Intent-to-treat analysis of a simultaneous multisite telehealth diabetes prevention program

Details

• Alternative Title:
  BMJ Open Diabetes Res Care
• Personal Author:
  Ciemins, Elizabeth L ; Coon, Patricia J ; Coombs, Nicholas C ; Holloway, Barbara L ; Mullette, Elizabeth J ; Dudley, William N
• Description:
  Objective
  
  Determine the effectiveness of a 16-week modified diabetes prevention program (DPP) administered simultaneously to multiple rural communities from a single urban site, as compared with a similar face-to-face intervention. A 12-week intervention was evaluated to consider minimization of staff costs in communities where resources are limited.
  
  Research design and methods
  
  A prospective cohort study compared DPP interventions implemented in rural (via telehealth technology) and urban (face-to-face) communities using an intent-to-treat analysis. Primary outcome measures included 5% and 7% body weight loss. Logistic regression analyses were used to determine predictors of intervention success and included a variable for treatment effect.
  
  Results
  
  Between 2010 and 2015, up to 667 participants were enrolled in the study representing one urban and 15 rural communities across Montana. The 16-week urban and rural interventions were comparable; 33.5% and 34.6% of participants lost 7% body weight, respectively; 50% and 47% lost 5% (p=0.22). Participants who were male (OR=2.41; 95% CI 1.32 to 4.40), had lower baseline body mass index (OR=1.03; 95% CI 1.01 to 1.07), attended more sessions (OR=1.33; 95% CI 1.11 to 1.58), and more frequently reported (OR=3.84; 95% CI 1.05 to 14.13) and met daily fat gram (OR=4.26; 95% CI 1.7 to 10.6) and weekly activity goals (OR=2.46; 95% CI 1.06 to 5.71) were more likely to meet their 7% weight loss goal. Predictors of meeting weight loss goals were similar for participants enrolled in the 12-week intervention.
  
  Conclusions
  
  Using telehealth technology to administer a modified DPP to multiple rural communities simultaneously demonstrated weight loss results comparable to those in a face-to-face intervention. Given the limitation of resources, linking rural areas to urban centers using telemedicine may increase access to much needed services to prevent or delay progression to diabetes.
  
  
• Subjects:
  1506 Clinical Care Prevention Rural Health Telemedicine Type 2 Diabetes
• Source:
  BMJ Open Diabetes Res Care. 2018; 6(1).
• Pubmed ID:
  29713481
• Pubmed Central ID:
  PMC5922481
• Document Type:
  Journal Article
• Funding:
  U58 DP004818/DP/NCCDPHP CDC HHS/United States
• Volume:
  6
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e6e41e0d824181f335042c3c24c8d4f3365ea27c45b7d6f124576584c930a630
• Download URL:
  https://stacks.cdc.gov/view/cdc/56100/cdc_56100_DS1.pdf
• File Type:
  [PDF - 404.03 KB ]