A Randomized Controlled Trial of a Community-based Behavioral Counseling Program

Johnston, Craig A.; Rost, Stephanie; Miller-Kovach, Karen; Moreno, Jennette P.; Foreyt, John P.

doi:10.1016/j.amjmed.2013.04.025

Cited by 42 publications

(66 citation statements)

References 14 publications

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“…While diabetes prevention programs are on the increase, there are still far too few to meet the current and expanding public health need. The data from this study show that a widely available weight management program results in changes in body weight after 18 and 24 months that are comparable to those observed in the DPP study and community [15][16][17][18][19] adaptations . The program studied here, Weight Watchers, is an evidence-based lifestyle intervention that combines face to face and digital offerings.…”

Section: Discussionsupporting

confidence: 63%

The Two-Year Outcomes and Cost Effectiveness of a Commercial Weight Loss Program for the Prevention of Type 2 Diabetes among People with Prediabetes

Palmer¹,

Saha²,

Phillips³

et al. 2018

Endocrinol Diabetes Obes

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Objectives: There is solid evidence that risk for developing type 2 diabetes can be prevented by lifestyle interventions. However, there are few diabetes prevention programs available. Given the increasing prevalence of prediabetes, we sought to investigate if a commercial weight loss program with significant capacity could address this need. This study, conducted in Indianapolis, Indiana in 2014-16, investigated if (Weight Watchers-WW) could cost effectively achieve and sustain sufficient weight loss in persons with prediabetes to reduce diabetes risk for 24 months. Methods:A previous, randomized controlled trial evaluated the effectiveness of the WW program in 225 persons with prediabetes as determined by an HbA1c value ≥5.7% and ≤6.4% or a self-reported history of gestational diabetes with an HbA1c <6.5% and/or casual capillary blood glucose (CCBG) <199 mg/dL on weight and metabolic regulation compared with a self-initiated program developed by the National Diabetes Education Program over a 12-month study period. This continuation study assessed outcomes at 18 and 24 months and also evaluated cost effectiveness at 12 and 24 months from a third-party payer perspective. Since this study used a cross over design in which control subjects were provided access to the WW program from 12-24 months, they were no longer randomized. Results:Intervention participants lost significantly more weight than the controls both at 18 (-5.1% vs -1.8%, p ≤ .008)-and 24-months (-4.5% vs -1.8%, p ≤.032 ). Although both groups showed some improvement in CVD risk factors, the only significant difference between groups was that WW participants had greater reductions than controls in HbA1c at both 18 (-0.27 vs-0.17; p=.03) and 24 months (-0.3 vs -0.2; p=.04). Converting the weight loss into quality adjusted life years saved (QALYs) yielded an incremental cost effectiveness ratio (ICER) of $19,034 per QALY gained for the intervention. Sensitivity analyses showed the ICER was well below commonly accepted thresholds for cost effectiveness. Conclusion:These data suggest that evidence-based, widely available weight management programs have the potential to cost effectively improve health outcomes for patients with prediabetes. Given their affordability and scalability, increasing access could result in a significant public health impact.

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Section: Discussionsupporting

confidence: 63%

The Two-Year Outcomes and Cost Effectiveness of a Commercial Weight Loss Program for the Prevention of Type 2 Diabetes among People with Prediabetes

Palmer¹,

Saha²,

Phillips³

et al. 2018

Endocrinol Diabetes Obes

View full text Add to dashboard Cite

show abstract

“…Novel wearable devices capable of tracking activity and a range of biometrics are gaining societal acceptance. 41,42 Although a systematic review of this literature is beyond the scope of this manuscript, we, as educators, must embrace these trends in an effort to meet patients where they are-and likely will be-in the years ahead. Moreover, current and future health care trainees as well as patients who are "digital natives" will surely welcome the marriage of wearable device technology and routine medical care.…”

Section: Innovations Enabling Healthy Choicesmentioning

confidence: 98%

Nutrition Education in an Era of Global Obesity and Diabetes

Eisenberg

Burgess

2015

Academic Medicine

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In an era when rates of obesity, diabetes, and other lifestyle-related diseases challenge medical educators and governments worldwide, it is necessary to consider novel educational strategies, both didactic and experiential, whereby current and future health professionals can be better prepared to proactively advise and teach patients enhanced self-care skills (e.g., diet, movement, stress management, and enhanced behavioral change).In this Perspective, the authors summarize current circumstances involving rising rates of obesity and diabetes worldwide, the lack of nutrition- and lifestyle-related curricular requirements for professional medical certification, societal trends regarding modern food culture and food availability in health care settings, and the misalignment of financial incentives to promote health.The authors assess what elements of self-care should or should not be required within future curricula and certification exams. They consider how best to educate trainees about diet and how to "translate" nutrition, exercise, and behavioral science knowledge into practical advice. They explore several ideas for reforming nutrition education, including "teaching kitchens" as required laboratory classes for nutrition and lifestyle instruction, wearable technologies for tracking behaviors and physiological data relating to lifestyle choices, and the prospect of hospitals and other medical venues serving as exemplars of healthy, delicious food options. Finally, the authors argue that "salutogenesis"-the study of the creation and maintenance of health and well-being-should assume its rightful position alongside the study of "pathogenesis"-disease diagnosis and treatment-in medical education and practice.

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“…For example, when tested using a commercially available website, participants who completed food diaries online were more likely to achieve a 5% or 10% weight loss goal at 6 months compared with those who did not use the online tools. 30 In another study by Tate and colleagues, 38 participants in an online self-monitoring group lost a mean of 4.0 kg at 3 months and 4.1 kg by 6 months, whereas the education group without self-monitoring and feedback lost 1.7 kg at 3 months and 1.6 kg at 6 months.…”

Section: Web-based Self-monitoring Approachmentioning

confidence: 96%

“…More recent studies provide further evidence regarding the effect of different types of dietary self-monitoring on weight loss among different populations. 8, [27][28][29][30][31] Dietary self-monitoring can be categorized into three types: paper record (pen and paper records), web-based self-monitoring, and mobile devices (personal digital assistants, wearables, and mobile telephones). The efficacy, strengths, and weaknesses for each type of self-monitoring are discussed below.…”

Section: The Efficacy Of Self-monitoring In Weight Managementmentioning

confidence: 99%

Dietary Self-Monitoring in Weight Management: Current Evidence on Efficacy and Adherence

Yu¹,

Sealey‐Potts²,

Rodriguez³

2015

Journal of the Academy of Nutrition and Dietetics

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A Randomized Controlled Trial of a Community-based Behavioral Counseling Program

Cited by 42 publications

References 14 publications

The Two-Year Outcomes and Cost Effectiveness of a Commercial Weight Loss Program for the Prevention of Type 2 Diabetes among People with Prediabetes

The Two-Year Outcomes and Cost Effectiveness of a Commercial Weight Loss Program for the Prevention of Type 2 Diabetes among People with Prediabetes

Nutrition Education in an Era of Global Obesity and Diabetes

Dietary Self-Monitoring in Weight Management: Current Evidence on Efficacy and Adherence

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