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Am J Prev Med. 2018 Nov;55(5):583-591. doi: 10.1016/j.amepre.2018.06.028. Epub 2018 Sep 24.

Results From a Trial of an Online Diabetes Prevention Program Intervention.

Author information

1
Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California; VA Health Services Research and Development, Center for Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California. Electronic address: tannaz.moin@va.gov.
2
Ann Arbor VA Center for Clinical Management Research, Ann Arbor, Michigan.
3
Department of Medicine, Durham VA Medical Center, Durham, North Carolina; Department of Medicine, Duke University School of Medicine, Durham, North Carolina.
4
Clement J. Zablocki VA Medical Center, Milwaukee, Wisconsin; Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
5
Clement J. Zablocki VA Medical Center, Milwaukee, Wisconsin.
6
Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California.
7
Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California.
8
Department of Medicine, Baltimore VA Medical Center, Baltimore, Maryland; Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
9
Department of Medicine, Minneapolis VA Healthcare System, Minneapolis, Minnesota; Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota.
10
Ann Arbor VA Center for Clinical Management Research, Ann Arbor, Michigan; Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, Michigan.
11
VHA National Center for Health Promotion and Disease Prevention, Durham, North Carolina.
12
Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, Michigan; Department of Family Medicine, University of Michigan, Ann Arbor, Michigan.

Abstract

INTRODUCTION:

Online Diabetes Prevention Programs (DPPs) can be scaled up and delivered broadly. However, little is known about real-world effectiveness and how outcomes compare with in-person DPP. This study examined online DPP weight loss and participation outcomes and secondarily compared outcomes among participating individuals with parallel in-person interventions.

STUDY DESIGN:

A large non-randomized trial supplemented by a comparative analysis of participating individuals from a concurrent trial of two parallel in-person programs: in-person DPP and the Veterans Administration's standard of care weight loss program (MOVE!).

SETTING/PARTICIPANTS:

Obese/overweight Veterans with prediabetes enrolled in online DPP (n = 268) between 2013 and 2014. Similar eligibility criteria were used to enroll in-person participants between 2012 and 2014 (n = 273 in-person DPP, n = 114 MOVE!) within a separate trial.

INTERVENTION:

Online DPP included a virtual group format, live e-coach, weekly modules delivered asynchronously, and wireless home scales. In-person programs included eight to 22 group-based, face-to-face sessions.

MAIN OUTCOMES MEASURES:

Weight change at 6 and 12 months using wirelessly uploaded home scale data or electronic medical record weights from clinical in-person visits. Outcomes were analyzed between 2015 and 2017.

RESULTS:

From 1,182 invitations, 268 (23%) participants enrolled in online DPP. Among these, 158 (56%) completed eight or more modules; mean weight change was -4.7kg at 6 months and -4.0kg at 12 months. In a supplemental analysis of participants completing one or more sessions/modules, online DPP participants were most likely to complete eight or more sessions/modules (87% online DPP vs 59% in-person DPP vs 55% MOVE!, p < 0.001). Online and in-person DPP participants lost significantly more weight than MOVE! participants at 6 and 12 months; there was no significant difference in weight change between online and in-person DPP.

CONCLUSIONS:

An intensive, multifaceted online DPP intervention had higher participation but similar weight loss compared to in-person DPP. An intensive, multifaceted online DPP intervention may be as effective as in-person DPP and help expand reach to those at risk.

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