scholarly journals A 12-month follow-up of the Effects of a Digital Diabetes Prevention Program (VP Transform for Prediabetes) on Weight and Physical Activity among Adults With Prediabetes: Secondary Analysis (Preprint)

JMIR Diabetes ◽  
10.2196/23243 ◽  
2020 ◽  
Author(s):  
Ryan Batten ◽  
Meshari F Alwashmi ◽  
Gerald Mugford ◽  
Misa Nuccio ◽  
Angele Besner ◽  
...  
Keyword(s):  
Physical Activity ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Secondary Analysis ◽  
Diabetes Prevention Program

Weight and Physical Activity: a 12-month follow-up of a digital diabetes prevention program (VP Transform for Prediabetes) in adults with prediabetes (Preprint)

2020 ◽  
Author(s):  
Ryan Batten ◽  
Meshari F Alwashmi ◽  
Gerald Mugford ◽  
Misa Muccio ◽  
Angele Besner ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Secondary Analysis ◽  
Diabetes Prevention Program ◽  
Global Scale ◽  
Lifestyle Modifications ◽  
Behavior Tracking

BACKGROUND The prevalence of diabetes increasingly rapidly. Previous research has demonstrated the efficacy of a diabetes prevention program (DPP) in lifestyle modifications which can prevent or delay the onset of type 2 diabetes among individuals at-risk. Digital DPPs have the potential to utilize technology, in conjunction with behavior change science, to prevent prediabetes on a national and global scale OBJECTIVE The aim of this study was to investigate the effects of a digital DPP (VP Transform for Prediabetes) on weight loss and physical activity among participants who had completed twelve months of the program. METHODS This study was a secondary analysis of retrospective data of adults with prediabetes who were enrolled in VP Transform for Prediabetes for 12 months of the program. The program incorporates interactive mobile computing, remote monitoring, an evidence-based curriculum, behavior tracking tools, health coaching and online peer support to prevent or delay the onset of type 2 diabetes. Analysis included data that were collected at baseline and after 12 months of the VP Transform for Prediabetes DPP. RESULTS The sample (N=1,095) comprised people with prediabetes who completed 12 months of the VP Transform for Prediabetes program. Participants included 67.7% female, with a mean age of 53.6 (SD 9.75). On average, participants decreased their weight by 10.9 pounds (5.5%) and increased their physical activity by 91.2 minutes per week. CONCLUSIONS These results suggest that VP Transform for Prediabetes is effective at preventing type 2 diabetes through significant reduction in body weight and increase of physical activity. Furthermore, these results suggest that the DPP remains effective 12 months after beginning the program. A prospective, controlled clinical study is warranted to validate these findings.

scholarly journals Patient-Centered Goal-Setting in the National Diabetes Prevention Program: A Pilot Study

2021 ◽  
Author(s):  
Natalie D. Ritchie ◽  
Katherine A. Sauder ◽  
Peter G. Kaufmann ◽  
Leigh Perreault
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Patient Centered ◽  
Weekly Physical Activity ◽  
One Year ◽  
Design And Methods

<b>Introduction: </b>Difficulty achieving preset goals (e.g., ≥5% weight loss, ≥150 minutes of weekly physical activity) in the yearlong National Diabetes Prevention Program (NDPP) can prompt dropout and diminish benefits. We piloted a more patient-centered NDPP adaptation (NDPP-Flex) that promotes a variety of attainable and individually-tailored goals to reduce diabetes risks, along with flexibility to adjust goals each week as needed. <p><b>Research Design and Methods: </b>Retention, physical activity, weight, and HbA1c were evaluated among diverse participants with diabetes risks who received our pilot of NDPP-Flex beginning in January and July 2018 (<i>n</i>=95), with a planned comparison to standard NDPP delivery in preceding cohorts that launched between September 2016 and October 2017 (<i>n</i>=245). Both the standard NDPP and NDPP-Flex interventions were one year in duration and implemented in phases (i.e., non-randomized). </p> <p><b>Results: </b>Average adjusted retention (e.g., 158.90 ± 15.20 vs. 166.71 ± 9.38 days; <i>P</i>=.674), physical activity (157.97 ± 11.91 vs. 175.64 ± 7.54 weekly minutes; <i>P</i>=.231), and weight loss (1.46 ± 0.38% vs. 1.90 ± 0.24%; <i>P</i>=.396) were similar between NDPP-Flex versus standard NDPP. However, NDPP-Flex participants had greater HbA1c reduction on average (0.22 ± 0.05% vs. 0.06 ± 0.03%, <i>P</i>=.018) and were more likely to have normoglycemia at follow-up (OR 4.62; <i>P</i>=.013; 95% CI 1.38-15.50) than participants in the standard NDPP. </p> <p><b>Conclusions: </b>An adapted, more patient-centered NDPP that focuses on flexible, self-selected goals may be a promising strategy to improve glycemia even in the absence of substantial weight loss.<b></b></p>

scholarly journals Patient-Centered Goal-Setting in the National Diabetes Prevention Program: A Pilot Study

2021 ◽  
Author(s):  
Natalie D. Ritchie ◽  
Katherine A. Sauder ◽  
Peter G. Kaufmann ◽  
Leigh Perreault
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Patient Centered ◽  
Weekly Physical Activity ◽  
One Year ◽  
Design And Methods

<b>Introduction: </b>Difficulty achieving preset goals (e.g., ≥5% weight loss, ≥150 minutes of weekly physical activity) in the yearlong National Diabetes Prevention Program (NDPP) can prompt dropout and diminish benefits. We piloted a more patient-centered NDPP adaptation (NDPP-Flex) that promotes a variety of attainable and individually-tailored goals to reduce diabetes risks, along with flexibility to adjust goals each week as needed. <p><b>Research Design and Methods: </b>Retention, physical activity, weight, and HbA1c were evaluated among diverse participants with diabetes risks who received our pilot of NDPP-Flex beginning in January and July 2018 (<i>n</i>=95), with a planned comparison to standard NDPP delivery in preceding cohorts that launched between September 2016 and October 2017 (<i>n</i>=245). Both the standard NDPP and NDPP-Flex interventions were one year in duration and implemented in phases (i.e., non-randomized). </p> <p><b>Results: </b>Average adjusted retention (e.g., 158.90 ± 15.20 vs. 166.71 ± 9.38 days; <i>P</i>=.674), physical activity (157.97 ± 11.91 vs. 175.64 ± 7.54 weekly minutes; <i>P</i>=.231), and weight loss (1.46 ± 0.38% vs. 1.90 ± 0.24%; <i>P</i>=.396) were similar between NDPP-Flex versus standard NDPP. However, NDPP-Flex participants had greater HbA1c reduction on average (0.22 ± 0.05% vs. 0.06 ± 0.03%, <i>P</i>=.018) and were more likely to have normoglycemia at follow-up (OR 4.62; <i>P</i>=.013; 95% CI 1.38-15.50) than participants in the standard NDPP. </p> <p><b>Conclusions: </b>An adapted, more patient-centered NDPP that focuses on flexible, self-selected goals may be a promising strategy to improve glycemia even in the absence of substantial weight loss.<b></b></p>

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

Circulation ◽  
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.

scholarly journals Effects of Mobile Health Prompts on Self-Monitoring and Exercise Behaviors Following a Diabetes Prevention Program: Secondary Analysis From a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Megan M MacPherson ◽  
Kohle J Merry ◽  
Sean R Locke ◽  
Mary E Jung
Keyword(s):  
Mobile Health ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Secondary Analysis ◽  
Diabetes Prevention Program ◽  
Exercise Behavior ◽  
Moderate Intensity ◽  
User Engagement ◽  
Self Monitoring ◽  
Exercise Behaviors

BACKGROUND A number of mobile health (mHealth) apps exist that focus specifically on promoting exercise behavior. To increase user engagement, prompts, such as text messages, emails, or push notifications, are often used. To date, little research has been done to understand whether, and for how long, these prompts influence exercise behavior. OBJECTIVE This study aimed to assess the impact of prompts on mHealth self-monitoring and self-reported exercise in the days following a prompt and whether these effects differ based on exercise modality. METHODS Of the possible 99 adults at risk for developing type II diabetes who participated in a diabetes prevention program, 69 were included in this secondary analysis. Participants were randomly assigned to 1 of the following 2 exercise conditions: high-intensity interval training or moderate-intensity continuous training. In the year following a brief, community-based diabetes prevention program involving counseling and supervised exercise sessions, all participants self-monitored their daily exercise behaviors on an mHealth app in which they were sent personalized prompts at varying frequencies. mHealth self-monitoring and self-reported exercise data from the app were averaged over 1, 3, 5, and 7 days preceding and following a prompt and subsequently compared using t tests. RESULTS In the year following the diabetes prevention program, self-monitoring (t68=6.82; P<.001; d=0.46) and self-reported exercise (t68=2.16; P=.03; d=0.38) significantly increased in the 3 days following a prompt compared with the 3 days preceding. Prompts were most effective in the first half of the year, and there were no differences in self-monitoring or self-reported exercise behaviors between exercise modalities (P values >.05). In the first half of the year, self-monitoring was significant in the 3 days following a prompt (t68=8.61; P<.001; d=0.60), and self-reported exercise was significant in the 3 days (t68=3.7; P<.001; d=0.37), 5 days (t67=2.15; P=.04; d=0.14), and 7 days (t68=2.46; P=.02; d=0.15) following a prompt, whereas no significant changes were found in the second half of the year. CONCLUSIONS This study provides preliminary evidence regarding the potential influence of prompts on mHealth self-monitoring and self-reported exercise and the duration for which prompts may be effective as exercise behavior change tools. Future studies should determine the optimal prompting frequency for influencing self-reported exercise behaviors. Optimizing prompt frequency can potentially reduce intervention costs and promote user engagement. Furthermore, it can encourage consumers to self-monitor using mHealth technology while ensuring prompts are sent when necessary and effective. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR2-10.2196/11226

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.

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