BRinging the Diabetes Prevention Program to GEriatric Populations (BRIDGE)

项目摘要 超过2400万美国人年龄≥65岁，患有前驱糖尿病。糖尿病前期可以使用 公共卫生方法：在糖尿病预防计划（DPP）的20%参与者中， 在60岁及以上的人群中，饮食和体力活动干预使糖尿病风险降低了71%， 平均随访3年。老年人人口预计将从5250万增加一倍以上 到2060年将增加到1亿，如果预测保持不变，大约一半（48.3%）将患有前驱糖尿病。的 拟议的研究将比较为老年人量身定制的DPP计划和通过远程医疗（DPP-TOAT）提供的DPP计划 组）与针对老年人定制的个人DPP（DPP组），采用随机对照试验设计 （n=230）。我们的初步数据表明，DPP-TOAT是一种可行且可接受的方式， 老年人，这将是第一项比较两种策略的有效性和实施情况的研究 （远程保健与面对面）提供量身定制的DPP，以满足不断增长的老年人口的独特需求 成年人了将通过电子健康记录（Epic和MyChart）招募合格患者，并进行随机化 为期12个月的DPP-TOAT或个人DPP计划。主要有效性结局为6个月 减肥和实施的结果将出席。我们将采取务实的态度， 为今后在社区和农村环境中开展的研究提供信息。调查结果将为以下方面的最佳做法提供信息： 提供基于证据的干预措施，可以覆盖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.