Effects of a Digital Diabetes Prevention Program: An RCT

Katula, Jeffrey A.; Dressler, Emily V.; Kittel, Carol; Harvin, Lea N.; Almeida, Fabio A.; Wilson, Kathryn E.; Michaud, Tzeyu L.; Porter, Gwenndolyn; Goessl, Cody; Jasik, Carolyn Bradner; Sweet, Cynthia Castro; Estabrooks, Paul A.

doi:10.1016/j.amepre.2021.10.023

Cited by 42 publications

(86 citation statements)

References 27 publications

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“…However, the success of these passive strategies in recruiting larger numbers of rural participants and the potential of including collaborations with rural healthcare providers and other community partners on improving participant recruitment and retention through CE are unknown and worthy of investigation. A recent trial testing the effectiveness of a commercial digital-DPP [ 12 ] used the population health management approach, which entailed an electronic health record query with local healthcare providers, an initial physician review of patients identified, sending a letter invitation with an option to mail back an ‘opt-out of care’ postcard, and then a telephone follow-up for those not opting out [ 13 ]. This method of recruitment is considered active [ 14 , 15 ] and may have the potential to increase the diversity and representativeness of the target population the NDPP is trying to reach.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Comparative Effectiveness for the Delivery of the National Diabetes Prevention Program through Cooperative Extension in Rural Communities

Gorczyca

Washburn

Smith

et al. 2022

IJERPH

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The U.S. Cooperative Extension Service (CE) has potential to deliver the National Diabetes Prevention Program (NDPP) to rural residents with prediabetes. However, the CE remains underutilized for the delivery of NDPP. We compared the feasibility/effectiveness of the NDPP (0–6 mos.) delivered by CE personnel to rural residents with prediabetes using Zoom® (CE-Zoom®) or by our research staff using Facebook® (FB). Adults (n = 31, age ~55 years) were enrolled (CE-Zoom® n = 16, FB n = 15). Attendance did not differ significantly between groups (CE Zoom® = 69%, FB = 83%, p = 0.15). Participant retention was similar in the CE Zoom® (88%) and FB groups (87%). CE-Zoom® and FB® groups provided weekly, self-monitoring data for 83% and 84% of the 24 potential weeks, respectively. Six-month weight loss was not different between groups (CE-Zoom® = −5.99 ± 8.0 kg, −5.4%, FB = −1.68 ± 3.3 kg, −1.6% p = 0.13). Participants achieving ≥5% weight loss was greater in the CE-Zoom® (44%) compared with the FB group (7%, p = 0.04). Participants achieving the NDPP program goal for physical activity (≥150 min/week) did not differ (CE-Zoom® = 75%, FB = 67%, p = 0.91). This pilot trial demonstrated the potential feasibility and effectiveness of the NDPP delivered by CE personnel in a group remote format (Zoom®) to adults with prediabetes living in rural areas.

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Section: Discussionmentioning

confidence: 99%

Feasibility and Comparative Effectiveness for the Delivery of the National Diabetes Prevention Program through Cooperative Extension in Rural Communities

Gorczyca

Washburn

Smith

et al. 2022

IJERPH

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“…having an HbA1c reading below 53 mmol/mol (7.0% using the Diabetes Control and Complications Trial method) [16] at month 12. Regarding reduction in HbA1c levels of at least 3 mmol/mol by month 12 among participants at high risk of T2D, we decided to use this cutoff based on findings from an intervention trial reported by Katula et al (2021) that aimed at reducing HbA1c levels among people with pre-diabetes [17]. In this study, investigators observed significant reduction in HbA1c levels, an average of -2.52 mmol/ mol [95% CI = -2.89 --2.16].…”

Section: Discussionmentioning

confidence: 99%

Prevention and management of type 2 diabetes mellitus in Uganda and South Africa: Findings from the SMART2D pragmatic implementation trial

Guwatudde

Delobelle

Absetz

et al. 2022

PLOS Glob Public Health

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Health systems in many low- and middle-income countries are struggling to manage type 2 diabetes (T2D). Management of glycaemia via well-organized care can reduce T2D incidence, and associated morbidity and mortality. The primary aim of this study was to evaluate the effectiveness of facility plus community care interventions (integrated care), compared to facility only care interventions (facility care) towards improvement of T2D outcomes in Uganda and South Africa. A pragmatic cluster randomized trial design was used to compare outcomes among participants with T2D and those at high risk. The trial had two study arms; the integrated care arm, and the facility care arm; and in Uganda only, an additional usual care arm. Participants were enrolled at nine primary health facilities in Uganda, and two in South Africa. Participants were adults aged 30 to 75 years, and followed for up to 12 months. Primary outcomes were glycaemic control among participants with T2D, and reduction in HbA1c > = 3 mmol/mol among participants at high risk. Secondary outcomes were retention into care and incident T2D. Adjusted analysis revealed significantly higher retention into care comparing integrated care and facility care versus usual care in Uganda and integrated care versus facility care in South Africa. The effect was particularly high among participants at high risk in Uganda with an incident rate ratio of 2.46 [1.33–4.53] for the facility care arm and 3.52 [2.13–5.80] for the integrated care arm. No improvement in glycaemic control or reduction in HbA1c was found in either country. However, considerable and unbalanced loss to follow-up compromised assessment of the intervention effect on HbA1c. Study interventions significantly improved retention into care, especially compared to usual care in Uganda. This highlights the need for adequate primary care for T2D and suggest a role for the community in T2D prevention. Trial registration number: ISRCTN11913581.

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“…This systematic review was comprised of 19 studies with randomized trial designs [ 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ] and 6 studies [ 55 , 56 , 57 , 58 , 59 , 60 ] with other types of trial designs (pragmatic trial and quasi-experimental). The features of the studies are detailed in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…A total of thirteen studies [ 36 , 39 , 40 , 41 , 43 , 44 , 46 , 48 , 50 , 51 , 53 , 57 , 58 ] only used hbA1c as a diagnostic tool for prediabetes. Research conducted by Ramachandran [ 36 ] only used an oral glucose tolerance test (OGTT) as a diagnostic standard for prediabetes.…”

Section: Resultsmentioning

confidence: 99%

“…There were 15 studies using only mobile phone apps, 3 other studies using websites, and 4 studies using text messages only. There were 6 studies that use wearable devices as part of the intervention [ 39 , 43 , 49 , 50 , 59 ]. The study outcomes were classified into five categories, which included the incidence of diabetes mellitus (DM), anthropometric measures, laboratory examinations, measures of physical activity, and eating behavior.…”

Section: Resultsmentioning

confidence: 99%

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The Use of Mobile Health Interventions for Outcomes among Middle-Aged and Elderly Patients with Prediabetes: A Systematic Review

Jeem

Andriani

Nabila

et al. 2022

IJERPH

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Background: There are currently limited systematic reviews of mobile health interventions for middle-aged and elderly patients with prediabetes from trial studies. This review aimed to gather and analyze information from experimental studies investigating the efficacy of mobile health usability for outcomes among middle-aged and elderly patients with prediabetes. Methods: We conducted a literature search in five databases: Clinicaltrials.gov, the International Clinical Trials Registry Platform (ICTRP), PubMed, ProQuest, and EBSCO, with a date range of January 2007 to July 2022 written in English, following a registered protocol on PROSPERO (CRD42022354351). The quality and possibility of bias were assessed using the Jadad score. The data extraction and analysis were conducted in a methodical manner. Results: A total of 25 studies were included in the qualitative synthesis, with 19 studies using randomized trial designs and 6 studies with non-randomized designs. The study outcomes were the incidence of diabetes mellitus, anthropometric measures, laboratory examinations, measures of physical activity, and dietary behavior. During long-term follow-up, there was no significant difference between mobile health interventions and controls in reducing the incidence of type 2 diabetes. The findings of the studies for weight change, ≥3% and ≥5% weight loss, body mass index, and waist circumference changes were inconsistent. The efficacy of mobile health as an intervention for physical activity and dietary changes was lacking in conclusion. Most studies found that mobile health lacks sufficient evidence to change hbA1c. According to most of these studies, there was no significant difference in blood lipid level reduction. Conclusion: The use of mobile health was not sufficiently proven to be effective for middle-aged and elderly patients with prediabetes.

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Effects of a Digital Diabetes Prevention Program: An RCT

Cited by 42 publications

References 27 publications

Feasibility and Comparative Effectiveness for the Delivery of the National Diabetes Prevention Program through Cooperative Extension in Rural Communities

Feasibility and Comparative Effectiveness for the Delivery of the National Diabetes Prevention Program through Cooperative Extension in Rural Communities

Prevention and management of type 2 diabetes mellitus in Uganda and South Africa: Findings from the SMART2D pragmatic implementation trial

The Use of Mobile Health Interventions for Outcomes among Middle-Aged and Elderly Patients with Prediabetes: A Systematic Review

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