Date of Award


Degree Name

Doctor of Philosophy


Interdisciplinary Health Sciences

First Advisor

Dr. Kieran Fogarty

Second Advisor

Dr. Mary D. Lagerwey

Third Advisor

Dr. Michalene A. King


Spirituality, spiritual interventions, Diabetes Prevention Program, faith community nursing, faith-based prevention programs



The purpose of this study is to explore a relationship between a modified Diabetes Prevention Program (DPP) for adults with pre-diabetes (pre-DM) or type-2 DM with variables of spirituality and religiosity (S/R) to illuminate the potential religion-health connection based in changes in participant weight, body mass index (BMI) and physical activity. A secondary purpose is identifying spiritual interventions used by faith-based DPP coaches in a group setting.


A mixed-methods study was conducted with 34 DPP participants and 11 DPP coaches who completed the core section (weeks 1-26) of DPP courses held in Macomb Country, Michigan. Independent variables are type of coach (faith-based or community-based) and three subscales of the Duke University Religion Index (DUREL). Dependent variables include pre- and post-core program measurements of weight, BMI and physical activity. A 2-round Delphi Survey Technique was completed by six faith-based coaches to identify spiritual interventions used while leading a DPP course.


Chi square and Independent-t and Pearson's r testing revealed no statistically significant differences in outcomes of weight loss, physical activity, or BMI based on type of coach or the three DUREL subscales. Chi square testing revealed a statistically significant difference between the men and women with more men meeting physical activity goals (X2(1)=6.28, p=.02). Fisher's Exact and Independent-t testing revealed no significant difference between type of coach based on the three subscales of the DUREL (NORp=.66 or IR p=.18). Results of the Delphi Survey show the faith-based coaches rated most important that used prayer, active listenin, and emotional support in leading their DPP courses.


Participants in this study did not achieve greater weight loss, a reduction in BMI, or increased physical activity levels based in variables of S/R or type of coach. Consensus was reported about three spiritual interventions used by all faith-based coaches in a group setting. Further study is needed with a larger, more diverse sample to further explore S/R dimensions related to successes with the DPP.

Access Setting

Dissertation-Open Access