INtegrating DIAbetes prevention in WORKplaceS (INDIA-WORKS)

Asian Indians have high rates of diabetes and prediabetes, and this disease has profound impacts not only on health outcomes, but on work productivity measures. There is strong evidence that lifestyle changes can improve health outcomes among this population and worksites present a unique and effective environment for potential interventions. The INtegrating DIAbetes prevention in WORKplaceS (INDIA-WORKS) study is implementing and evaluating a worksite-based lifestyle intervention. The worksite education program includes 2,000 adults with either prediabetes or unmedicated diabetes at eight diverse worksites in India. The program uses scientific innovations (text message support for lifestyle changes), social innovations (peer health educators delivering the program), and business innovation (worksite partnership).

The study aims to measure: (1) Success of implementation in terms of program adoption (participation and changes in weight and diet and physical activity behaviors among lifestyle class participants); fidelity to the program (activities of study-affiliated worksite staff; changes to the food options at the worksite canteen; management support for the program; and changes in the worksite environment); and program acceptability as reported by employees, managers, supervisors, and lifestyle education program participants and dropouts during in-depth, semi-structured interviews and focus group discussions. (2) Program effectiveness by evaluating the number of cardiometabolic risk goals reached for reductions in blood pressure, triglycerides, and HbA1c (the primary outcome) and through changes in secondary outcomes including rates of diabetes incidence and regression to normoglycemia and changes in anthropometry, lipids, and fasting glucose. (3) Value and return on the investment of the program for employers by assessing program costs, cost-effectiveness, and changes in staff productivity, absenteeism, health status, and quality of life.

This project will combine scientific innovations (lifestyle education programs with text message supports during maintenance) with social innovations (educated peer health educators delivering a program to a large at risk population) and business innovation (worksite stakeholder commitment and partnering researchers to help deliver the program with fidelity, improve the workplace health environment, and evaluate the model). If the program is shown to be feasible, acceptable, effective, and cost-effective at these worksites, the program could be disseminated to other worksites throughout India and elsewhere.

Funded by grant number R01HL125442 from the National Heart, Lung, And Blood Institute of the US National Institutes of Health