We examined participation rates, engagement, and weight-loss outcomes of comparison group participants in a diabetes prevention trial who enrolled in a digitally delivered diabetes prevention program (ie, an active intervention) after the original trial ended. We evaluated these outcomes by using the Wilcoxon signed-rank test and 1-sample z test. We found a high participation rate (73%) among comparison group participants and comparable weight-loss outcomes at 12 months (6.
View Article and Find Full Text PDFAlthough technology-assisted diabetes prevention programs (DPPs) have been shown to improve glycemic control and weight loss, information are limited regarding relevant costs and their cost-effectiveness. To describe a retrospective within-trial cost and cost-effectiveness analysis (CEA) to compare a digital-based DPP (d-DPP) with small group education (SGE), over a 1-year study period. The costs were summarized into direct medical costs, direct nonmedical costs (i.
View Article and Find Full Text PDFObjective: To examine changes in cardiovascular disease (CVD) risk outcomes of overweight/obese adults with prediabetes.
Methods: Using data from a randomized control trial of digital diabetes prevention program (d-DPP) with 599 participants. We applied the atherosclerotic CVD (ASCVD) risk calculator to predict 10-year CVD risk for d-DPP and small education (comparison) groups.
Introduction: In light of the need to expand the reach and access of clinically proven digital Diabetes Prevention Programs (d-DPPs) and the need for rigorous evidence of effectiveness, the purpose of this study was to determine the effectiveness of a digital Diabetes Prevention Program for improving weight, HbA1c, and cardiovascular risk factors among people with prediabetes compared to enhanced standard care plus waitlist control.
Study Design: This was a single-blind RCT among participants at risk of developing type 2 diabetes and included 12 months of follow-up.
Setting/participants: A total of 599 volunteer patients with prediabetes were recruited primarily through electronic medical records and primary care practices.
Physical activity (PA) promotion messages are commonly used to engage target populations in PA programs. However, little is known about how recruitment messages impact program reach. Evidence suggests that framing messages to be congruent with individuals' motivational orientation can maximize effectiveness.
View Article and Find Full Text PDFBackground: Physical activity (PA) mitigated psychological distress during the initial weeks of the COVID-19 pandemic, yet not much is known about whether PA had effects on stress in subsequent months. We examined the relationship between change over time in COVID-related stress and self-reported change in PA between March and July 2020.
Methods: Latent growth modeling was used to examine trajectories of change in pandemic-related stress and test their association with self-reported changes in PA in an international sample (n = 679).
Self-efficacy is a commonly examined cognitive determinant of behavior change in weight-loss trials, but there has been little uniformity in its measurement. To address this, a recently developed survey captures self-efficacy as it relates to three behavioral domains of interest to weight-loss interventionists: physical activity (PA), healthful eating, and weight loss. The purpose of this study was to test the psychometric properties of the Brief Weight-Loss-Related Behavior Self-Efficacy Scales in a large sample ( = 599) of adults with prediabetes.
View Article and Find Full Text PDFWe assessed the impact of tailored versus targeted messages on program non-compliance during Desire2Move (D2M), an 8-week eHealth program that promotes physical activity (PA). Participants recorded minutes of PA using MapMyFitness, which counted toward their departments' PA total. Departments were randomized into the targeted messaging (TM) or tailored messaging (TM+) group based on participant-reported goals.
View Article and Find Full Text PDFPopulation health management (PHM) strategies to address diabetes prevention have the potential to engage large numbers of at-risk individuals in a short duration. We examined a PHM approach to recruit participants to a diabetes prevention clinical trial in a metropolitan health system. We examined reach and representativeness and assessed differences from active and passive respondents to recruitment outreach, and participants enrolled through two clinical screening protocols.
View Article and Find Full Text PDFTransl J Am Coll Sports Med
February 2020
Unlabelled: Evidence supports the use of technology supported multicomponent interventions for promoting weight loss. Many such programs include the opportunity to synchronously pair commercially available physical activity trackers (PA-T) with a goal to enhance weight loss outcomes. However, little is known about the reach and effectiveness of allowing participants to pair a PA-T within an existing online program.
View Article and Find Full Text PDFBackground: This study aimed to examine associations of personality with generalized anxiety disorder (GAD) and physical activity (PA), PA with GAD, and PA mediates associations between personality and incident GAD.
Methods: Participants aged ≥50 years completed the 60-item NEO-Five Factor Inventory questionnaire to assess personality and short-form International Physical Activity Questionnaire at baseline, and the Composite International Diagnostic Interview - Short Form to clinically assess GAD at baseline and 2, 4, and 6 years later. Participants who had GAD at baseline or reported having ever been told by a doctor that they had anxiety were excluded from analyses.
Appl Psychol Health Well Being
November 2020
Background: The delivery of physical activity (PA) promotion messages is an important component of any PA intervention. Gain-framed messages appear beneficial for prevention (rather than detection) behaviors such as PA, but the effects are small and inconsistent. It is possible that these effects are moderated by motivational traits, but this has not been systematically tested in the context of PA promotion messages.
View Article and Find Full Text PDFBackground: Diabetes prevention remains a top public health priority; digital approaches are potential solutions to existing scalability and accessibility challenges. There remains a gap in our understanding of the relationship between effectiveness, costs, and potential for sustained implementation of digital diabetes prevention strategies within typical healthcare settings.
Purpose: To describe the methods and design of a type 1 hybrid effectiveness-implementation trial of a digital diabetes prevention program (DPP) using the iPARIHS and RE-AIM frameworks.
This study assessed the lifetime health and economic consequences of an efficacious scalable community weight loss program for overweight and obese adults. We applied a state-transition Markov model to project lifetime economic outcome (US dollar) and the degree of disease averted as a result of a weight loss intervention, compared with no intervention, from a payer perspective. Effect sizes of the intervention on weight loss, by sex, race and ethnicity, and body mass index (BMI) of participants, were derived from a 12-month community program.
View Article and Find Full Text PDFBackground: Primary care addresses obesity through physician oversight of intensive lifestyle interventions or referral to external programs with demonstrated efficacy. However, limited information exists on community program reach, effectiveness, and costs across different groups of participants.
Objective: To evaluate a scalable, community weight loss program using reach, effectiveness, and cost metrics.
Background: It is recommended for women to have a healthy body mass index before conception. However, there is limited research on appropriate preconception interventions for weight loss. Furthermore, there is a lack of knowledge on providers' willingness to refer to particular behavioral interventions and the degree to which patients would attend those interventions.
View Article and Find Full Text PDFSelf-efficacy is a commonly included cognitive variable in weight-loss trials, but there is little uniformity in its measurement. Weight-loss trials frequently focus on physical activity (PA) and eating behavior, as well as weight loss, but no survey is available that offers reliable measurement of self-efficacy as it relates to each of these targeted outcomes. The purpose of this study was to test the psychometric properties of brief, pragmatic self-efficacy scales specific to PA, healthful eating and weight-loss (4 items each).
View Article and Find Full Text PDFBackground: A positive association between physical activity and mental health is well established, particularly for lower symptoms of depression and anxiety among active adults. However, it is unclear whether the association is influenced by personality, which might moderate or otherwise explain the association. In addition, past studies have not confirmed the association using an objective measure of physical activity.
View Article and Find Full Text PDFUnlabelled: Commonly reported relationships of the broad personality traits of extraversion and neuroticism with self-reports of physical activity (PA) have not been elaborated within motivational theory that posits how functioning of the behavioral inhibition (BIS) and activation (BAS) systems can explain or modify the influence of personality on PA. Whether personality predicts physical activity when it is measured objectively has not been established.
Purpose: The study was aimed to test direct, indirect, and interactive relations between extraversion, neuroticism, BIS and BAS, and PA measured by validated self-report and accelerometry.