Usefulness of a Novel Mobile Diabetes Prevention Program Delivery Platform With Human Coaching: 65-Week Observational Follow-Up

Abstract

BackgroundIt is widely recognized that the prevalence of obesity and comorbidities including prediabetes and type 2 diabetes continue to increase worldwide. Results from a 24-week Diabetes Prevention Program (DPP) fully mobile pilot intervention were previously published showing promising evidence of the usefulness of DPP-based eHealth interventions on weight loss.ObjectiveThis pilot study extends previous findings to evaluate weight loss results of core (up to week 16) and maintenance (postcore weeks) DPP interventions at 65 weeks from baseline.MethodsOriginally, 140 participants were invited and 43 overweight or obese adult participants with a diagnosis of prediabetes signed up to receive a 24-week virtual DPP with human coaching through a mobile platform. At 65 weeks, this pilot study evaluates weight loss and engagement in maintenance participants by means of repeated measures analysis of variances and backward multiple linear regression to examine predictors of weight loss. Last observation carried forward was used for endpoint measurements.ResultsAt 65 weeks, mean weight loss was 6.15% in starters who read 1 or more lessons per week on 4 or more core weeks, 7.36% in completers who read 9 or more lessons per week on core weeks, and 8.98% in maintenance completers who did any action in postcore weeks (all P<.001). Participants were highly engaged, with 80% (47/59) of the sample completing 9 lessons or more and 69% (32/47) of those completing the maintenance phase. In-app actions related to self-monitoring significantly predicted weight loss.ConclusionsIn comparison to eHealth programs, this pilot study shows that a fully mobile DPP can produce transformative weight loss. A fully mobile DPP intervention resulted in significant weight loss and high engagement during the maintenance phase, providing evidence for long-term potential as an alternative to in-person DPP by removing many of the barriers associated with in-person and other forms of virtual DPP.

Digital Healthcare Intervention to Improve Self-Management for Patients with Type 2 Diabetes: A Scoping Review

“…Using this type of features in the mHealth system demonstrates a potential efficacy in reducing the risk of developing diabetes in overweight patients. The studies also showed that improving engagement with the mHealth system and group interaction had a direct impact on self-monitoring through food logging, resulting in higher weight loss [3,23,41].…”

Virtual Coaching to Enhance Diabetes Care

“…However, the existing literature demonstrates clinically meaningful benefits beyond glycemic control. These include improved medication adherence, 30 improved exercise habits, 30 prolonged weight loss including in those who were at risk for diabetes, 33,[42][43][44] fewer symptoms of hypoglycemia, 30 fewer symptoms of depression, 30 and significant cost savings. 45 Prolonged engagement with the system also looks promising.…”

“…45 Prolonged engagement with the system also looks promising. 32,43 In one 65-week study, a diabetes prevention program using virtual coaching was able to engage 80% of subjects for the majority of the study and 69% of subjects for the entire duration of the study, resulting in 7.36% and 8.98% weight loss, respectively. 43 Furthermore, users report high levels of satisfaction with virtual coach-enhanced apps.…”

“…32,43 In one 65-week study, a diabetes prevention program using virtual coaching was able to engage 80% of subjects for the majority of the study and 69% of subjects for the entire duration of the study, resulting in 7.36% and 8.98% weight loss, respectively. 43 Furthermore, users report high levels of satisfaction with virtual coach-enhanced apps. 46,47 The benefits of virtual coaching are similar to what has been found with diabetes health coaching, 8 but they have the potential to be more widespread.…”

A Remote Intervention to Prevent or Delay Cognitive Impairment in Older Adults: Design, Recruitment, and Baseline Characteristics of the Virtual Cognitive Health (VC Health) Study

“…Additionally, a 5-year postponement could almost halve the projected Alzheimer disease prevalence by 2050 [ 9 - 11 ]. Due to the proven ability to decrease some of the modifiable risk factors implicated in Alzheimer disease [ 12 , 13 ], lifestyle-based interventions hold the potential to greatly reduce the burden of dementia as populations continue to age worldwide.…”