Diabetes Prevention Program: Group Lifestyle Balance™ Curriculum Changes Copyright © 2017

Welcome to the 2017 revision of the DPP Group Lifestyle Balance (GLB) curriculum. The GLB curriculum was last updated in 2011 and this document summarizes the main changes that have been made to the GLB sessions since that time.

The current 22-session DPP GLB curriculum and manual of operations is a direct adaptation of the original Lifestyle Balance (© 1996) curriculum utilized in the Diabetes Prevention Program (DPP) randomized clinical trial (DPP Research Group, NEJM, 2002). The DPP lifestyle intervention was developed by the Lifestyle Resource Core at the University of Pittsburgh specifically for the trial. To provide clarity and consistency, the 2017 curriculum is referred to as the Diabetes Prevention Program: Group Lifestyle Balance (DPP-GLB). A summary of the historical background regarding modifications to the original DPP lifestyle intervention as well as information on licensing and proper use of DPP-GLB may be found by clicking here.

A brief overview of the changes/updates to the 2011 GLB curriculum are provided. Several of the modifications to the 2011 curriculum have resulted from feedback provided by previously trained GLB coaches nationally and internationally. Most changes are related to the ongoing evidence-based science of behavioral lifestyle interventions for diabetes  prevention, and they also reflect the most recent guidelines provided by major scientific organizations (such as American Diabetes Association, American Heart Association, Society for Behavioral Medicine, American College of Sports Medicine, and others).

Main changes across sessions:
•Focused on dietary self-monitoring shifted to calories, more than fat, to reflect currenthealth recommendations.
•Referred to “Food and Activity records” rather than “Keeping Track books”, as manyprograms/ participants use other preferred tracking methods, including digital trackingoptions.
•Formatted the “To Do” (home assignment) pages for consistency across all sessions.
•Added a “Resources” section at the end of each session for optional/additional participant handouts and reference information.
•Added more language about the importance of the physical activity approach and self-awareness of physical movement throughout the DPP GLB curriculum.
•Changed the order of some sessions and modified session titles.

Session 1: Welcome to the Diabetes Prevention Program: Group Lifestyle Balance
•Moved information about finding a personal weight goal to Session 9.
•Moved information about minimum weight goal to Session 9.
•Weight charts go up to 450 pounds.
•Added information about tracking options: Food and Activity records/digital options.
•Followed recent ACSM guidelines, encouraging “talk with your health care providerabout becoming physically active”.
•Revised “Weekly Record”. Space to record goals for calories, fat, and 7% weight loss.
•Modified “How Am I Doing” template so participants may track weight for one year.

Session 2: Be a Calorie Detective:
•Focused on calories more than fat.
•Deleted “Menu Make-Over” from original.
•Focused on eating fewer calories, less fat, and less unhealthy fat.
•Discussed the use of healthier fats (comparison examples have been modified).
•Added information on the rationale for the calorie and fat gram goals, specifically:
o  Acknowledged that there are individual differences in achieving weight loss goals, but the goals provide a good evidence-based starting point.
o  Emphasized that one can expect 1-2 pounds of weight loss/week when achieving calorie and fat goals as prescribed.
o  Clarified that 25% of calories from fat is considered a moderate fat eating plan,not low-fat.
o  Included information on the importance of not going below 1200 calories/day.
•Added “menus, menu boards, and displays” as a source of nutrition information to reflect pending federal regulations.
•Changed sample Nutrition Facts label to reflect pending federal regulations.

Session 3: Healthy Eating
•Moved “Build a Better” (snack, meal) pages to Session 9.
•Focused on staying close to calorie goal, more than fat gram goal.
•Added information on importance of increasing physical activity levels for weight loss.
•Added language to “replace”, “limit”, or “include” certain foods to improve health.
•Added information about MyPlate based on 2016 revisions, included new graphic.
•Added information about “healthy eating pattern” based on 2015 Dietary Guidelines.
•Deleted section about Cholesterol due to changes in 2015 Dietary Guidelines.
•Added “use a slow cooker” and directions for oven roasting vegetables.

Session 5: Tip the Calorie Balance
•Added more information about the role of physical activity.
•Added information about liquid calories.
•Added guidelines about caffeine as outlined in the 2015 Dietary Guidelines.
•Added websites for additional meal plans per emphasis in 2015 Dietary Guidelines.
•Modified “To Do” page language about the activity goal in Sessions 5-8.

Session 7: Problem Solving
•Added problem-solving activity (“Sam and Sadie”) and worksheets.

Session 8: Step Up Your Physical Activity Plan
•Moved this session from 10 to 8. Rationale was to better balance the sequence of diet and activity focused sessions, and provide pedometer learning activities earlier.

Session 9: Manage Slips and Self-Defeating Thoughts
•Changed “negative thoughts” to “self-defeating thoughts”.
•Added personal weight goal and BMI chart to this session.
•Clarified personal weight goal using a 5-pound weight range (rather than a 3-5 poundweight range).
•Added Slippery Slope reflection/discussion activity.
•Added “Checking in with the Pedometer” section.
•Added “Build a Better” (snack, meal) pages to this session.
•Added step goal to the “To Do” in sessions 9-11.

Session 10: Four Keys to Healthy Eating Out
•Addressed nutrition information on menus, menu boards, and displays to reflect new federal regulations.
•Added small group activity and practice sheets.

Session 12: Ways to Stay Motivated
•Revised “What’s Your Purpose Now”.
•Increased emphasis on physical activity
•Added structured menu of tracking options: gold, silver, bronze.

Session 13: Strengthen Your Physical Activity Plan
•Added a new Resistance Training poster and self-monitoring log.
•Added new “Basics” for the “To Do” pages, Sessions 13-21.

Session 14: Take Charge of Your Lifestyle
•Added weight loss plateau information.
•Added “Resistance Training Review” section.
•Added “When You Reach Your Goal Weight” handout.

Session 15: Mindful Eating; Mindful Movement
•Added Mindful Movement.

Session 16: Mange Your Stress
•Added 7-Day Sitting Diary.

Session 17: Sit Less for Your Health
•New session to reflect increasing focus on the importance of reducing sedentary behaviors throughout the day.

Session 18: More Volume, Fewer Calories
•Added graphic of stomach to reflect Volumetrics nutrition principles.
•Added information on satiety and included a reflection/discussion activity.

Session 19: Stay Active
•New session to reflect the importance of a well-rounded physical activity plan that includes sitting less and posture awareness to support staying active.

Session 21: Heart Health
•Updated per 2015 Dietary Guidelines and recent American Heart Association (AHA)guidelines.
•Added graphic from AHA public website.
•Added sample Nutrition Facts label to reflect new federal regulations.

Session 22: Look Back and Look Forward
•Included more physical activity examples