The Design and Implementation of a Weight Management Program in Underserved Communities: A Medical Student-Led Initiative

Background: Lifestyle change programs, like the Diabetes Prevention Program (DPP), are successful at addressing obesity and related comorbidities; however, they are often inaccessible. We describe our experience developing and implementing Healthier Together (HT), a medical student-led condensed adaptation of the DPP designed for low-income adults within Miami. Methods: Participants, both English- and Spanish-speaking, are referred via various community partners to participate in the year-long program. Run by medical students as Lifestyle Coaches (LC), participants attend an initial 1:1 interview with their LC, six, group-based, nutrition and activity sessions, a 1:1 exit interview, followed by one year of monthly phone check-ins. Metrics such as weight, blood pressure, attendance, pre- and post-lesson quiz scores, and four standardized surveys are measured throughout the program. A 22-question Knowledge Attainment Survey measured medical student nutrition knowledge and feelings of self-efficacy with patient interactions gained through leading the program. Results: From 2020-2023, HT has completed five cohorts consisting of 23 1:1 interviews, 17 enrolled individuals, and 17 exit interviews among 45 participant referrals, with 20 additional referrals for future cohorts. The mean attendance rate across was 70%. Overall mean program satisfaction was a 5 ± 0 (1=very dissatisfied, 5=very satisfied) (n=8). Eleven medical students have led the program, with a mean of 14 ± 3 hours of hands-on experience. Medical student Knowledge Attainment mean score increased from 61% to 81%. Conclusions: The implementation of HT demonstrates the feasibility of a medical student adaptation of the DPP for both community members and medical student facilitators.