Effectiveness of a Community-based Diabetes Prevention Program on Knowledge, Self-Reported Practices, and Clinical Risk Indicators among High-Risk Schoolchildren: A Quasi-Experimental Study

Abstract

Background: The increasing prevalence of unhealthy dietary behaviours, physical inactivity, overweight and obesity among children and adolescents has increased their future risk of type 2 diabetes mellitus. School- and community-based health promotion interventions may provide an opportunity to identify high-risk children and promote healthy lifestyle behaviours at an early age.

Objective: To evaluate the effectiveness of a community-based diabetes prevention program on knowledge, self-reported preventive practices and selected clinical risk indicators among high-risk school children.

Methods: A quantitative quasi-experimental pre-test–post-test control-group design was adopted. The study included 200 high-risk school children, with 100 participants in the experimental group and 100 in the control group. Participants were selected using purposive sampling. Data were collected using a sociodemographic questionnaire, a structured 30-item knowledge questionnaire and a self-reported practice checklist. Clinical risk indicators included body mass index (BMI), waist circumference and random blood sugar. The intervention included diabetes-prevention education, promotion of physical activity, dietary modification and family involvement. Knowledge and practice were assessed at baseline and at 2, 4 and 8 weeks after the intervention. Data were analysed using descriptive and inferential statistics.

Results: At baseline, 45% of participants had average knowledge and 42% had poor knowledge; only 13% demonstrated good knowledge. Similarly, 46% reported poor preventive practices, 42% average practices and 12% good practices. In the experimental group, mean knowledge scores increased from 13.24 ± 4.10 at pre-test to 18.67 ± 3.82, 22.45 ± 3.36 and 25.92 ± 2.84 at 2, 4 and 8 weeks, respectively (F=286.4, p<0.001). Mean practice scores increased from 11.82 ± 3.54 to 15.73 ± 3.18, 19.86 ± 2.74 and 23.44 ± 2.36, respectively (F=258.7, p<0.001). BMI, waist circumference and random blood sugar decreased significantly from 25.8 ± 2.4 to 24.6 ± 2.2 kg/m², 82.4 ± 4.8 to 79.3 ± 4.1 cm, and 110.6 ± 8.7 to 101.8 ± 7.5 mg/dL, respectively (all p<0.001). Knowledge was positively correlated with preventive practices (r=0.78, p<0.001).

Conclusion: The community-based diabetes prevention program was associated with significant improvements in diabetes-prevention knowledge and self-reported practices and favorable changes in selected clinical risk indicators among high-risk school children. Integrating structured diabetes prevention and lifestyle promotion into school health services may strengthen early prevention of diabetes-related risk.