BRinging the Diabetes Prevention Program to GEriatric Populations (BRIDGE)

项目摘要 超过2,400万美国人≥65岁，并患有糖尿病前期。糖尿病前期可以用一种 公共卫生方法：在糖尿病预防计划(DPP)的20%参与者中， 在60岁及以上的人中，饮食和体力活动干预使糖尿病的风险降低了71% 平均随访3年。老年人口预计将从5250万增加一倍以上 2019年到2060年将达到1亿人，如果预测成立，大约一半(48.3%)将患有前驱糖尿病。这个 拟议的研究将比较为老年人量身定做的DPP计划和通过远程医疗(DPP-TOAT)提供的计划 ARM)到为老年人量身定做的DPP(DPP ARM)，使用随机对照试验设计 (n=230)。我们的初步数据表明，DPP-TOAT是一种可行和可接受的方式，将DPP传递到 这将是第一次比较这两种策略的有效性和实施情况的研究 (远程医疗与面对面)提供量身定制的DPP，满足不断增长的老年人口的独特需求 成年人。符合条件的患者将通过电子健康记录(Epic和MyChart)招募并随机分配 为期12个月的DPP-TOAT或面对面DPP计划。初步有效结果为6个月。 减肥和实施的结果将是出勤率。我们将使用务实的方法，以便 为今后在社区和农村环境中进行的研究提供信息。调查结果将为以下领域的最佳实践提供参考 提供循证干预，可惠及2400多万65岁及以上的成年人 糖尿病前期。

PROJECT ABSTRACT Over 24 million Americans are ≥65 years and have prediabetes. Prediabetes can be addressed using a public health approach: among the 20% of participants in the Diabetes Prevention Program (DPP) who were ages 60 and over, the diet and physical activity intervention conferred a 71% risk reduction of diabetes after an average follow-up of 3 years. The population of older adults is projected to more than double from 52.5 million in 2019 to ~100 million by 2060, and if projections hold, about half (48.3%) will have prediabetes. The proposed study will compare a DPP program Tailored for Older Adults and delivered via Telehealth (DPP-TOAT arm) to an in person DPP tailored for older adults (DPP arm) using a randomized, controlled trial design (n=230). Our preliminary data suggests DPP-TOAT is a feasible and acceptable way to deliver the DPP to older adults, and this will be the first study to compare the effectiveness and implementation of two strategies (telehealth versus in-person) to deliver a tailored DPP for the unique needs of the growing population of older adults. Eligible patients will be recruited through electronic health records (Epic and MyChart) and randomized to the 12-month DPP-TOAT or the in-person DPP program. The primary effectiveness outcome will be 6-month weight loss and implementation outcome will be attendance. We will use a pragmatic approach in order to inform future studies conducted in community-based and rural settings. Findings will inform best practices in the delivery of an evidence-based intervention that could reach the 24+ million adults aged 65 and over with prediabetes.