Retention key for US national diabetes prevention efforts
medwireNews: Data from the first 4 years of implementation of the US National Diabetes Prevention Program (NDPP) show promising results, with the more engaged patients achieving the best outcomes.
The researchers obtained data from 35,844 adults who attended at least one class of the NDPP, but based their analyses on 14,747 participants (80.3% female) who had data covering at least 12 months after they enrolled onto the program.
In total, 35.5% of the 13,893 participants with at least two weight measurements achieved the weight loss goal of at least 5%, report Elizabeth Ely (Centers for Disease Control and Prevention, Atlanta, Georgia, USA) and co-researchers in Diabetes Care.
They stress that although only a third of participants achieved this target, the average weight loss of 4.2% indicates that many participants were close to achieving it.
“Perhaps more importantly, we found that those who remained in the program were successful,” say Ely et al.
They report that each additional session attended was associated with a further 0.31% weight loss, with the 5% goal generally achieved by participants who attended 17 sessions or more (ie, completed the initial weekly phase plus at least one of the monthly sessions).
Participants attended a median of 14 sessions, with about one in 10 attending the full 22 program sessions. In all, 86.6% of participants attended at least four classes – the threshold above which the lifestyle program is thought most likely to show an effect – and these patients lost an average of 3.6% of their weight, compared with 0.4% for those who attended fewer classes.
A similar pattern emerged for physical activity, with participants reporting an increasing amount of physical activity the more sessions they attended, and most of those who attended at least 18 sessions achieving the target 150 minutes per week.
These give us clear targets to help us in achieving weight loss and exercise goals in this at risk population.
Participants’ demographics also appeared to influence their weight loss success, with non-Hispanic Whites achieving the highest average (4.6%) and non-Hispanic Blacks the lowest (3.2%). Older age was associated with greater weight loss, at 3.7%, 4.0%, and 4.2% for the 18–44 years, 45–64 years, and 65 years and older age categories, respectively. And obese participants achieved more weight loss (4.5%) than those in the overweight category (4.1%), who in turn lost more than the normal-weight participants (3.3%).
The study authors suggest that interviews with participants who dropped out of the program may offer insight into how to retain people and maximise the program’s effectiveness. They also note that the program is now being delivered remotely for people who are unable or unwilling to attend in-person group sessions.
“As data from these virtual programs and the growing number of in-person programs become available, they will offer a rich opportunity for ongoing program evaluation and improvement,” the team concludes.
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