scholarly journals Intent-to-treat analysis of a simultaneous multisite telehealth diabetes prevention program

2018 ◽  
Vol 6 (1) ◽  
pp. e000515 ◽  
Author(s):  
Elizabeth L Ciemins ◽  
Patricia J Coon ◽  
Nicholas C Coombs ◽  
Barbara L Holloway ◽  
Elizabeth J Mullette ◽  
...  

ObjectiveDetermine the effectiveness of a 16-week modified diabetes prevention program (DPP) administered simultaneously to multiple rural communities from a single urban site, as compared with a similar face-to-face intervention. A 12-week intervention was evaluated to consider minimization of staff costs in communities where resources are limited.Research design and methodsA prospective cohort study compared DPP interventions implemented in rural (via telehealth technology) and urban (face-to-face) communities using an intent-to-treat analysis. Primary outcome measures included 5% and 7% body weight loss. Logistic regression analyses were used to determine predictors of intervention success and included a variable for treatment effect.ResultsBetween 2010 and 2015, up to 667 participants were enrolled in the study representing one urban and 15 rural communities across Montana. The 16-week urban and rural interventions were comparable; 33.5% and 34.6% of participants lost 7% body weight, respectively; 50% and 47% lost 5% (p=0.22). Participants who were male (OR=2.41; 95% CI 1.32 to 4.40), had lower baseline body mass index (OR=1.03; 95% CI 1.01 to 1.07), attended more sessions (OR=1.33; 95% CI 1.11 to 1.58), and more frequently reported (OR=3.84; 95% CI 1.05 to 14.13) and met daily fat gram (OR=4.26; 95% CI 1.7 to 10.6) and weekly activity goals (OR=2.46; 95% CI 1.06 to 5.71) were more likely to meet their 7% weight loss goal. Predictors of meeting weight loss goals were similar for participants enrolled in the 12-week intervention.ConclusionsUsing telehealth technology to administer a modified DPP to multiple rural communities simultaneously demonstrated weight loss results comparable to those in a face-to-face intervention. Given the limitation of resources, linking rural areas to urban centers using telemedicine may increase access to much needed services to prevent or delay progression to diabetes.

2020 ◽  
Author(s):  
Charlotte Summers

BACKGROUND Prediabetes is the state of elevated blood glucose levels with glycaemic parameters above normal but below the (type 2) diabetes threshold. Prediabetes is considered a state of high risk for developing type 2 diabetes with yearly transition rate of 5%-10% to type 2 diabetes. There are almost 86 million adults with prediabetes in the United States alone. The world-wide prevalence of impaired glucose tolerance (IGT; a parameter of prediabetes) in 2010 was estimated to be 343 million (7.8%). Prediabetes is a global burden, with the International Diabetes Federation projecting an increase in prevalence of prediabetes to 471 million globally by 2035. OBJECTIVE Our objective was to evaluate the 1-year outcomes of the smart-phone delivered Low Carb Program for Prediabetes, a nutritionally focused, 12-session educational intervention for glycaemic control and weight loss for adults with prediabetes (i.e. a type 2 diabetes prevention program). The program reinforces carbohydrate restriction using behavioural techniques including goal setting, peer support, and behavioural self-monitoring. METHODS The study used a quasi-experimental research design comprised of an open-label, single-arm, pre-post intervention using a sample of convenience. We followed all of the 260 adults with prediabetes who had activated their referral to the program as a result of an NHS consultation between December 2018 and March 2019 and followed them for 12 months (N=260; mean age 44.7, SD 9.48 years; 36.1% (94/260) women; mean glycated haemoglobin A1c (HbA1c) 6.25%, SD 0.11%; mean body weight 77.1kg, SD 17.5kg; taking mean 0.41, SD 0.49 diabetes medications). RESULTS Of the 260 participants followed, 221 (85%) individuals reported outcomes at 12 months. 122 (46.9%) completed 80% or more of lessons of the program. Of the 260 participants with a starting HbA1c at or above the prediabetes threshold of 6.0%, 124 (49.6%) reduced their HbA1c to below the threshold. Over a third (33.8%, 88/260) of all participants lost at least 5% of their body weight. Overall, glycaemic control and weight loss improved, especially for participants who completed all modules of the program. For example, participants who engaged in at least 10 of the 12 weekly modules reduced their HbA1c from 6.3% to 5.8% (P<.001) and lost an average of 4.38kg or 5.4% of their body weight (P<.001). CONCLUSIONS A smart-phone delivered program that teaches a carbohydrate-reduced diet to adults with prediabetes with behaviour change support can be scalable and effective for glycaemic control, weight loss and can act as an engaging intervention for diabetes prevention.


2019 ◽  
Vol 184 (11-12) ◽  
pp. 647-652 ◽  
Author(s):  
Amy Taetzsch ◽  
Cheryl H Gilhooly ◽  
Asma Bukhari ◽  
Sai Krupa Das ◽  
Edward Martin ◽  
...  

Abstract Introduction Effective, standardized, and easily accessible weight management programs are urgently needed for military beneficiaries. Videoconference interventions have the potential for widespread scaling, and can provide both real time interaction and flexibility in delivery times regardless of location, but there is little information on their effectiveness and acceptability. Materials and Methods This study as part of a larger weight loss trial describes the videoconference adaption of Group Lifestyle Balance (GLB) program, a community group-based Diabetes Prevention Program intervention, and provides a comparison of weight loss and meeting attendance between in-person and videoconference delivery modes over 12 weeks in adult family members of military service members. Forty-three participants were enrolled from two military installations and received either the videoconference-adapted or an in-person GLB program in a non-randomized trial design. Differences in program attendance and percent weight lost at 12 weeks were compared by independent samples t-tests and nonparametric methods. Group differences in the percentage of weight lost over the 12-week period were analyzed using a linear mixed model. Results All GLB intervention components were successfully delivered by videoconference with minor adaptations for the different delivery mechanism. Participant retention was 70% and 96% in the in-person and videoconference groups, respectively (p = 0.04). Completing participants in both groups lost a significant percent body weight over the 12 week intervention (p &lt; 0.001) and there was no difference in percent body weight after 12 weeks of intervention (6.2 ± 3.2% and 5.3 ± 3.4% for in-person and videoconference at 12 weeks, respectively; p = 0.60). Conclusion This study describes the first videoconference adaption of the GLB program for use in military families. Attrition was lower in the videoconference group, and there were a similar levels of weight loss in both groups regardless of delivery modality. Videoconference weight loss interventions are effective and feasible for scaling to support healthy weight management in military as well as civilian populations.


2008 ◽  
Vol 27 (1, Suppl) ◽  
pp. S91-S98 ◽  
Author(s):  
Sherry L. Pagoto ◽  
Lyle Kantor ◽  
Jamie S. Bodenlos ◽  
Mitchell Gitkind ◽  
Yunsheng Ma

2012 ◽  
Vol 10 (3) ◽  
pp. 143-143
Author(s):  
S. Fuller ◽  
E. Ludman ◽  
A. Mohelnitzky ◽  
G. Gundersen ◽  
R. Wellman ◽  
...  

2017 ◽  
Vol 4 (3) ◽  
pp. 165-166
Author(s):  
Gabriela Vazquez-Benitez ◽  
Jay Desai ◽  
Gretchen Taylor ◽  
Sara Vine ◽  
Julie Anderson ◽  
...  

2018 ◽  
Vol 53 ◽  
pp. 32-37 ◽  
Author(s):  
Carol A. Janney ◽  
Jared M. Greenberg ◽  
Tannaz Moin ◽  
Hyungjin Myra Kim ◽  
Robert G. Holleman ◽  
...  

Obesity ◽  
2008 ◽  
Vol 16 (6) ◽  
pp. 1413-1420 ◽  
Author(s):  
Delia S. West ◽  
T. Elaine Prewitt ◽  
Zoran Bursac ◽  
Holly C. Felix

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