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

Author(s):  
Natalie D. Ritchie ◽  
Katherine A. Sauder ◽  
Peter G. Kaufmann ◽  
Leigh Perreault

<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>

2021 ◽  
Author(s):  
Natalie D. Ritchie ◽  
Katherine A. Sauder ◽  
Peter G. Kaufmann ◽  
Leigh Perreault

<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>


2014 ◽  
Vol 6 (1) ◽  
pp. 01-12 ◽  
Author(s):  
Pouran D. Faghri ◽  
Rui Li

Purpose: To evaluate the effect of financial incentive in a diabetes prevention weight loss program at worksites. Design: Group-level randomized intervention study. Setting: Four long term care facilities, randomly assigned to “incentive-IG” or “non incentive- NIG” groups. Participants: Ninety-nine employees, all overweight or obese (BMI= mean 34.8+7.4 kg/m2) and at risk for type 2 diabetes. Intervention: A 16 weeks weight loss program (diabetes prevention program) with a 3 month follow up. IG could either choose a "standard incentive" to receive cash award when achieving the projected weight loss or to participate in a "standard plus deposit incentive" to get additional money matched with their deposit for projected weight loss. All of the participants received a one-hour consultation for a healthy weight loss at the beginning. Measures: Weight-loss, diabetes risk score (DRS), and cardiovascular risk outcomes. Analyses: Linear and logistic regressions for completed cases with adjustments for clustering effect at group level. Results: IG lost on average more pounds (p=0.027), reduced BMI (p=0.04), and reduced in DRS (p=0.011) compared to NIG at week 16. At the 12-week follow-up period, those in IG plus deposit subgroup had twice the odds (OR=2.2, p=0.042) and those in the standard IG had three times the odds of achieving weight loss goals than NIG; those in the IG plus deposit group reduced DRS by 0.4 (p=0.045). Conclusion: Monetary incentives appear to be effective in reducing weight and diabetes risk.


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