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PreDiabetesHCISNCT06440395

Small Steps for Big Changes - Healthy Cities Implementation Science

An observational study of PreDiabetes, run by University of British Columbia at 12 sites in Canada.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Small Steps for Big Changes (SSBC) is a diet and exercise counselling program that significantly reduces the risk of developing Type 2 Diabetes (T2D). In partnership with YMCAs in Canada spanning 8 provinces, the aim of this study is to scale-up program delivery and evaluate the implementation and effectiveness of… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
PreDiabetes
What is being tested?
Behavioural: Small Steps for Big Changes Diabetes Prevention Program
How many people
4,400 participants
Where
12 sitesCanada
Study dates
3 Jun 2024to Sep 2029
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: The investigators aim to recruit a community-based sample of adults at risk of type 2 diabetes

Who may be able to join

  • Community-dwelling adults aged 18 years or older
  • able to read and speak English
  • has prediabetes assessed by one of the following means: (a) physician-diagnosed prediabetes, (b) HbA1c values between 5.7 - 6.4% (American Diabetes Association, 2012), (c) an American Diabetes Association risk questionnaire score indicating increased risk (>5)
  • Individuals who have previously been diagnosed with type 2 diabetes but who are in remission (defined as achieving glycated hemoglobin (A1C) of < 6.4% without any diabetes-related medications for a minimum of 3 months) will be eligible to participate.
  • Senior leadership and/or management of our Canadian YMCA delivery partner organizations
  • YMCA staff who manage/coordinate programs (e.g., general manager of health programs) for each site willing to act as SSBC site lead champion.
  • Site staff certified as SSBC coaches to deliver the program.

Who cannot join

  • Patients currently diagnosed type 2 diabetes with an HbA1c of 6.5% or greater.
  • Organizational partners
  • Site leads/managers
  • Coaches

Trial locations and contacts

12 sites in 1 country. Contact the study team or a site near you to ask about taking part.

12 sites in 1 country

Canada12 sites, 12 recruiting
  • YMCA of Brandon Health and Fitness Centre

    Brandon, Manitoba, R7A 3X2

    Lon Cullen, lon.cullen@ymanitoba.ca

    Diana Sherifali

    Not yet recruiting
  • Castle Downs Family YMCA

    Edmonton, Alberta, T5X 6A3

    Jody Kyle, jody.kyle@northernalberta.ymca.ca

    Linda Li

    Not yet recruiting
  • John W. Lindsay YMCA

    Halifax, Nova Scotia, B3J 3Y3

    Joy Chiekwe, joy.chiekwe@halifax.ymca.ca

    Katie Wadden

    Not yet recruiting
  • Health and Exercise Psychology Laboratory

    Kelowna, British Columbia, V1V 1V7

    Mary E June, PhD, 250-807-8419, mary.jung@ubc.ca

    Mary E Jung, PhD

    Recruiting
  • YMCA 3 Rivers

    Kitchener, Ontario, N2G 3C5

    Crystal Hughes, (613) 921-4159, Crystal.Hughes@ytr.ymca.ca

    Diana Sherifali

    Not yet recruiting
  • Prince George Family YMCA

    Prince George, British Columbia, V2L 4V7

    Alyssa O'Connor, 250 562 9341 ext. 2116, alyssa.oconnor@bc.ymca.ca

    Linda Li

    Not yet recruiting
  • YMCA of Regina Health, Fitness and Aquatics Centre

    Regina, Saskatchewan, S4X 2P9

    Steve Compton, Steve.compton@regina.ymca.ca

    Linda Li

    Not yet recruiting
  • Saint John Regional Y

    Saint John, New Brunswick, E2K 3E2

    Sherry Fitzgerald, S.Fitzgerald@saintjohny.ca

    Katie Wadden

    Not yet recruiting
  • YMCA of Greater Toronto - Scarborough Health and Fitness Centre

    Scarborough Village, Ontario, M1B 3C6

    Samantha Casmey, Samantha.Casmey@YMCAGTA.ORG

    Diana Sherifali

    Not yet recruiting
  • Ches Penney Family YMCA

    St. John's, Newfoundland and Labrador, A1A 5G6

    Sherry Squires, sherry.squires@nl.ymca.ca

    Katie Wadden

    Not yet recruiting
  • Tong Louie Family YMCA

    Surrey, British Columbia, V3S 7S6

    Alyssa O'Connor, 604.320-5846, alyssa.oconnor@bc.ymca.ca

    Linda Li

    Not yet recruiting
  • Elmwood-Kildonan

    Winnipeg, Manitoba, R2K 2M6

    Casie Nishi, 204-831-2972, casie.nishi@ymanitoba.ca

    Diana Sherifali

    Not yet recruiting

Other trials in Canada

About this study

Official title: Small Steps for Big Changes: Implementing an Evidence-Based Diabetes Prevention Program Into Diverse Urban Communities

Small Steps for Big Changes (SSBC) is a diet and exercise counselling program that significantly reduces the risk of developing Type 2 Diabetes (T2D). In partnership with YMCAs in Canada spanning 8 provinces, the aim of this study is to scale-up program delivery and evaluate the implementation and effectiveness of SSBC. To evaluate implementation, the number of staff trained/patients enrolled, attendance, sessions delivered as planned, delivery costs, and number of sites continuing to deliver the program will be examined. To evaluate program effectiveness, changes in patient health (e.g., T2D status, blood glucose, weight, exercise, diet) will be measured over 2 years following program completion.

Read the detailed description

In partnership with YMCAs in Canada spanning 8 provinces (overseeing 44 distinct community facilities/sites), the investigators will adapt and deliver our evidence-based diabetes prevention program, Small Steps for Big Changes. The purpose of this project is to evaluate the implementation and effectiveness of SSBC across diverse urban communities.

Specifically, the investigators aim to:

  1. Evaluate the implementation and sustainability of the program by examining the number of staff trained/patients enrolled, attendance, sessions delivered as planned, delivery costs, and number of sites continuing to deliver the program.
  2. Examine clinical-effectiveness of the program on: T2D status (self-report and HbA1c; primary outcomes), cardiorespiratory fitness, anthropometric (weight, waist circumference, resting heart rate), health behaviours (exercise, diet).
  3. Examine cost-effectiveness of the program on: healthcare resource utilization, and health-related quality of life (secondary outcomes).

Research Design:

A hybrid type 2 implementation-effectiveness study design (Curran et al., 2012) with multi/mixed methods will be used to evaluate the implementation and effectiveness of SSBC.

SSBC program:

SSBC will be administered and facilitated by the community facility trainers at YMCA locations. SSBC consists of 6 sessions delivered over 4 consecutive weeks, with each session comprising brief (20-30 mins) counselling that support participants self-regulatory skills to promote independence and long-term adherence to healthy dietary behaviours and regular exercise, followed by 20-30 mins of supervised aerobic exercise.

Conditions
PreDiabetes
Being tested
Behavioural: Small Steps for Big Changes Diabetes Prevention Program
Keywords
Implementation Science, Exercise Behaviour, Diet Behaviour, Adherence, Health Behaviour Change
Medical subject headings
Prediabetic State

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Behavioural: Small Steps for Big Changes Diabetes Prevention ProgramBehavioural

    The 4-week behaviour change program will introduce participants to a regular healthy lifestyle including exercise and dietary changes for reducing sugar intake, reducing refined/processed carbohydrate intake, increasing vegetable consumption. The 4-week program will include six supervised exercise sessions and three exercise sessions performed independently (e.g., at home or outside of the YMCA). The supervised session will include brief behavioural counselling sessions that teach participants self-regulatory skills to promote independence and long-term adherence to exercising and dietary changes.

Study groups in NCT06440395
Study groupRoleWhat they receive
Small Steps for Big Changes: Diabetes Prevention ProgramDiabetes Prevention Program (one-treatment group) The diabetes prevention program is a 4-week program that will introduce participants to a regular healthy behaviours that includes exercise and simple dietary strategies. There is no randomization to this program - all individuals enrolled will partake in the same program and will be followed up for 24 months after the program has concluded.
Receives: Behavioral: Behavioural: Small Steps for Big Changes Diabetes Prevention Program

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Type 2 diabetes status

    Self reported HbA1c%

    Measured: 0, 12, and 24 months post intervention

  2. Change in HbA1c

    Venipuncture blood collection of HbA1c% through laboratory testing in a subsample of participants

    Measured: 0, 12 and 24 months post intervention

  3. Adoption of SSBC

    Proportion and representativeness of coaches and implementation support team obtained through program records

    Measured: 0, 52, 104, 156, 208 weeks

  4. Reach of SSBC

    Proportion of patients' enrolled and completing the intervention, proportion of implementation staff trained and retained. Demographics of the patients and staff

    Measured: 0, 52, 104, 156, 208 weeks

  5. Dose Delivered

    Number of SSBC sessions delivered by coaches (0-6) will be gathered through coach checklists

    Measured: During delivery of the intervention

  6. Fidelity of SSBC delivery

    Frequency with which clients recieve each core component and quality of counselling skills measured using session checklists.

    Measured: During delivery of the intervention

  7. Number of adaptations of SSBC

    Number of adaptations made prior to delivery of SSBC and during SSBC delivery. Number of adaptations needed for sustainment and during sustainment. Adaptation information will be gathered through meeting minutes with site leads, annual reports from delivery sites and through interviews with coaches and site leads.

    Measured: Prior to, and throughout delivery of the intervention (0-104 weeks), sustainment planning and delivery (104-208 weeks)

  8. Types of adaptations of SSBC

    Type of adaptations made prior to delivery of SSBC and during SSBC delivery. Adaptation information will be gathered through meeting minutes with site leads, annual reports from delivery sites and through interviews with coaches and site leads.

    Measured: Prior to, and throughout delivery of the intervention (0-104 weeks), sustainment planning and delivery (104-208 weeks)

  9. Receptivity to SSBC among patients' and staff

    Patient acceptability and satisfaction will be assessed using the 1-item net promoter score, overall satisfaction measure developed in house and the theoretical framework of acceptability measure. Interviews will be conducted with a subsample of patients at each site (2-3 per site) after completing SSBC. Staff satisfaction and burden will be assessed using brief surveys a various points through the program delivery with coaches (baseline, after 5, 10, 20 clients) and site leads (baseline and at the end of SSBC delivery). Satisfaction and acceptability will also be examined among staff using qualitative interviews.

    Measured: 4, and 52 weeks (patients), during delivery (staff)

  10. Cost of Delivering SSBC

    Costs incurred for implementing SSBC at the delivery sites will be collected through annual reporting from the delivery sites.

    Measured: 104, 156, 208 weeks

  11. Membership rates

    The proportion of individuals who convert their one-month free pass to a facility membership and the retention of this membership over time will be calculated. This information will be collected from annual reports from delivery sites and client surveys.

    Measured: 104, 156, 208 weeks

Secondary outcomes (10)
  1. Change in body weight

    Measured in pounds

    Measured: 0, 4, 52, and 104 weeks

  2. Change in cardiorespiratory fitness

    Distance walked in the six minute walk test will be conducted at sites with access to a walking track.

    Measured: 0, 4, 52, and 104 weeks

  3. Change in physical activity behaviour using the Godin Leisure Time Physical Activity Questionnaire

    The Godin Leisure Time Physical Activity Questionnaire will be used to examine physical activity behaviour. Respondents report the frequency of strenuous, moderate, and mild physical activity for bouts of 15 or more minutes during a 7-day period. The scores are multiplied by weigths and summed into an overall score reports in metabolic equivalents of task (METs)/minutes of physical activity per week.

    Measured: 0, 4, 52, and 104 weeks

  4. Changes in physical activity using the 2-item Physical Activity Vital Signs measure

    The 2-item Physical Activity Vital Signs measure will be used to collect information on physical activity behaviour. Two questions are self-reported: 1) "How many days during the past week have you performed physical activity where your heart beats faster and your breathing is harder than normal for 30 minutes or more?" and 2) "How many days in a typical week do you perform activity such as this?" The responses are reported as days during the past week over days in a typical week, with scores ranging from 0 to 7 for each question.

    Measured: 0, 4, 52, and 104 weeks

  5. Change in dietary intake

    Assessed using the brief food frequency questionnaire. Participants are asked about their intake of five foods within the past week: fruits, vegetables, sweets, bread and rice/pasta. Items are rated on a 6-point scale. The questionnaire also uses a composite score for refined carbohydrates (sum of bread and rice/pasta).

    Measured: 0, 4, 52, and 104 weeks

  6. Determinants of intervention implementation

    Aspects of the larger social, political and economic environment that may influence delivery of the adapted intervention will be assessed by interview. These interviews will also gather qualitative data potential factors that impact delivery of SSBC at the site including context, acceptability, adaptability, feasibility, compatibility, cost, culture, complexity and self efficacy. These interviews will be conducted among coaches and managerial staff.

    Measured: 52 weeks

  7. Sustainability outcomes and determinants

    Data will be collected on the number of sites continuing delivery, the number of coaches continuing delivery, the number of clients run through SSBC and the number of implementation strategies that are utilized. This data will be gathered through program records. Focus groups will be conducted at each site over the 2-year sustainability phase to gather information on the contextual factors that impact sustainment outcomes.

    Measured: 104, 156 and 208 weeks

  8. Change in health-related quality of life (EQ-5D-5L Profile)

    The EQ-5D-5L consists of five dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). Participants are asked to indicate their level of functioning (from 1 "no problems" to 5 "extreme problems") on each of the five dimensions of the EQ-5D-5L. The EQ-5D-5 L describes 3125 distinct health states, with 11111 representing the best and 55555 the worst possible health states. The Canadian EQ-5D-5 L scoring algorithm will be applied to generate index scores which range from - 0.148 for the worst (55555) to 0.949 for the best (11111) health states.

    Measured: 0, 4, 52, and 104 weeks

  9. Change in health-related quality of life (EQ-5D-5L Visual Analogue Scale)

    Health status will be assessed with the EQ-5D-5L visual analogue scale. Participants report on their health on a visual analogue scale from 0 (worst health) to 100 (best health)

    Measured: 0, 4, 52, and 104 weeks

  10. Change in health resource utilization

    The extent to which participants use medical services will be assessed using the Health Resource Utilization Survey. The information will be combined with the EQ-5D-5L health related quality of life profiles to calculate the cost-effectiveness of the program.

    Measured: 0, 52, and 104 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Jun 2024
  2. Study start3 Jun 2024
  3. Primary completionSep 2029 (estimated)
  4. Study completionSep 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
4,400 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06440395
Sponsor's protocol ID
H23-01930
Acronym
HCIS
Status last verified
Jul 2026
First submitted
13 May 2024
Last updated
3 Aug 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Weatherson K, Bourne JE, Cranston K, Braaten K, Grieve N, Kelly J, Jung ME. Scaling Up a Diabetes Prevention Program in Geographically and Ethnoculturally Diverse Urban Regions of Canada: Protocol for a Hybrid Type 2 Implementation-Effectiveness Study. JMIR Res Protoc. 2026 Jan 19;15:e80276. doi: 10.2196/80276.

    PubMed 41553750

Questions about this trial

What is this clinical trial studying?

An observational study of PreDiabetes, run by University of British Columbia at 12 sites in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 3 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Type 2 diabetes status (time frame: 0, 12, and 24 months post intervention). The study lists 11 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06440395, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Aug 2026.

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