Results From a Trial of an Online Diabetes Prevention Program Intervention

Tannaz Moin, Laura J. Damschroder, Mona AuYoung, Matthew L. Maciejewski, Kathryn Havens, Kristyn Ertl, Elena Vasti, Jane E. Weinreb, Nanette I. Steinle, Charles J. Billington, Maria Hughes, Fatima Makki, Bradley Youles, Robert G. Holleman, H. Myra Kim, Linda S. Kinsinger, Caroline R. Richardson

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

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 –4.7 kg at 6 months and –4.0 kg 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.

Original languageEnglish (US)
Pages (from-to)583-591
Number of pages9
JournalAmerican journal of preventive medicine
Volume55
Issue number5
DOIs
StatePublished - Nov 2018

Bibliographical note

Funding Information:
This work was funded by the VA (QUERI SDP-13-230, SDP 12-549 and NCP XVA 41-048). TM received support from VA QUERI (QUE 15-272) and Centers for Disease Control and Prevention/National Institute of Diabetes and Digestive and Kidney Diseases (U18DP006128) and NIH/National Institute of Diabetes and Digestive and Kidney Diseases (1R18DK105464-01) and the VA Office of Academic Affiliations through the VA Health Services Research and Development Advanced Fellowship Program (TPM65-010, 2011–2014). MAY received support through the VA Health Services Research and Development Advanced Postdoctoral Fellowship Program, VA Ann Arbor. MLM reported receiving support from the VA (RCS 10-391).

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