scholarly journals Motivation and Problem Solving Versus Mobile 360° Videos to Promote Enrollment in the National Diabetes Prevention Program’s Lifestyle Change Program Among People With Prediabetes: Protocol for a Randomized Trial

10.2196/28884 ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. e28884
Author(s):  
Bryan Gibson ◽  
Sara Simonsen ◽  
Jonathan Barton ◽  
Yue Zhang ◽  
Roger Altizer ◽  
...  
Keyword(s):  
Problem Solving ◽  
Mobile Phone ◽  
Self Efficacy ◽  
Diabetes Prevention ◽  
Risk Perceptions ◽  
Best Practice ◽  
Lifestyle Change ◽  
Practice Condition ◽  
Phone Calls ◽  
Program Enrollment

Background More than 88 million Americans are at risk of developing type 2 diabetes mellitus (T2DM). The National Diabetes Prevention Program’s Lifestyle Change Program (DPP LCP) has been shown to be effective in reducing the risk of progressing from prediabetes to T2DM. However, most individuals who could benefit from the program do not enroll. Objective The aim of this trial is to test the real-world efficacy of 3 mobile phone–based approaches to increasing enrollment in the DPP LCP including a best-practice condition and 2 novel approaches. Methods We will conduct a 3-armed randomized clinical trial comparing enrollment and 1-month engagement in the DPP LCP among adults with prediabetes from 2 health care settings. Participants in the best-practice condition will receive SMS-based notifications that they have prediabetes and a link to a website that explains prediabetes, T2DM, and the DPP LCP. This will be followed by a single question survey, “Would you like the DPP LCP to call you to enroll?” Participants in the 2 intervention arms will receive the same best-practice intervention plus either 2 mobile 360° videos or up to 5 brief phone calls from a health coach trained in a motivational coaching approach known as Motivation and Problem Solving (MAPS). We will collect measures of diabetes-related knowledge, beliefs in the controllability of risk for T2DM, risk perceptions for T2DM, and self-efficacy for lifestyle change pre-intervention and 4 weeks later. The primary outcomes of the study are enrollment in the DPP LCP and 4-week engagement in the DPP LCP. In addition, data on the person-hours needed to deliver the interventions as well as participant feedback about the interventions and their acceptability will be collected. Our primary hypotheses are that the 2 novel interventions will lead to higher enrollment and engagement in the DPP LCP than the best-practice intervention. Secondary hypotheses concern the mechanisms of action of the 2 intervention arms: (1) whether changes in risk perception are associated with program enrollment among participants in the mobile 360° video group and (2) whether changes in self-efficacy for lifestyle change are associated with program enrollment among participants in the MAPS coaching group. Finally, exploratory analyses will examine the cost effectiveness and acceptability of the interventions. Results The project was funded in September 2020; enrollment began in February 2021 and is expected to continue through July 2022. Conclusions We are conducting a test of 2 novel, scalable, mobile phone–based interventions to increase enrollment in the DPP LCP. If effective, they have tremendous potential to be scaled up to help prevent T2DM nationwide. Trial Registration ClinicalTrials.gov NCT04746781; https://clinicaltrials.gov/ct2/show/NCT04746781 International Registered Report Identifier (IRRID) DERR1-10.2196/28884

scholarly journals Motivation and Problem Solving Versus Mobile 360° Videos to Promote Enrollment in the National Diabetes Prevention Program’s Lifestyle Change Program Among People With Prediabetes: Protocol for a Randomized Trial (Preprint)

2021 ◽  
Author(s):  
Bryan Gibson ◽  
Sara Simonsen ◽  
Jonathan Barton ◽  
Yue Zhang ◽  
Roger Altizer ◽  
...  
Keyword(s):  
Problem Solving ◽  
Mobile Phone ◽  
Self Efficacy ◽  
Diabetes Prevention ◽  
Risk Perceptions ◽  
Best Practice ◽  
Lifestyle Change ◽  
Practice Condition ◽  
Phone Calls ◽  
Program Enrollment

BACKGROUND More than 88 million Americans are at risk of developing type 2 diabetes mellitus (T2DM). The National Diabetes Prevention Program’s Lifestyle Change Program (DPP LCP) has been shown to be effective in reducing the risk of progressing from prediabetes to T2DM. However, most individuals who could benefit from the program do not enroll. OBJECTIVE The aim of this trial is to test the real-world efficacy of 3 mobile phone–based approaches to increasing enrollment in the DPP LCP including a best-practice condition and 2 novel approaches. METHODS We will conduct a 3-armed randomized clinical trial comparing enrollment and 1-month engagement in the DPP LCP among adults with prediabetes from 2 health care settings. Participants in the best-practice condition will receive SMS-based notifications that they have prediabetes and a link to a website that explains prediabetes, T2DM, and the DPP LCP. This will be followed by a single question survey, “Would you like the DPP LCP to call you to enroll?” Participants in the 2 intervention arms will receive the same best-practice intervention plus either 2 mobile 360° videos or up to 5 brief phone calls from a health coach trained in a motivational coaching approach known as Motivation and Problem Solving (MAPS). We will collect measures of diabetes-related knowledge, beliefs in the controllability of risk for T2DM, risk perceptions for T2DM, and self-efficacy for lifestyle change pre-intervention and 4 weeks later. The primary outcomes of the study are enrollment in the DPP LCP and 4-week engagement in the DPP LCP. In addition, data on the person-hours needed to deliver the interventions as well as participant feedback about the interventions and their acceptability will be collected. Our primary hypotheses are that the 2 novel interventions will lead to higher enrollment and engagement in the DPP LCP than the best-practice intervention. Secondary hypotheses concern the mechanisms of action of the 2 intervention arms: (1) whether changes in risk perception are associated with program enrollment among participants in the mobile 360° video group and (2) whether changes in self-efficacy for lifestyle change are associated with program enrollment among participants in the MAPS coaching group. Finally, exploratory analyses will examine the cost effectiveness and acceptability of the interventions. RESULTS The project was funded in September 2020; enrollment began in February 2021 and is expected to continue through July 2022. CONCLUSIONS We are conducting a test of 2 novel, scalable, mobile phone–based interventions to increase enrollment in the DPP LCP. If effective, they have tremendous potential to be scaled up to help prevent T2DM nationwide. CLINICALTRIAL ClinicalTrials.gov NCT04746781; https://clinicaltrials.gov/ct2/show/NCT04746781 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/28884

Mobile Virtual reality vs. Mobile 360 Video to Promote Enrollment in the Diabetes Prevention Program Amongst Hispanic Adults (Preprint)

2020 ◽  
Author(s):  
Bryan Gibson ◽  
Sara Simonsen ◽  
Jakob Jensen ◽  
Leah Yingling ◽  
Julia Schaeffer ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Virtual Reality ◽  
Health Literacy ◽  
Mobile Phone ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Risk Perceptions ◽  
Diabetes Prevention Program ◽  
Pilot Test

BACKGROUND The Diabetes Prevention Program (DPP) reduces the risk of developing Type 2 Diabetes, however enrollment is very low. OBJECTIVE The goal of this project was to pilot test the efficacy of two brief, immersive mobile phone videos (presented either in virtual reality or 360 video) on risk perceptions and enrollment in the DPP. METHODS Adults with prediabetes were recruited at a clinic serving a low income Hispanic community. After consenting, participants completed a baseline survey that collected demographics and risk perceptions based on the tripartite model of risk perceptions.. They were then informed that they had prediabetes and provided with a link to an educational website that explains: what prediabetes and Type 2 Diabetes (T2DM) are, how lifestyle affects risk of T2DM, what the DPP is, and where to enroll. Participants then viewed two videos using their smartphone ; either with a cardboard VR headset (VR) or their smartphone alone (360 video), per random assignment. Two weeks later a follow-up survey collected measures of: enrollment in the DPP, risk perceptions, health literacy, the importance of contextual factors related to the DPP in their decision of whether or not to enroll in the DPP (e.g. distance to the class ), and qualitative feedback on the interventions. We used logistic regression to determine whether enrollment in the DPP differed by intervention mode, while accounting for heath literacy and contextual factors related to the DPP. We used unpaired t-tests to examine differences in change in risk perceptions between groups. We used paired t-tests to examine within-subject changes in risk perceptions. RESULTS 116 participants provided complete data. Most participants were middle-aged (mean age= 44.6 yrs.; SD= 11.9) Hispanic (114/116), female (79/116), with low health literacy (mean score =12.3/20; SD=3.4). Enrollment in the DPP was 44/116 overall (37.9% ) but did not differ by group ( OR for enrolling in VR group= 1.78 ; 95% CI: 0.75-4.3, p=0.19) . Individuals who rated t the distance needed to travel to attend the DPP as more important were less likely to enroll in the DPP (OR = 0.56, 95% CI:0.33-0.92; p=0.03) Risk perceptions did not differ by group ( mean change in 360 video group = -0.07, mean change in VR group = 0.03, t==0.6, p= 0.54) and did not change within subjects ( mean 0.02, t=0.21, p=0.83). Participants feedback suggested that the videos are emotionally engaging and educational. CONCLUSIONS We present a pilot test of immersive mobile phone videos which appear to be efficacious in promoting enrollment in the DPP. Further work to determine the replicability of these findings, the mechanism of action of the videos, and potential moderators of the efficacy of these videos is discussed.

scholarly journals Efficacy of Mobile phone use on adherence to Nevirapine prophylaxis and retention in care among the HIV-exposed infants in prevention of mother to child transmission of HIV: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lilian M. N. Kebaya ◽  
Dalton Wamalwa ◽  
Nyambura Kariuki ◽  
Bashir Admani ◽  
Philip Ayieko ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Infant Feeding ◽  
Retention In Care ◽  
Control Group ◽  
Hiv Exposed Infants ◽  
Randomized Controlled ◽  
Phone Calls ◽  
Hiv Exposed ◽  
To Receive

Abstract Background HIV is a major contributor to infant mortality. A significant gap remains between the uptake of infant and maternal antiretroviral regimens and only a minority of HIV-exposed infants receives prophylaxis and safe infant feeding. Losses to follow-up of HIV-exposed infants are associated with shortcomings of facility-based PMTCT models with weak community support of linkages. Use of mobile phones offers an opportunity for improving care and promoting retention assessed by timely attendance of scheduled appointments for the mother-baby pairs and achievement of an HIV-free generation. The objective of this study was to compare self-reported adherence to infant Nevirapine (NVP) prophylaxis and retention in care assessed by timely attendance of scheduled appointments over 10 weeks in HIV exposed infants randomized to 2-weekly mobile phone calls (intervention) versus no phone calls (control). Methods In this open label randomized controlled study, one hundred and fifty HIV infected women drawn from 3 health facilities in Western Kenya and their infants were randomly assigned to receive either phone-based reminders on PMTCT messages or standard health care messages (no calls) within 24 h of delivery. Women in the intervention arm continued to receive fortnightly phone calls. At 6- and 10-weeks following randomization we collected data on infant adherence to Nevirapine, mode of infant feeding, early HIV testing and retention in care in both study arms. All analyses were intention to treat. Results At 6 weeks follow-up, 90.7% (n = 68) of participants receiving phone calls reported adherence to infant NVP prophylaxis, compared with 72% (n = 54) of participants in the control group (p = 0.005). Participants in the intervention arm were also significantly more likely to remain in care than participants in the control group [78.7% (n = 59) vs. 58.7% (n = 44), p = 0.009 at 6 weeks and 69.3% (n = 52) vs. 37.3% (n = 28), p < 0.001 at 10 weeks]. Conclusions These results suggest that phone calls are potentially an important tool to improve adherence to infant NVP prophylaxis and retention in care for HIV-exposed infants. Trial registration PACTR202007654729602. Registered 6 June 2018 - Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3449

scholarly journals Social Networks, Trust, and Disaster-Risk Perceptions of Rural Residents in a Multi-Disaster Environment: Evidence from Sichuan, China

2021 ◽  
Vol 18 (4) ◽  
pp. 2106 ◽  
Author(s):  
Kaijing Xue ◽  
Shili Guo ◽  
Yi Liu ◽  
Shaoquan Liu ◽  
Dingde Xu
Keyword(s):  
Social Networks ◽  
Risk Perception ◽  
Self Efficacy ◽  
Risk Perceptions ◽  
Ordinary Least Squares ◽  
Disaster Risk ◽  
Mountainous Areas ◽  
Rural Residents ◽  
Response Efficacy ◽  
The Impact

Individual perception of disaster risk is not only the product of individual factors, but also the product of social interactions. However, few studies have empirically explored the correlations between rural residents’ flat social networks, trust in pyramidal channels, and disaster-risk perceptions. Taking Sichuan Province—a typical disaster-prone province in China—as an example and using data from 327 rural households in mountainous areas threatened by multiple disasters, this paper measured the level of participants’ disaster-risk perception in the four dimensions of possibility, threat, self-efficacy, and response efficacy. Then, the ordinary least squares method was applied to probe the correlations between social networks, trust, and residents’ disaster-risk perception. The results revealed four main findings. (1) Compared with scores relating to comprehensive disaster-risk perception, participants had lower perception scores relating to possibility and threat, and higher perception scores relating to self-efficacy and response efficacy. (2) The carrier characteristics of their social networks significantly affected rural residents’ perceived levels of disaster risk, while the background characteristics did not. (3) Different dimensions of trust had distinct effects on rural residents’ disaster-risk perceptions. (4) Compared with social network variables, trust was more closely related to the perceived level of disaster risks, which was especially reflected in the impact on self-efficacy, response efficacy, and comprehensive perception. The findings of this study deepen understanding of the relationship between social networks, trust, and disaster-risk perceptions of rural residents in mountainous areas threatened by multiple disasters, providing enlightenment for building resilient disaster-prevention systems in the community.

scholarly journals Choice of Intensive Lifestyle Change and/or Metformin after Shared Decision Making for Diabetes Prevention: Results from the Prediabetes Informed Decisions and Education (PRIDE) Study

2021 ◽  
pp. 0272989X2110012
Author(s):  
Tannaz Moin ◽  
Jacqueline M. Martin ◽  
Carol M. Mangione ◽  
Jonathan Grotts ◽  
Norman Turk ◽  
...  
Keyword(s):  
Decision Making ◽  
Usual Care ◽  
Shared Decision Making ◽  
Diabetes Prevention ◽  
Lifestyle Change ◽  
Diabetes Incidence ◽  
Shared Decision ◽  
Informed Decisions ◽  
Unit Increase ◽  
Pride Study

Introduction While the Diabetes Prevention Program Study demonstrated that intensive lifestyle change and metformin both reduce type 2 diabetes incidence, there are little data on patient preferences in real-world, clinical settings. Methods The Prediabetes Informed Decisions and Education (PRIDE) study was a cluster-randomized trial of shared decision making (SDM) for diabetes prevention. In PRIDE, pharmacists engaged patients with prediabetes in SDM using a decision aid with information about both evidence-based options. We recorded which diabetes prevention option(s) participants chose after the SDM visit. We also evaluated logistic regression models examining predictors of choosing intensive lifestyle change ± metformin, compared to metformin or usual care, and predictors of choosing metformin ± intensive lifestyle change, compared to intensive lifestyle change or usual care. Results Among PRIDE participants ( n = 515), 55% chose intensive lifestyle change, 8.5% chose metformin, 15% chose both options, and 21.6% declined both options. Women (odds ratio [OR] = 1.60, P = 0.023) had higher odds than men of choosing intensive lifestyle change. Patients >60 years old (OR = 0.50, P = 0.028) had lower odds than patients <50 years old of choosing metformin. Participants with higher body mass index (BMI) had higher odds of choosing intensive lifestyle change (OR = 1.07 per BMI unit increase, P = 0.005) v. other options and choosing metformin (OR = 1.06 per BMI unit increase, P = 0.008) v. other options. Conclusions Patients with prediabetes are making choices for diabetes prevention that generally align with recommendations and expected benefits from the published literature. Our results are important for policy makers and clinicians, as well as program planners developing systemwide approaches for diabetes prevention.

scholarly journals Risk perception regarding the COVID-19 outbreak among the general population: a comparative Middle East survey

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Mahmoud Abdel Hameed Shahin ◽  
Rasha Mohammed Hussien
Keyword(s):  
Risk Perception ◽  
General Population ◽  
Self Efficacy ◽  
Risk Perceptions ◽  
Preventive Measures ◽  
Public Awareness ◽  
Cross Sectional ◽  
Convenience Sample ◽  
The Mean ◽  
Novel Coronavirus

Abstract Background People’s perceptions of pandemic-associated risk are key factors contributing to increased public participation in disease preventive measures. The aim of the study was to investigate risk perceptions regarding the coronavirus disease 2019 (COVID-19) outbreak, among the general population. A descriptive, cross-sectional design was used with a convenience sample of 723 participants, recruited from the general population of Saudi Arabia, Egypt, and Jordan. Data collection was performed using a standardized risk perception assessment questionnaire, in April 2020. Results The mean score for the perception of COVID-19 seriousness was significantly higher and the mean scores for the perception of disease susceptibility and extent of anxiety were also higher among Saudi Arabian participants than participants from Egypt and Jordan. Participants from Egypt had significantly lower mean scores for the perception of efficacy and self-efficacy to cope with COVID-19, and significantly lower intention to comply with COVID-19 precautionary measures than the other populations. A significant positive correlation was detected between the perception of COVID-19 seriousness and self-efficacy to handle COVID-19, for the entire sample. The primary reasons reported by participants driving their willingness to perform certain preventive measures against COVID-19 was a feeling of responsibility toward their own health, followed by preventing transmission to other people and the feeling that COVID-19 can be serious. Most of the study sample reported a desire to receive information about COVID-19 treatment, ways to prevent disease contraction, and the incubation period for the novel coronavirus. Also, most of the study sample reported that they prefer receiving COVID-19 updates from national authorities. Conclusions During the COVID-19 pandemic, communications designed to promote the adoption of preventive behaviors should focus on increasing the perception of seriousness, the risk perception, self-efficacy to cope with the COVID-19 pandemic, and the effectiveness of the adopted behavioral measures for reducing risk. Health education programs that are tailored to various sociodemographic categories, to improve public awareness, perceptions, and attitudes, are vital for increasing the adoption of outbreak preventive measures.

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