Saturday, March 28, 2020

Using Teleconferencing to Deliver the Diabetes Prevention Program

For health related programs that require intensive intervention, the intervention can be costly because there are many barriers to delivering the programs. One of these health-related programs is the CDC's National Diabetes Prevention Program or NDPP. It can be difficult for program participants to attend enough in-person sessions to meet their weight loss and other goals. Teleconferencing, which can be used for telehealth, can eliminate many of the barriers hindering attendance at in-person sessions. One study, called SHINE for “Support, Health Information, Nutrition and Exercise,” has shown that teleconferencing can be effective in delivering a version of the CDC’s NDPP for weight loss. It should be noted that in this article, teleconferencing is performed via the telephone.

The NDPP program is a year-long program, consisting of a set of 16 weekly core sessions during the first six months, and a set of core maintenance sessions during the last six months. The NDPP is based on the Diabetes Prevention Program (DPP) study carried out between 1996 and 2001.  In the above mentioned SHINE study, the sessions lasted two years rather than one year. The 16 session curriculum, taken from the original CDC DPP study, was used during the first year of the SHINE study, and a modified version of the curriculum was used for the second year of the SHINE sessions.

Unlike the original DPP study, where the primary outcome was type 2 diabetes, the primary outcome of the SHINE study was weight loss.  For the study, the participants were randomized to two groups – an individual call (IC) group, and a conference call (CC) group. Individuals in the IC-groups received individual telephone calls from a counselor, and individuals in the CC-group received calls from the counselor in a teleconference.

After randomization of subjects to one of the two groups, the IC-group consisted of 129 participants and the CC-group consisted of 128 participants. Measurements, including weight, were taken at baseline, six months, 12 months and 24 months. And the average weight loss for CC-group  was more at the 6, 12 and 24 month assessments than  the average weight loss for the IC-group.  At 6 months, the CC-group average weight loss was 4.0 %  compared to 3.9% for the IC group. At 12 months, the CC-group average weight loss was 4.5% compared to 4.2% for the IC-group. And at the two year period, the CC-group average weight loss was 5.6% compared to 1.8% for the IC-group.

So using teleconferencing is a viable option for weight loss. And a version of the CDC's DPP program curriculum, including the NDPP, can be used to deliver the weight loss program. Those wanting to deliver a version of the DPP should consider using teleconferencing to deliver the program to improve attendance and weight loss.


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