scholarly journals The role of Sociodemographic factors on goal achievement in a community-based diabetes prevention program behavioral lifestyle intervention

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Susan M. Devaraj ◽  
Jenna M. Napoleone ◽  
Rachel G. Miller ◽  
Bonny Rockette-Wagner ◽  
Vincent C. Arena ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Lifestyle Intervention ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Sociodemographic Factors ◽  
Goal Achievement ◽  
Community Based ◽  
Race Ethnicity ◽  
Hispanic White

Abstract Background The Diabetes Prevention Program (DPP) behavioral lifestyle intervention was effective among a diverse sample of adults with prediabetes. Demonstrated effectiveness in translated versions of the DPP lifestyle intervention (such as Group Lifestyle Balance, DPP-GLB) led to widescale usage with national program oversight and reimbursement. However, little is known about the success of these DPP-translation programs across subgroups of sociodemographic factors. This current effort investigated potential disparities in DPP-translation program primary goal achievement (physical activity and weight) by key sociodemographic factors. Methods Data were combined from two 12-month community-based DPP-GLB trials among overweight/obese individuals with prediabetes and/or metabolic syndrome. We evaluated change in weight (kilograms and percent) and activity (MET-hrs/week) and goal achievement (yes/no; ≥5% weight loss and 150 min per week activity) after 6 and 12 months of intervention within and across subgroups of race/ethnicity (non-Hispanic white, non-Hispanic black), employment status, education, income, and gender. Results Among 240 participants (85%) with complete data, most sociodemographic subgroups demonstrated significant weight loss. However, non-Hispanic white lost more weight at both 6 and 12 months compared to non-Hispanic black participants [median weight loss (IQR), 6 months: 5.7% (2.7–9.0) vs. 1.5% (1.2–7.5) p = .01 and 12 months: 4.8% (1.1–9.6) vs. 1.1% (− 2.0–3.7) p = .01, respectively]. In addition, a larger percentage of non-Hispanic white demonstrated a 5% weight loss at 6 and 12 months. Employment was significantly related to 12-month weight loss, with retired participants being the most successful. Men, participants with graduate degrees, and those with higher income were most likely to meet the activity goal at baseline and 12 months. Differences in physical activity goal achievement across gender, education, and income groups were significant at baseline, attenuated after 6 months, then re-emerged at 12 months. Conclusions The DPP-GLB was effective in promoting weight loss and helped to alleviate disparities in physical activity levels after 6 months. Despite overall program success, differences in weight loss achievement by race/ethnicity were found and disparities in activity re-emerged after 12 months of intervention. These results support the need for intervention modification providing more tailored approaches to marginalized groups to maximize the achievement and maintenance of DPP-GLB behavioral goals. Trial registration NCT01050205, NCT02467881.

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

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.

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

2021 ◽  
Vol 12 ◽  
pp. 215013272110298
Author(s):  
Susan M. Devaraj ◽  
Bonny Rockette-Wagner ◽  
Rachel G. Miller ◽  
Vincent C. Arena ◽  
Jenna M. Napoleone ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Lifestyle Intervention ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Cardiovascular Health ◽  
Diabetes Prevention Program ◽  
Behavioral Risk ◽  
Community Based ◽  
The Impact

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.

scholarly journals A Community-Based Intervention Reduces Diabetes Risk in a Low-Income Community

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 155-155
Author(s):  
Jeneen Ali ◽  
Shavonnea Brown ◽  
Arlene Guindon ◽  
Sarah Mills ◽  
Alyssa Beavers ◽  
...  
Keyword(s):  
Weight Loss ◽  
Low Income ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Program Completion ◽  
Diabetes Risk ◽  
National Kidney Foundation ◽  
Food Bank ◽  
Community Based ◽  
Paired T Test

Abstract Objectives Promote diabetes prevention in low-income communities by offering Cooking MattersTM (CM) in coordination with the Diabetes Prevention Program (DPP). Reducing food insecurity is necessary for reducing chronic disease rates. DPP is a validated and effective intervention for reducing progression to Type II diabetes, but significant outcome disparities occur in low-income communities. Our research aims to address these outcome disparities. This study is a partnership between Gleaners Community Food Bank (GCFB), National Kidney Foundation of Michigan (NKFM), and Wayne State University. DPP, administered by NKFM, is a community-based intervention that significantly reduces diabetes risk. CM, locally administered through GCFB, is also an effective community program that teaches food skills, and provides food provisions. We hypothesize that combining DPP and CM in a low-income setting will improve program completion, and effectively reduce risk for progressing to Type 2 diabetes. Methods Over 12 months, low-income individuals participated in the combined DPP/CM study. Demographics were collected at the onset of the study. Survey information was collected for diet and physical activity at four time-points throughout the study. Body weight was collected at every session, and HbA1C was collected at the onset and conclusion of the program. Results Combining DPP and CM resulted in a 79% program completion rate. Mean HbA1C dropped 10.6% (paired t-test, P &lt; 0.01), and each participant demonstrated lower post-test HbA1C values. Participants experienced a mean weight loss of 7.6% (paired t-test, P &lt; 0.01), and &gt;75% of participants exceeded the 5% DPP weight loss outcome objective at 12 months. Conclusions Cooking Matters TM coupled with the Diabetes Prevention Program is an effective strategy to improve outcomes and reduce diabetes risk in low-income communities. Food bank resources can be coupled with existing chronic illness prevention programs to improve both disease risk and food security. Funding Sources Gleaners Community Food Bank and National Kidney Foundation of Michigan provided funding for this study.

scholarly journals The Pre-Diabetes Interventions and Continued Tracking to Ease-out Diabetes (Pre-DICTED) program: study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kar-Fu Yeung ◽  
Mihir Gandhi ◽  
Amanda Yun Rui Lam ◽  
Selly Julianty ◽  
Alvin Yeow Meng Chia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Plasma Glucose ◽  
Prevention Program ◽  
Financial Incentives ◽  
Diabetes Prevention ◽  
Controlled Trial ◽  
Diabetes Prevention Program ◽  
Community Based ◽  
Randomized Controlled

Abstract Background Community-based diabetes prevention programs varied widely in effectiveness, and the intervention strategy consisting of lifestyle interventions, stepwise addition of metformin, and financial incentives has not been studied in real-world clinical practice settings. The Pre-Diabetes Interventions and Continued Tracking to Ease-out Diabetes (Pre-DICTED) trial is a pragmatic trial that aims to compare the effectiveness of a community-based stepwise diabetes prevention program with added financial incentives (intervention) versus the standard of care (control) in reducing the risk of type 2 diabetes over 3 years among overweight or obese individuals with pre-diabetes. Methods This is an open-label, 1:1 randomized controlled trial which aims to recruit 846 adult individuals with isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT), or both IFG and IGT from Singapore. Intervention arm participants attend 12 group-based sessions (2 nutrition workshops, 9 exercise sessions, and a goal-setting workshop) delivered at community sites (weeks 1 to 6), receive weekly physical activity and nutrition recommendations delivered by printed worksheets (weeks 7 to 12), and receive monthly health tips delivered by text messages (months 4 to 36). From month 6 onwards, intervention arm participants who remain at the highest risk of conversion to diabetes are prescribed metformin. Intervention arm participants are also eligible for a payment/rewards program with incentives tied to attendance at the group sessions and achievement of the weight loss target (5% of baseline weight). All participants are assessed at baseline, month 3, month 6, and every 6 months subsequently till month 36. The primary endpoint is the proportion of participants with diabetes at 3 years. Secondary endpoints include the mean change from baseline at 3 years in fasting plasma glucose, 2-hour plasma glucose, HbA1c, body weight, body mass index, physical activity, and dietary intake. Discussion The Pre-DICTED trial will provide evidence of the effectiveness and feasibility of a community-based stepwise diabetes prevention program with added financial incentives for individuals with pre-diabetes in Singapore. The study will provide data for a future cost-effectiveness analysis, which will be used to inform policymakers of the value of a nationwide implementation of the diabetes prevention program. Trial registration ClinicalTrials.govNCT03503942. Retrospectively registered on April 20, 2018. Protocol version: 5.0 Date: 1 March 2019

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

Circulation ◽  
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.

The Pre-Diabetes Interventions and Continued Tracking to Ease-out Diabetes (Pre-DICTED) Program: Study Protocol for a Randomized Controlled Trial

2021 ◽  
Author(s):  
Kar-Fu Yeung ◽  
Mihir Gandhi ◽  
Amanda Yun Rui Lam ◽  
Selly Julianty ◽  
Alvin Yeow Meng Chia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Plasma Glucose ◽  
Prevention Program ◽  
Financial Incentives ◽  
Diabetes Prevention ◽  
Controlled Trial ◽  
Diabetes Prevention Program ◽  
Community Based ◽  
Randomized Controlled

Abstract BackgroundCommunity-based diabetes prevention programs varied widely in effectiveness, and the intervention strategy consisting of lifestyle interventions, stepwise addition of metformin and financial incentives has not been studied in real-world clinical practice settings. The Pre-Diabetes Interventions and Continued Tracking to Ease-out Diabetes (Pre-DICTED) trial is a pragmatic trial that aims to compare the effectiveness of a community-based stepwise diabetes prevention program with added financial incentives (intervention) versus the standard of care (control) in reducing the risk of type 2 diabetes over 3 years among overweight or obese individuals with pre-diabetes. MethodsThis is an open-label, 1:1 randomized controlled trial which aims to recruit 846 adult individuals with isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT), or both IFG and IGT from Singapore. Intervention arm participants attend 12 group-based sessions (2 nutrition workshops, 9 exercise sessions and a goal-setting workshop) delivered at community sites (weeks 1 to 6), receive weekly physical activity and nutrition recommendations delivered by printed worksheets (weeks 7 to 12), and receive monthly health tips delivered by text messages (months 4 to 36). From month 6 onwards, intervention arm participants who remain at the highest risk of conversion to diabetes are prescribed metformin. Intervention arm participants are also eligible for a payment/rewards program with incentives tied to attendance at the group sessions and achievement of the weight loss target (5% of baseline weight). All participants are assessed at baseline, month 3, month 6, and every 6 months subsequently till month 36. The primary endpoint is the proportion of participants with diabetes at 3 years. Secondary endpoints include the mean change from baseline at 3 years in fasting plasma glucose, 2-hour plasma glucose, HbA1c, body weight, body mass index, physical activity and dietary intake. DiscussionThe Pre-DICTED trial will provide evidence of the effectiveness and feasibility of a community-based stepwise diabetes prevention program with added financial incentives for individuals with pre-diabetes in Singapore. The study will provide data for a future cost-effectiveness analysis, which will be used to inform policymakers of the value of a nationwide implementation of the diabetes prevention program.Trial registrationClinicalTrials.gov ID: NCT03503942; April 20, 2018 retrospectively registered; https://clinicaltrials.gov/ct2/show/NCT03503942Protocol version: 5.0 Date: 1 March 2019

Effect of the National Diabetes Prevention Program on Weight Loss for English- and Spanish-Speaking Latinos

2017 ◽  
Vol 32 (3) ◽  
pp. 812-815 ◽  
Author(s):  
Natalie D. Ritchie ◽  
Liesel Christoe-Frazier ◽  
Kim K. McFann ◽  
Edward P. Havranek ◽  
Rocio I. Pereira
Keyword(s):  
Weight Loss ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Body Weight Loss ◽  
Diabetes Prevention Program ◽  
Spanish Language ◽  
Analysis Of Covariance ◽  
No Weight Loss ◽  
Control Cohort Study ◽  
Hispanic White

Purpose: To study the effect of the National Diabetes Prevention Program (NDPP) on weight loss in Latinos. Design: No-control, cohort study comparing Latino and non-Hispanic white (NHW) participants. Setting: A health-care system. Participants: Five hundred sixty-seven Latino and 175 NHW patients who enrolled in the NDPP. A total of 45.2% of Latinos selected the Spanish-language NDPP. Intervention: The NDPP is a nationwide translation of a clinical trial and seeks to prevent diabetes through weight loss in a yearlong group program. Measures: Independent variables included ethnicity, class language, and number of sessions attended. Main outcomes were initial attendance, number of sessions attended, and weight loss. Analysis: Multivariate logistic regression and analysis of covariance were used to determine differences in NDPP outcomes by ethnicity, language, and number of sessions attended. Results: Mean attendance was 8.60 of 22 sessions. Each session was associated with 0.30% (±0.02; P < .001) body weight loss. Latinos were half as likely to attend as NHWs, odds ratio 0.52 ( P < .001). Latino attendees came to 2.67 ± 0.63 ( P < .001) fewer sessions than NHWs. There were no weight loss differences by ethnicity after controlling for attendance. Outcomes did not differ among Latinos in the English- and Spanish-language NDPP. Conclusion: Latinos appeared to benefit less from the NDPP compared to NHWs, likely due to lower attendance rates. Further efforts are needed to support their participation.

scholarly journals Translating the Diabetes Prevention Program Lifestyle Intervention for Weight Loss Into Primary Care

2013 ◽  
Vol 173 (2) ◽  
pp. 113 ◽  
Author(s):  
Jun Ma ◽  
Veronica Yank ◽  
Lan Xiao ◽  
Philip W. Lavori ◽  
Sandra R. Wilson ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Lifestyle Intervention ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program
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