The Impact of a Yearlong Diabetes Prevention Program-Based Lifestyle Intervention on Cardiovascular Health Metrics

Introduction The American Heart Association created “Life’s Simple Seven” metrics to estimate progress toward improving US cardiovascular health in a standardized manner. Given the widespread use of federally funded Diabetes Prevention Program (DPP)-based lifestyle interventions such as the Group Lifestyle Balance (DPP-GLB), evaluation of change in health metrics within such a program is of national interest. This study examined change in cardiovascular health metric scores during the course of a yearlong DPP-GLB intervention. Methods Data were combined from 2 similar randomized trials offering a community based DPP-GLB lifestyle intervention to overweight/obese individuals with prediabetes and/or metabolic syndrome. Pre/post lifestyle intervention participation changes in 5 of the 7 cardiovascular health metrics were examined at 6 and 12 months (BMI, blood pressure, total cholesterol, fasting plasma glucose, physical activity). Smoking was rare and diet was not measured. Results Among 305 participants with complete data (81.8% of 373 eligible adults), significant improvements were demonstrated in all 5 risk factors measured continuously at 6 and 12 months. There were significant positive shifts in the “ideal” and “total” metric scores at both time points. Also noted were beneficial shifts in the proportion of participants across categories for BMI, activity, and blood pressure. Conclusion AHA-metrics could have clinical utility in estimating an individual’s cardiovascular health status and in capturing improvement in cardiometabolic/behavioral risk factors resulting from participation in a community-based translation of the DPP lifestyle intervention.

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Abstract P438: The Impact of a Yearlong Diabetes Prevention Program-based Lifestyle Intervention on Cardiovascular Health Metrics

Circulation ◽

10.1161/circ.141.suppl_1.p438 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Susan Devaraj ◽

Bonny Rockette-Wagner ◽

Vincent Arena ◽

Rachel G Miller ◽

Jenna Napoleone ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Lifestyle Intervention ◽

Prevention Program ◽

Diabetes Prevention ◽

Fasting Blood Glucose ◽

Diabetes Prevention Program ◽

Rank Test ◽

Cvd Risk ◽

The Impact

Introduction: The AHA created “Life’s Simple Seven” metrics to measure progress toward the goal of improving the cardiovascular (CV) health of all Americans, classifying each metric as “ideal”, “intermediate,” or “poor”. Few studies have examined the impact of behavioral lifestyle interventions on CV health metrics. We evaluated changes in CV health metrics during the course of a CDC recognized Diabetes Prevention Program-based lifestyle intervention known as Group Lifestyle Balance (DPP-GLB). Hypothesis: DPP-GLB will be associated with improvements in CV health metrics after 6 months of intervention and maintenance of these improvements at 12 months post-baseline. Methods: We used combined data from two similar intervention trials (occurring 6 years apart) offering a 12 month DPP-GLB program in the community setting to overweight/obese individuals with prediabetes and/or metabolic syndrome. Changes in individual CV health metrics (BMI, blood pressure, total cholesterol, fasting blood glucose, physical activity; measures of smoking and diet were not available) and total metric score (sum of metric profile where ideal=2, intermediate=1 and poor=0 for each metric, possible “total “range of 0-10) were considered after 6 and 12 months of intervention. Results: Among 222 participants (76%) with complete data for all 5 metrics at intervention baseline, 6 and 12 month follow up, there was a significant beneficial shift from baseline to 6 and 12 months in the proportion of participants within CV health metric categories for BMI, physical activity and blood pressure (Figure 1). Total metric score also improved significantly (p<0.01, signed-rank test) at 6 [median (IQR) change: +1.0 (0-1.0)] and 12 months [median (IQR) change: 0.0 (0-1.0)]. Significant improvement was also seen in the median number of ideal metrics at 6 and 12 months (p<0.01 for both). Conclusions: The DPP-GLB intervention was successful in improving CV health metrics at both 6 and 12 months, demonstrating the potential of this program to decrease CVD risk.

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Impact of Maintenance Session Attendance and Early Weight Loss Goal Achievement on Weight Loss Success in a Community-Based Diabetes Prevention Program Intervention

The Science of Diabetes Self-Management and Care ◽

10.1177/26350106211023990 ◽

2021 ◽

pp. 263501062110239

Author(s):

Jenna M. Napoleone ◽

Rachel G. Miller ◽

Susan M. Devaraj ◽

Bonny Rockette-Wagner ◽

Vincent C. Arena ◽

...

Keyword(s):

Weight Loss ◽

Lifestyle Intervention ◽

Prevention Program ◽

Diabetes Prevention ◽

Program Effectiveness ◽

Diabetes Prevention Program ◽

Goal Achievement ◽

Medicare Reimbursement ◽

Community Based ◽

Session Attendance

Purpose The purpose of this study was to examine how maintenance session attendance and 6-month weight loss (WL) goal achievement impacted 12-month 5% WL success in older adults participating in a community-based Diabetes Prevention Program (DPP) lifestyle intervention. Methods Data were combined from 2 community trials that delivered the 12-month DPP-based Group Lifestyle Balance (GLB) to overweight/obese adults (mean age = 62 years, 76% women) with prediabetes and/or metabolic syndrome. Included participants (n = 238) attended ≥4 core sessions (months 0-6) and had complete data on maintenance attendance (≥4 of 6 sessions during months 7-12) and 6- and 12-month WL (5% WL goal, yes/no). Multivariate logistic regression was used to estimate the odds of 12-month 5% WL associated with maintenance attendance and 6-month WL. Associations between age (Medicare-eligible ≥65 vs <65 years) and WL and attendance were examined. Results Both attending ≥4 maintenance sessions and meeting the 6-month 5% WL goal increased the odds of meeting the 12-month 5% WL goal. For those not meeting the 6-month WL goal, maintenance session attendance did not improve odds of 12-month WL success. Medicare-eligible adults ≥65 years were more likely to meet the 12-month WL goal (odds ratio = 3.03, 95% CI, 1.58-5.81) versus <65 years. Conclusions The results of this study provide important information regarding participant attendance and WL for providers offering DPP-based lifestyle intervention programs across the country who are seeking Medicare reimbursement. Understanding Medicare reimbursement-defined success will allow these providers to focus on and develop strategies to enhance program effectiveness and sustainability.

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Effect of Self-Efficacy on Weight Loss: A Psychosocial Analysis of a Community-Based Adaptation of the Diabetes Prevention Program Lifestyle Intervention

Diabetes Spectrum ◽

10.2337/diaspect.27.4.270 ◽

2014 ◽

Vol 27 (4) ◽

pp. 270-275 ◽

Cited By ~ 16

Author(s):

Laura M. Hays ◽

Emily A. Finch ◽

Chandan Saha ◽

David G. Marrero ◽

Ronald T. Ackermann

Keyword(s):

Weight Loss ◽

Lifestyle Intervention ◽

Prevention Program ◽

Self Efficacy ◽

Diabetes Prevention ◽

Diabetes Prevention Program ◽

Community Based ◽

Community Based Adaptation

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Community-based participatory research to design a faith-enhanced diabetes prevention program: The Better Me Within randomized trial

Contemporary Clinical Trials ◽

10.1016/j.cct.2017.08.003 ◽

2017 ◽

Vol 62 ◽

pp. 77-90 ◽

Cited By ~ 9

Author(s):

Heather Kitzman ◽

Leilani Dodgen ◽

Abdullah Mamun ◽

J. Lee Slater ◽

George King ◽

...

Keyword(s):

Randomized Trial ◽

Participatory Research ◽

Prevention Program ◽

Diabetes Prevention ◽

Community Based Participatory Research ◽

Diabetes Prevention Program ◽

Community Based

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Implementation and Outcomes of the New York State YMCA Diabetes Prevention Program: A Multisite Community-Based Translation, 2010–2012

Preventing Chronic Disease ◽

10.5888/pcd11.140006 ◽

2014 ◽

Vol 11 ◽

Cited By ~ 16

Author(s):

Anne Bozack ◽

Susan Millstein ◽

Jacqueline Martinez Garcel ◽

Kim Kelly ◽

Rachael Ruberto ◽

...

Keyword(s):

New York ◽

Prevention Program ◽

Diabetes Prevention ◽

New York State ◽

Diabetes Prevention Program ◽

Community Based ◽

York State

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Abstract P121: Comparative Effectiveness Study of the Diabetes Prevention Program in Families: Preliminary Results

Circulation ◽

10.1161/circ.131.suppl_1.p121 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Jennifer Wessel ◽

Erin O'Kelly-Phillips ◽

Kelly Palmer ◽

Chandan Saha ◽

Tamara Hannon ◽

...

Keyword(s):

Blood Pressure ◽

Prevention Program ◽

Diabetes Prevention ◽

Intervention Group ◽

Diabetes Prevention Program ◽

Comparative Effectiveness Study ◽

Develop Type ◽

History Of ◽

Family Based

The prevalence of gestational diabetes (GDM) is increasing substantially and currently affects up to 14% of pregnancies. As many as 70% of women with GDM will develop type 2 diabetes (T2D) in the next 10 years. Moreover as many as 40% of children exposed to in-utero diabetes will develop obesity and T2D. The Diabetes Prevention Program (DPP) is an evidence-based lifestyle intervention that has been shown to lower T2D risk by 58% in high-risk adults. Family based lifestyle interventions that target either children, parents or both have reported mixed results. We modified the DPP curriculum to use with families (DPPF) and recruited mothers with a history of GDM and their children 8-15 years old. We randomized n=130 families to test which method of delivering the DPPF (mothers only (M) or mothers and their children (M+C)) is more effective at lowering families T2D risk. Baseline characteristics of women were similar among each intervention group (n=65 M and n=65 M+C, respectively): age (38±8 vs 39±11, P=0.5), ethnicity (Black 55% vs 55%, White 20% vs 17%, Latino 20% vs 27%, other 5% vs 2%, P=0.6), body mass index (BMI, 37±8 vs 38±7, P=0.24), systolic blood pressure (SBP, 121±11 vs 122±13, P=0.8), diastolic blood pressure (DBP, 103±26 vs 105±21, P=0.6), HbA1c (5.6±0.4 vs 5.7±0.3, p=0.2). The majority of women self-reported low levels of physical activity (PA): moderate PA (2 days or less per week, 42% vs 26%, P=0.06) or vigorous PA (2 days or less per week, 38% vs 25%, P=0.1), and high levels of sedentary activities (3 or more hours per day, 49% vs 58%, P=0.2). For diet related obesogenic behaviors women self-reported high levels of eating meals while watching TV (3 days or more per week, 58% vs 74%, P=.06) and eating at restaurants (3 days or more per week, 28% vs 41%, P=0.1). Follow-up is ongoing and currently n=32 families have completed the 3-month follow-up. Preliminary analyses of mothers show decreases in HbA1c (-.01±.3 vs -.1±.2), SBP (-9.7±30 vs -3.1±8), DBP (-8±19 vs -1±9) but not BMI (0.07±1.6 vs 0.04±1.2); however results were not significantly different by intervention group.

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Current practices, facilitators, and barriers experienced by program providers implementing the National Diabetes Prevention Program in Los Angeles County

Translational Behavioral Medicine ◽

10.1093/tbm/ibaa033 ◽

2020 ◽

Cited By ~ 1

Author(s):

Gabrielle Green ◽

Amelia R DeFosset ◽

Megala Sivashanmugam ◽

Jennifer Mosst ◽

Tony Kuo

Keyword(s):

Los Angeles ◽

Prevention Program ◽

Diabetes Prevention ◽

Los Angeles County ◽

Diabetes Prevention Program ◽

Community Based ◽

Data Reporting ◽

Facilitators And Barriers ◽

Program Costs ◽

Current Practices

Abstract Individuals with prediabetes can lower their diabetes risk by participating in the National Diabetes Prevention Program (National DPP), an evidence-based, group lifestyle change program that is taught by a certified lifestyle coach. To date, studies have not explicitly compared National DPP implementation across multiple settings (i.e., types of organizations) to understand comparative setting advantages or challenges to engaging priority groups. The purpose of this study was to gain an in-depth understanding of: (a) the variation in National DPP implementation across clinic, community-based, and digital settings and (b) associated facilitators and barriers. The study focused on three core implementation domains: recruitment, retention, and data reporting. This study used a descriptive, qualitative approach to identify current practices, facilitators, and barriers to National DPP implementation by conducting semistructured key informant interviews in spring 2018 with 12 organizations delivering the National DPP in Los Angeles County. There was a general commonality between in-person settings (clinics and community-based), while the experiences of digital providers were relatively distinct. Recruitment and retention were widely described by all settings as labor- and time-intensive, while data reporting was seen as relatively less burdensome. All respondents reported using multiple recruitment strategies. Lifestyle coaches were seen as key to retention, and they spent substantial time engaging with participants outside of class, which often was not accounted for in program costs. Data reporting was easier for organizations that invested in sophisticated data management systems and had staff with sufficient data experience. This study advances knowledge around the translation of the National DPP in diverse settings in the nation’s largest county and highlights opportunities for targeted, setting-specific support.

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