For Lois Hourston, a diagnosis was a wake-up call.

“I received notification from my doctor’s office that my lab reports indicated I was pre-diabetic,” she recalls. “I joined Small Steps for Big Changes very quietly—I didn’t even tell my husband—because I was so afraid I was going to fail. But when I started learning about diabetes, I was scared straight. Overnight, I became a convert.”

Small Steps for Big Changes is a groundbreaking initiative that started in Dr. Mary Jung’s lab at UBC Okanagan. It is an evidence-based program that lowers the risk of developing type 2 diabetes by making changes to diet and activity levels—while using community-based counselors for the crucial one-on-one guidance to ensure success.

The number of diabetes cases is rising across the globe, and the strain of treating them is being felt in health-care systems worldwide. In Canada alone, diagnosing and treating diabetes patients costs an estimated $30 billion per year.

Living with diabetes can lead to debilitating complications such as blindness, limb amputation and chronic pain. Early prevention offers hope for those at risk of developing diabetes—and Small Steps for Big Changes is turning hope into reality.

Dr. Mary Jung recalls the program’s humble beginnings.

“We designed and developed it in my lab in 2012, always with the intention for it to be sustainable and community-led,” she says. “Our focus was on the psychology of behaviour change—specifically, adherence to diet and exercise.”

The program has grown from a local effort to a national and international model for diabetes prevention. It is now poised to expand to 40 more YMCA locations across Canada, from a YMCA in Portugal to four new locations in Australia. This rapid growth can be traced in part back to support from a donor coming at a pivotal moment.

“A philanthropic donation in 2018 was very close to our official launch,” Dr. Jung explains. “It helped drive the expansion within the community, allowing us to transition from researchers delivering the program to training community staff to take the lead. This was a huge game changer.”

With donor funding, the program was able to scale up, testing its effectiveness in real-world community settings and training local YMCA staff to become program counsellors.

For Dr. Jung, the program’s success lies in its patient-centered approach.

“We empower the person in front of us rather than prescribing to them,” she says. “Listening and supporting an individual’s autonomy is key to our success and sets us apart from a lot of health care provision mentality.”

However, scaling the program to diverse communities presents its own set of challenges.

“One of the big questions we’re trying to answer is how can we adapt to make this culturally appropriate in very diverse communities,” Dr. Jung notes. “It’s not just about translation costs but also about building trust and buy-in from communities across the country. This takes donor support.”

With research tripling in the last ten years at UBC Okanagan—the innovation ecosystem has also been instrumental in SSBC’s growth.

“My autonomy as a researcher has been fully supported,” Dr. Jung says. “We are now celebrated for being the only human diabetes research group at UBC Okanagan and hold our ground across both UBC campuses.”

The potential for Small Steps for Big Changes to provide simple, accessible health-care options for diabetes prevention is significant for our health-care system—with the potential to save billions in health-care dollars while freeing up valuable health-care resources.

The impact can also be felt at a personal level. Lois credits the program with helping reverse her pre-diabetes and adopt a healthier lifestyle.

“It’s kept me on the straight and narrow for the last six years. I exercise three times a week, hike, and watch what I eat all the time. It’s been marvellous.”