Participants’ perspectives on perceived usefulness of digital and in‐person diabetes prevention programs: A qualitative study to inform decisions related to program participation

Gruß, Inga; Mayhew, Meghan; Firemark, Alison; Fitzpatrick, Stephanie L.

doi:10.1002/osp4.562

Cited by 4 publications

(4 citation statements)

References 35 publications

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“…This is comparable to a recent large study from the Diabetes Prevention Research Group that analyzed 41,000 members of in‐person DPPs and observed a median retention of 28 weeks (IQR 15, 41) 34 . However, comparing in‐person and digital DPPs may not be of high importance given that both are recognized by the CDC 36 and perceived by participants to be similarly useful and beneficial for different reasons 37 . Having different modes of delivery enables participating members to select a program that best meets their individual needs.…”

Section: Discussionsupporting

confidence: 77%

“… 34 However, comparing in‐person and digital DPPs may not be of high importance given that both are recognized by the CDC 36 and perceived by participants to be similarly useful and beneficial for different reasons. 37 Having different modes of delivery enables participating members to select a program that best meets their individual needs. The program that offers the best fit for a particular member should be the one that encourages the longest retention and thus facilitates the best outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Weight loss and modeled cost savings in a digital diabetes prevention program

Branch¹,

Rikhy²,

Auster‐Gussman³

et al. 2023

Obesity Science & Practice

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Background: Participation in the National Diabetes Prevention Program (DPP) can improve individual health through reduced risk of type 2 diabetes and save the healthcare system substantial medical costs associated with a diagnosis of type 2 diabetes and its associated complications. There is less evidence of outcomes and cost savings associated with a fully digital delivery of the DPP. Methods: This study assessed 13,593 members who provided an initial digital weight and subsequently achieved various weight loss and engagement outcomes during their participation in a digital DPP. Analyzed data included both complete observations and missing observations imputed using maximum likelihood estimation. Findings include members' behavioral correlates of weight loss and a literature-based cost-savings estimate associated with achieving three mutually exclusive weight loss or engagement benchmarks: ≥5% weight loss, >2% but <5% weight loss, and completion of ≥4 educational lessons. Results: 11,976 members (88%) provided a weight after 2 months of participation, enabling calculation of their weight nadir. Considering complete data, 97% of members maintained or lost weight. Using the imputed data for these calculations, 32.0% of members achieved ≥5%, 32.4% achieved >2% but <5%, 32.0% maintained �2%, and 3.6% gained weight. Members who lost the most weight achieved their weight nadir furthest into the program (mean day = 189, SE = 1.4) and had the longest active engagement (mean days = 268, SE = 1.4), particularly compared to members who gained weight (mean nadir day = 119, SE = 3.7; active engagement mean days = 199, SE = 4.9) (both p ≤ 0.0001). Modeled 1-year cost-savings estimates ranged from $11,229,160 to $12,960,875. Conclusions: Members of a fully digital DPP achieved clinical and engagement outcomes during their participation in the program that confer important health benefits and cost savings.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Weight loss and modeled cost savings in a digital diabetes prevention program

Branch¹,

Rikhy²,

Auster‐Gussman³

et al. 2023

Obesity Science & Practice

View full text Add to dashboard Cite

show abstract

“…Development and use of digital and online platforms to deliver DPP has increased considerably over the years 21 . In addition to its proven effectiveness for weight loss, 22–25 digital DPP has a broader reach than in‐person and is considered more convenient by participants 26 . Given that digital DPP has the potential to expand access to an evidence‐based behavioral intervention, which has become even more imperative during the COVID‐19 pandemic, it seems relevant to also examine the effectiveness of this delivery modality in the context of mental health.…”

Section: Introductionmentioning

confidence: 99%

“… 21 In addition to its proven effectiveness for weight loss, 22 , 23 , 24 , 25 digital DPP has a broader reach than in‐person and is considered more convenient by participants. 26 Given that digital DPP has the potential to expand access to an evidence‐based behavioral intervention, which has become even more imperative during the COVID‐19 pandemic, it seems relevant to also examine the effectiveness of this delivery modality in the context of mental health. Therefore, this study examined the moderating effect of a mental health diagnosis on weight change over a 12 and 24‐month period among older adults who were invited to participate in digital DPP.…”

Section: Introductionmentioning

confidence: 99%

Mental health diagnosis attenuates weight loss among older adults in a digital diabetes prevention program

Mayhew

Smith

Fortmann

et al. 2022

Obesity Science & Practice

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Objective Diabetes Prevention Programs (DPP) are effective at reducing diabetes incidence via clinically significant weight loss. Co‐morbid mental health condition(s) may reduce the effect of DPP administered in‐person and telephonically but this has not been assessed for digital DPP. This report examines the moderating effect of mental health diagnosis on weight change among individuals who enrolled in digital DPP (enrollees) at 12 and 24 months. Methods Secondary analysis of prospective, electronic health record data from a study of digital DPP among adults (N = 3904) aged 65–75 with prediabetes (HbA1c 5.7%–6.4%) and obesity (BMI ≥30 kg/m2). Results Mental health diagnosis only moderated the effect of digital DPP on weight change during the first 7 months (p = 0.003) and the effect attenuated at 12 and 24 months. Results were unchanged after adjusting for psychotropic medication use. Among those without a mental health diagnosis, digital DPP enrollees lost more weight than non‐enrollees: −4.17 kg (95% CI, −5.22 to −3.13) at 12 months and −1.88 kg (95% CI, −3.00 to −0.76) at 24 months, whereas among individuals with a mental health diagnosis, there was no difference in weight loss between enrollees and non‐enrollees at 12 and 24 months (−1.25 kg [95% CI, −2.77 to 0.26] and 0.02 kg [95% CI, −1.69–1.73], respectively). Conclusions Digital DPP appears less effective for weight loss among individuals with a mental health condition, similar to prior findings for in‐person and telephonic modalities. Findings suggest a need for tailoring DPP to address mental health conditions.

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Evaluation of a Workplace Diabetes Prevention Program Delivered via Distance Learning: A Qualitative Study

Audet,

Roller,

Aliyu

et al. 2024

Health Educ Behav

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Little is known about how distance learning impacts delivery of the National Diabetes Prevention Program (DPP) despite a rapid shift to this platform during the coronavirus disease 2019 (COVID-19) public health emergency. We explored how a workplace DPP, delivered via distance learning, impacted knowledge, motivation, and behavioral skills of participants throughout the program. We conducted repeated qualitative interviews with distance learning participants at baseline, 6 months, and 12 months from September 2020 to July 2022. Three study team members coded interview data using individual responses as the unit of analysis. We used a thematic approach, using the information–motivation–behavioral skills framework, to analyze responses and generate understanding of the program’s impact. The 27 individuals who participated in the interviews (89% women, mean age 56 years) reported the distance learning platform was effective in changing their behavior. The program’s focus on food logging and setting limits on specific types of caloric intake was perceived as essential. Education on ideal levels of fat and sugar consumption, lessons on how to read food labels, and dissemination of recipes with healthy food substitutions allowed participants to initiate and sustain healthy decision-making. Strategies to increase physical activity, including breaking up exercise throughout the day, made reaching their goals more feasible. Participants reported food logging and weight reporting, as well as group support during sessions, either sustained or increased their motivation to adhere to the program over time. A workplace DPP delivered via distance learning successfully prompted improvements in the knowledge, motivation, and behavioral skills necessary to increase healthy eating and physical activity among participants.

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Participants’ perspectives on perceived usefulness of digital and in‐person diabetes prevention programs: A qualitative study to inform decisions related to program participation

Cited by 4 publications

References 35 publications

Weight loss and modeled cost savings in a digital diabetes prevention program

Weight loss and modeled cost savings in a digital diabetes prevention program

Mental health diagnosis attenuates weight loss among older adults in a digital diabetes prevention program

Evaluation of a Workplace Diabetes Prevention Program Delivered via Distance Learning: A Qualitative Study

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