOGARTY INTERNATIONAL CENTER

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/01/2020

PERIOD OF PERFORMANCE END DATE: 04/30/2023

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