Diabetes Prevention Program attendance is associated with improved patient activation: Results from the Prediabetes Informed Decisions and Education (PRIDE) study
Diabetes Prevention Program attendance is associated with improved patient activation: Results from the Prediabetes Informed Decisions and Education (PRIDE) study
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DOI：
10.1016/j.pmedr.2019.100961
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发表时间：
2019-12-01
影响因子：
2.8
通讯作者：
Duru, O. Kenrik
中科院分区：
文献类型：
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作者：
Jeffers, Kia Skrine;Castellon-Lopez, Yelba;Duru, O. Kenrik
糖尿病预防计划（DPP）是一项为期12个月的行为改变计划，旨在增加体力活动并改善2型糖尿病风险患者的饮食模式，以促进适度减肥并改善心脏代谢状况。尚不清楚基线患者激活是否与DPP摄取增加相关，以及DPP治疗是否导致患者激活的后续改善。我们分析了2015年11月至2017年9月期间收集的糖尿病前期知情决策和教育（PRIDE）糖尿病预防共享决策（SDM）试验的352名成年参与者的数据。PRIDE参与者完成了基线和4个月的随访调查，包括患者激活的Altarum消费者参与度（ACE）测量。我们使用合作DPP提供商的数据跟踪了8个多月的DPP出席情况。在多变量模型中，我们测量了自我报告的基线激活是否与DPP“摄取”（参加1+次会议）或DPP“出席”（9+次会议）相关。我们还检查了DPP出席率是否与4个月随访时激活的变化相关。我们没有发现基线激活和DPP摄取或出勤率之间的关联。然而，我们确实发现DPP的出席与总体ACE评分的增加（6.68分，95% CI 1.97-11.39，p = 0.005）和3个ACE分量表中2个（承诺和知情选择）的激活增加相关。我们发现DPP参与增加了患者激活，这表明在DPP真实世界转化研究中观察到的改善健康结局的机制。这项工作对糖尿病预防和其他行为改变计划具有重要意义。
The Diabetes Prevention Program (DPP) is a 12-month behavior change program designed to increase physical activity and improve dietary patterns among patients at risk for Type 2 diabetes, in order to facilitate modest weight loss and improve cardio-metabolic profiles. It is unknown whether baseline patient activation is related to increased DPP uptake, and whether DPP attendance leads to subsequent improvement in patient activation. We analyzed data from 352 adult participants in the Prediabetes Informed Decisions and Education (PRIDE) trial of shared decision-making (SDM) in diabetes prevention, collected from November 2015 through September 2017. PRIDE participants completed baseline and 4-month follow-up surveys, including the Altarum Consumer Engagement (ACE) MeasureT of patient activation. We tracked DPP attendance over 8 months using data from partnering DPP providers. In multivariate models, we measured whether self-reported baseline activation was associated with DPP "uptake" (1+ session attended) or DPP "attendance" (9+ sessions). We also examined whether DPP attendance was associated with change in activation at 4-months follow-up. We did not find an association between baseline activation and DPP uptake or attendance. However, we did find that DPP attendance was associated with an increase in the overall ACE score (6.68 points, 95% CI 1.97-11.39, p = 0.005) and increased activation in 2 of the 3 ACE subscales (Commitment and Informed Choice). Our finding of increased patient activation with DPP attendance suggests a mechanism for the improved health outcomes seen in DPP real-world translational studies. This work has important implications for diabetes prevention and other behavior change programs.