Multiple-behavior-change interventions for women with type 2 diabetes

As part of comprehensive clinical care for people with diabetes, there is a need for multifaceted interventions that address the primary lifestyle factors that contribute to women's type 2 diabetes and place them at elevated risk for heart disease. The Mediterranean Lifestyle Program (MLP) demonstrated that a multiple-behavior-change intervention focusing on diet, exercise, stress management, and social support had beneficial effects on biological, behavioral, and psychosocial outcomes within the first 2 years of the program. A cultural adaptation of MLP, ¡Viva Bien!, partially replicated those effects when it was extended to Latina women recruited from a large health maintenance organization and a community health center. Both projects indicated that refinements are warranted to increase the sustainability of intervention effects and the feasibility of dissemination.