Engagement and outcomes in a digital Diabetes Prevention Program: 3-year update.
Engagement and outcomes in a digital Diabetes Prevention Program: 3-year update.
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DOI：
10.1136/bmjdrc-2017-000422
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发表时间：
2017
影响因子：
4.1
通讯作者：
Peters AL
中科院分区：
文献类型：
--
作者：
Sepah SC;Jiang L;Ellis RJ;McDermott K;Peters AL
糖尿病预防计划（DPP）的翻译近年来激增，越来越多地扩展到数字格式。尽管这些DPP翻译一直显示出良好的临床结果，但数字格式的长期数据有限。本研究的目的是检查基线后3年的临床结果，以及数字DPP中项目参与与临床结果之间的关系。在一项单臂、非随机试验中，220名先前诊断为前驱糖尿病的患者被纳入Omada健康计划，这是一种市售的、为期16周的基于dpp的减肥干预，随后是持续的体重维持干预。每年评估体重和糖化血红蛋白的变化。研究了第一年参与项目与3年临床结果之间的关系。参与者具有不同的社会经济背景（62%为女性，50.2%为非西班牙裔白人，51.7%为大学及以上学历）。从基线到3年，那些完成了4节或更多课程和9节或更多课程的参与者获得了显著的持续体重减轻（分别为-3.0%和-2.9%）和糖化血红蛋白的绝对降低（分别为-0.31和-0.33），平均从糖尿病前期范围缓解到正常血糖范围。第一年参与指标的因素分析揭示了两个基本维度，一个包括课程完成和健康行为跟踪一致性，另一个包括网站登录和小组参与。当使用这两个因素来预测体重减轻时，只有登录和小组参与因素是16周和1年体重减轻的显著预测因子。该研究表明，在数字DPP中，体重和糖化血红蛋白的长期显著降低，并确定了预测体重减轻的项目参与模式。
Translations of the Diabetes Prevention Program (DPP) have proliferated in recent years, with increasing expansion to digital formats. Although these DPP translations have consistently shown favorable clinical outcomes, long-term data for digital formats are limited. This study’s objective was to examine clinical outcomes up to 3 years post-baseline and the relationship between program engagement and clinical outcomes in a digital DPP. In a single-arm, non-randomized trial, 220 patients previously diagnosed with prediabetes were enrolled in the Omada Health Program, a commercially available, 16-week DPP-based weight loss intervention followed by an ongoing weight maintenance intervention. Changes in body weight and A1c were assessed annually. Relationships between program engagement during the first year and clinical outcomes across 3 years were examined. Participants were socioeconomically diverse (62% women, 50.2% non-Hispanic white, 51.7% college educated or higher). From baseline to 3 years, those participants who completed four or more lessons and nine or more lessons achieved significant sustained weight loss (–3.0% and –2.9%, respectively) and an absolute reduction in A1c (–0.31 and –0.33, respectively) with an average remission from the prediabetes range to the normal glycemic range. Factor analysis of engagement metrics during the first year revealed two underlying dimensions, one comprising lesson completion and health behavior tracking consistency, and the other comprising website logins and group participation. When these two factors were used to predict weight loss, only the logins and group participation factor was a significant predictor of weight loss at 16 weeks and 1 year. This study demonstrates significant long-term reductions in body weight and A1c in a digital DPP and identifies patterns of program engagement that predict weight loss.
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影响因子：
3
作者：
Cotter AP;Durant N;Agne AA;Cherrington AL
通讯作者：
Cherrington AL
影响因子：
7.4
作者：
Bian RR;Piatt GA;Sen A;Plegue MA;De Michele ML;Hafez D;Czuhajewski CM;Buis LR;Kaufman N;Richardson CR
通讯作者：
Richardson CR
影响因子：
5.5
作者：
Fukuoka Y;Gay CL;Joiner KL;Vittinghoff E
通讯作者：
Vittinghoff E
影响因子：
16.2
作者：
Jiang L;Manson SM;Beals J;Henderson WG;Huang H;Acton KJ;Roubideaux Y;Special Diabetes Program for Indians Diabetes Prevention Demonstration Project
通讯作者：
Special Diabetes Program for Indians Diabetes Prevention Demonstration Project
影响因子：
158.5
作者：
Knowler, WC;Barrett-Connor, E;Nathan, DM
通讯作者：
Nathan, DM