Comparative Effectiveness of Lifestyle Intervention Efforts in the Community

Abstract

OBJECTIVETo determine the comparative effectiveness of three lifestyle intervention modalities in decreasing risk for diabetes.RESEARCH DESIGN AND METHODSFive hundred and fifty-five individuals (86.1% female, 95.1% white, and 55.8% obese) from eight rural communities were screened for BMI ≥25 kg/m2 and waist circumference >40 inches in men and >35 inches in women. Communities with their eligible participants (n = 493; mean age 51 years, 87.6% female, 94.1% Caucasian) were assigned to four Group Lifestyle Balance (GLB) intervention groups: face to face (FF) (n = 119), DVD (n = 113), internet (INT) (n = 101), and self-selection (SS) (n = 101). SS participants chose the GLB modality. GLB is a comprehensive lifestyle behavior–change program.RESULTSA marked decline was observed in weight after the intervention in all groups (FF −12.5 lbs, P = 0.01; DVD −12.2 lbs, P < 0.0001; INT −13.7 lbs, P < 0.0001; and SS −14 lbs, P < 0.0001). Participants in SS experienced the largest average weight loss. Weight loss was sustained in >90% of participants in each group at 6 months (FF 90.7%, DVD 90.9%, INT 92.1%, and SS 100%). All groups experienced improvements in the proportion of participants with CVD risk factors. The proportion of individuals with CVD risk factors remained steady between 3 and 6 months in all groups and never returned back to baseline. All associations remained after multivariate adjustment.CONCLUSIONSDespite the modality, the GLB intervention was effective at decreasing weight and improving CVD risk factor control. SS and FF participants experienced greater improvements in outcomes compared with other groups, establishing the importance of patient-centered decision making and a support network for successful behavior change.

Lifestyle interventions based on the diabetes prevention program delivered via eHealth: A systematic review and meta-analysis

“…Other study designs were single group intervention studies (n=5) (McTigue et al, 2009; Pagoto et al, 2015; Sepah et al, 2014; Skoyen et al, 2015; Thomas and Wing, 2013), non-randomized controlled trials (n=2) (Kramer et al, 2010; Vadheim et al, 2010), a comparative effectiveness trial (n=1) (Piatt et al, 2013), and a retrospective cohort study (n=1) (Ahrendt et al, 2014). Mean length of study follow-up was 3.8 months and ranged from 3 to 15 months.…”

Improving Employee Health

“…The DPP-GLB program, delivered by DPSC trained prevention professionals in face to face groups and/or via DVD, has been shown to be effective in reducing weight and other risk factors for diabetes and CVD in several community settings (24, 25, 27-29, 32, 33, 35, 37), but has not been evaluated within a workplace setting.…”

Impact of Self-Preference Community Fitness Interventions in High-Risk African Americans

“…38, 39 Participants who were allowed to select either the modality or frequency of an intervention showed greater weight loss and higher session attendance in addition to lower dropout rates than participants who were assigned an intervention. 38, 39 Our study is rare in that all participants were allowed to select the intervention venue. While this was not our original design, it may be more appropriate for the real world, particularly in a situation where neither randomization nor even delayed cross-over was acceptable to participants.…”