Filipinos Fit and Trim - A feasible and efficacious DPP-based intervention trial

Abstract

IntroductionFilipino Americans are at higher risk for obesity and related Type 2 diabetes (T2D) compared to other Asian subgroups and non-Hispanic whites. Yet, there are limited research studies to reduce health disparities and improve health outcomes for Filipinos. Weight loss lifestyle intervention trials such as the Diabetes Prevention Program (DPP) can reduce obesity and T2D risks through physical activity and healthy eating.MethodsThus, we conducted a pilot Fit&Trim (DPP-based) intervention study - a randomized controlled trial 3-month intervention augmented with mobile technology + 3-month maintenance follow-up with a waitlist control. The objective assessed the intervention feasibility and potential efficacy to reduce T2D risks in Filipino Americans with overweight/obesity. The overall study goal was a mean 5% weight reduction.ResultsSixty-seven eligible Filipino men and women were enrolled and randomized to either an intervention or waitlist control group. Participant retention was 91%. In Phase 1 (baseline to 3-months), the intervention group had greater weight reduction compared to the waitlist control (−4.3% vs. −0.88%; cross-level interaction = −0.85 (−1.4, −0.35). In Phase 2 (3- to 6-months), after receiving the Fit&Trim intervention, the waitlist group also had similar significant weight reduction [-4.8% (- 0.75 (−0.92, −0.58)]. A majority of intervention group (57%) also maintained their weight loss. Overall, 41% of study participants achieved a 5% weight loss.ConclusionThe Fit&Trim intervention demonstrated feasibility and potential efficacy for Filipino Americans. Findings warrant a further larger, longer trial to test the Fit&Trim feasibility and effectiveness in a real-world Filipino community setting.ClinicalTrials.gov registration numberNCT02278939.

Primary Prevention of Cardiovascular Disease and Type 2 Diabetes Mellitus Using Mobile Health Technology: Systematic Review of the Literature

“…In 4 studies the participants received text messages [ 23 , 25 , 29 , 31 ], in 1 study the intervention was delivered via WhatsApp [ 24 ], and in the remaining 4 studies a specifically developed mobile phone app was involved [ 26 - 28 , 30 ]. Only 1 intervention was delivered fully automated [ 28 ]; all other interventions included human involvement [ 23 - 27 , 29 - 31 ].…”

“…Of the studies, 6 used usual care as the control group. In 1 trial, the control group received pedometers only [ 30 ]; 1 study had a second comparator group, additional to usual care, which received face-to-face training sessions [ 24 ]; and 2 studies used waitlist controls [ 27 , 28 ], meaning that the control group received the intervention after the intervention group had completed it.…”

“…The mobile phone interventions led to statistically significant weight loss compared with the control group in 4 studies [ 25 , 27 , 28 , 30 ], ranging from a difference of −0.66 kg ( P =.04) over 12 months [ 25 ] to −6.2 kg for the intervention compared with 0.3 kg for the control group ( P <.001) over 5 months [ 30 ]. The same studies reported a statistically significant decrease in BMI compared with the control group [ 25 , 27 , 28 , 30 ], ranging from a difference of −0.3 kg/m 2 ( P =.02) over 12 months [ 25 ] to −2.2 kg/m 2 for the intervention compared with 0.1 kg/m 2 for the control group ( P <.001) over 5 months [ 30 ]. A smaller waist circumference due to the intervention was measured in 2 T2DM studies [ 27 , 28 ], from −4.56 cm for the intervention compared with −2.22 cm ( P <.001) for the control group over 6 months [ 28 ] to a cross-level interaction of −4.9 cm (95% CI −7.5 to −2.6) over 3 months [ 27 ].…”

Communication strategies in the prevention of type 2 diabetes and gestational diabetes in vulnerable groups: A scoping review

“…However, some of the included studies used more than one strategy, for example, some kind of diabetes prevention program (DPP) and a TA [16], in which case we pointed out the study's main focus. * each group has a private online social network where they can discuss goals, challenges, progress, and provide social support to one another at any time, similar to a private chat board or discussion board.…”

“…Another communication strategy was an approach using any kind of technical device. Overall, nine studies focused on TA in combination with an ADPP [16,33,[36][37][38][39][40][41][42], but two used a TA alone [36,37].…”