1 Ambulatory Care Services, Denver Health and Hospital Authority, Denver, CO, USA.
2 Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA.
Am J Health Promot. 2019 Feb;33(2):289-292. doi: 10.1177/0890117118786195. Epub 2018 Jul 9.
The National Diabetes Prevention Program (NDPP) is a widely disseminated lifestyle intervention. Attendance is problematic, leading to suboptimal weight loss, especially among racial/ethnic minority participants. We conducted a novel "presession" protocol to improve engagement of diverse NDPP candidates, comparing NDPP participants who attended a presession to those who did not on attendance and weight loss outcomes.
Longitudinal cohort study.
A safety net health-care system.
A total of 1140 patients with diabetes risks (58.9% Hispanic, 19.8% non-Hispanic black, 61.8% low income).
The NDPP has been delivered in a Denver, Colorado health-care system since 2013. The program included 22 to 25 sessions over 1 year. Beginning September 2016, individuals were required to attend a presession before enrollment that focused on (1) increasing risk awareness, (2) motivational interviewing to participate in the NDPP, and (3) problem-solving around engagement barriers.
Duration and intensity of NDPP attendance and weight loss.
Outcomes of 75 presession participants who enrolled in the NDPP were compared to 1065 prior participants using analysis of covariance and multivariable logistic regression.
Presession participants stayed in the NDPP 99.8 days longer ( P < .001) and attended 14.3% more sessions ( P < .001) on average than those without a presession. Presession participants lost 2.0% more weight ( P < .001) and were 3.5 times more likely to achieve the 5% weight loss target ( P < .001).
Presessions may improve NDPP outcomes for individuals from diverse backgrounds. A full-scale trial is needed to determine whether presessions reliably improve NDPP effectiveness.
国家糖尿病预防计划（NDPP）是一种广泛传播的生活方式干预措施。但参与度存在问题，导致体重减轻效果不理想，尤其是在少数族裔参与者中。我们采用了一种新颖的“会前”方案来提高不同 NDPP 候选人的参与度，比较了参加和未参加会前方案的 NDPP 参与者的参与度和体重减轻效果。
纵向队列研究。
一个医疗保障系统。
共有 1140 名糖尿病高危患者（58.9%西班牙裔，19.8%非西班牙裔黑人，61.8%低收入）。
NDPP 自 2013 年以来一直在科罗拉多州丹佛市的医疗保健系统中实施。该计划包括在 1 年内进行 22-25 次课程。从 2016 年 9 月开始，个人在参加 NDPP 之前必须参加一个会前方案，该方案侧重于：（1）提高风险意识；（2）参与 NDPP 的动机访谈；（3）解决参与障碍问题。
NDPP 参与度和体重减轻的持续时间和强度。
采用协方差分析和多变量逻辑回归比较了参加 NDPP 会前方案的 75 名参与者与 1065 名先前参与者的结果。
参加会前方案的参与者在 NDPP 中的停留时间延长了 99.8 天（P<0.001），平均多参加了 14.3%的课程（P<0.001）。参加会前方案的参与者体重减轻了 2.0%（P<0.001），达到 5%体重减轻目标的可能性是未参加会前方案的参与者的 3.5 倍（P<0.001）。
会前方案可能会改善不同背景个体的 NDPP 结果。需要进行全面的试验来确定会前方案是否能可靠地提高 NDPP 的效果。
