Lifestyle Intervention for Prevention of Type 2 Diabetes in Primary Health Care: One-year follow-up of the Finnish National Diabetes Prevention Program (FIN-D2D)

Background Type 2 diabetes mellitus (T2DM) is an international problem of alarming epidemic proportions. T2DM can develop due to multiple factors, and it usually begins with prediabetes. Fortunately, this disease can be prevented by following a healthy lifestyle. However, many health care systems fail to properly educate the public on disease prevention and to offer support in embracing behavioral interventions to prevent diabetes. SMS messaging has been combined with cost-effective ways to reach out to the population at risk for medical comorbidities. To our knowledge, the use of nationwide SMS messaging in the Middle East as a screening tool to identify individuals who might be at risk of developing T2DM has not been reported in the literature. Objective The primary aim of this study was to assess the feasibility of conducting a series of SMS messaging campaigns directed at random smartphone users in Kuwait for the detection and prevention of T2DM. It was predicted that 1% of those receiving the text message would find it relevant and participate in the study. The secondary aim of this study was to assess the incidence of participation of those who were forwarded the initial text message by family members and friends. Methods In this study, 5 separate text message screening campaigns were launched inviting recipients to answer 6 questions to determine the risk of developing T2DM. If subjects agreed to participate, a link to the prediabetes screening test devised by the Centers for Disease Control and Prevention was automatically transmitted to their mobile devices. Those identified as high risk were invited to participate in a diabetes prevention program. Results A total of 180,000 SMSs were sent to approximately 6% of the adult population in Kuwait. Of these, 0.14% (260/180,000) of the individuals who received the SMS agreed to participate, of whom 58.8% (153/260) completed the screening. Surprisingly, additional surveys were completed by 367 individuals who were invited via circulated SMS messages forwarded by family members and friends. Altogether, 23.3% (121/520) qualified and agreed to participate in a diabetes prevention program. The majority of those who chose to participate in the prevention program were overweight, aged 45-65 years, and reported being less physically active than those who chose not to participate (χ22=42.1, P<.001). Conclusions Although health care screening via text messaging was found to have limited effectiveness by itself, it exhibited increased reach through shared second-party social media messaging. Despite the fact a subpopulation at possible risk of developing T2DM could be reached via text messaging, most responders were informed about the screening campaign by family and friends. Future research should be designed to tap into the benefits of social media use in health risk campaigns.

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Predictors of completing a primary health care diabetes prevention intervention programme in people at high risk of type 2 diabetes

Medicine ◽

10.1097/md.0000000000009790 ◽

2018 ◽

Vol 97 (5) ◽

pp. e9790 ◽

Cited By ~ 3

Author(s):

Aleksandra Gilis-Januszewska ◽

Jaana Lindström ◽

Noël C Barengo ◽

Jaakko Tuomilehto ◽

Peter EH Schwarz ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Care ◽

Primary Health Care ◽

High Risk ◽

Diabetes Prevention ◽

Intervention Programme ◽

Prevention Intervention ◽

Primary Health

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Cost-effectiveness of the SLIMMER diabetes prevention intervention in Dutch primary health care: economic evaluation from a randomised controlled trial

BMC Health Services Research ◽

10.1186/s12913-019-4529-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Geerke Duijzer ◽

Andrea J. Bukman ◽

Aafke Meints-Groenveld ◽

Annemien Haveman-Nies ◽

Sophia C. Jansen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Care ◽

Primary Health Care ◽

Cost Effectiveness ◽

Lifestyle Intervention ◽

Diabetes Prevention ◽

Cost Effective ◽

Primary Health ◽

The Cost

Abstract Background Although evidence is accumulating that lifestyle modification may be cost-effective in patients with prediabetes, information is limited on the cost-effectiveness of interventions implemented in public health and primary health care settings. Evidence from well-conducted pragmatic trials is needed to gain insight into the realistic cost-effectiveness of diabetes prevention interventions in real-world settings. The aim of this study is to assess the cost-effectiveness of the SLIMMER lifestyle intervention targeted at patients at high risk of developing type 2 diabetes compared with usual health care in a primary care setting in the Netherlands. Methods Three hundred and sixteen high-risk subjects were randomly assigned to the SLIMMER lifestyle intervention or to usual health care. Costs and outcome assessments were performed at the end of the intervention (12 months) and six months thereafter (18 months). Costs were assessed from a societal perspective. Patients completed questionnaires to assess health care utilisation, participant out-of-pocket costs, and productivity losses. Quality Adjusted Life Years (QALY) were calculated based on the SF-36 questionnaire. Cost-effectiveness planes and acceptability curves were generated using bootstrap analyses. Results The cost-effectiveness analysis showed that the incremental costs of the SLIMMER lifestyle intervention were €547 and that the incremental effect was 0.02 QALY, resulting in an incremental cost-effectiveness ratio (ICER) of €28,094/QALY. When cost-effectiveness was calculated from a health care perspective, the ICER decreased to €13,605/QALY, with a moderate probability of being cost-effective (56% at a willingness to pay, WTP, of €20,000/QALY and 81% at a WTP of €80,000/QALY). Conclusions The SLIMMER lifestyle intervention to prevent type 2 diabetes had a low to moderate probability of being cost-effective, depending on the perspective taken. Trial registration The SLIMMER study is retrospectively registered with ClinicalTrials.gov (Identifier NCT02094911) since March 19, 2014.

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Shifting the Care of Type 2 Diabetes Mellitus from Hospital to Primary Health Care Institutions through an Educational Intervention for Health Care Professionals: An Example from Rural China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17062076 ◽

2020 ◽

Vol 17 (6) ◽

pp. 2076

Author(s):

Shaofan Chen ◽

Dongfu Qian ◽

Bo Burström

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Health Care ◽

Health Care Professionals ◽

Intervention Group ◽

Control Group ◽

Primary Health ◽

One Year

This study assessed the impact of an educational intervention on the knowledge, attitudes, and practice regarding Type 2 Diabetes Mellitus (T2DM) of Primary Health Care (PHC) professionals, as well as on the types of T2DM care services which they were able to provide. The intervention was carried out in collaboration with county hospitals. The study was conducted from 2015 to 2016 among 241 health care professionals in 18 township health centers and 55 village clinics in three counties in Jiangsu Province, randomly divided into an intervention group and a control group. Participants in the intervention group received professional skills training sessions and team communication and were involved in regular meetings. The control group followed the routine work plan. At one-year follow up, the diabetes knowledge score, practice score, and attitudes score were significantly higher in the intervention group than in the control group. A significantly higher proportion of health care professionals in the intervention group was able to provide services compared with the control group, for all types of services, except T2DM emergency treatment. The intervention among health care professionals in PHC had a positive impact on their professional diabetes skills, knowledge, attitudes, practices, and types of services they were able to provide, at one-year follow-up.

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Secondary Impact of Social Media via Text Message Screening for Type 2 Diabetes Risk in Kuwait: Survey Study (Preprint)

10.2196/preprints.20532 ◽

2020 ◽

Author(s):

Naeema Alqabandi ◽

Ebaa Al-Ozairi ◽

Adel Ahmed ◽

Edgar L Ross ◽

Robert N Jamison

Keyword(s):

Type 2 Diabetes ◽

Health Care ◽

At Risk ◽

Social Media ◽

Prevention Program ◽

Text Messaging ◽

Diabetes Prevention ◽

Text Message ◽

Diabetes Prevention Program

BACKGROUND Type 2 diabetes mellitus (T2DM) is an international problem of alarming epidemic proportions. T2DM can develop due to multiple factors, and it usually begins with prediabetes. Fortunately, this disease can be prevented by following a healthy lifestyle. However, many health care systems fail to properly educate the public on disease prevention and to offer support in embracing behavioral interventions to prevent diabetes. SMS messaging has been combined with cost-effective ways to reach out to the population at risk for medical comorbidities. To our knowledge, the use of nationwide SMS messaging in the Middle East as a screening tool to identify individuals who might be at risk of developing T2DM has not been reported in the literature. OBJECTIVE The primary aim of this study was to assess the feasibility of conducting a series of SMS messaging campaigns directed at random smartphone users in Kuwait for the detection and prevention of T2DM. It was predicted that 1% of those receiving the text message would find it relevant and participate in the study. The secondary aim of this study was to assess the incidence of participation of those who were forwarded the initial text message by family members and friends. METHODS In this study, 5 separate text message screening campaigns were launched inviting recipients to answer 6 questions to determine the risk of developing T2DM. If subjects agreed to participate, a link to the prediabetes screening test devised by the Centers for Disease Control and Prevention was automatically transmitted to their mobile devices. Those identified as high risk were invited to participate in a diabetes prevention program. RESULTS A total of 180,000 SMSs were sent to approximately 6% of the adult population in Kuwait. Of these, 0.14% (260/180,000) of the individuals who received the SMS agreed to participate, of whom 58.8% (153/260) completed the screening. Surprisingly, additional surveys were completed by 367 individuals who were invited via circulated SMS messages forwarded by family members and friends. Altogether, 23.3% (121/520) qualified and agreed to participate in a diabetes prevention program. The majority of those who chose to participate in the prevention program were overweight, aged 45-65 years, and reported being less physically active than those who chose not to participate (χ22=42.1, P<.001). CONCLUSIONS Although health care screening via text messaging was found to have limited effectiveness by itself, it exhibited increased reach through shared second-party social media messaging. Despite the fact a subpopulation at possible risk of developing T2DM could be reached via text messaging, most responders were informed about the screening campaign by family and friends. Future research should be designed to tap into the benefits of social media use in health risk campaigns.

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An active patient approach to improve patient with Type 2 diabetes in primary health care center (Puskesmas)

PsycEXTRA Dataset ◽

10.1037/e627722013-417 ◽

2013 ◽

Author(s):

Rosana Ika Pramitasari ◽

Kwartarini Wahyu Yuniarti

Keyword(s):

Type 2 Diabetes ◽

Health Care ◽

Primary Health Care ◽

Care Center ◽

Primary Health Care Center ◽

Health Care Center ◽

Primary Health ◽

Active Patient ◽

Improve Patient

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

10.2196/preprints.23243 ◽

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.

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