Carroll College, Department of Health Sciences, Helena, MT, USA.
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
Transl Behav Med. 2021 Mar 16;11(2):351-358. doi: 10.1093/tbm/ibaa031.
The Diabetes Prevention Program (DPP) and its translational adaptations have been shown to be effective. However, individual-level economic impacts, such as the out-of-pocket costs borne by participants due to involvement in these programs have not been consistently and thoroughly evaluated. As cost is an important consideration that will impact the willingness of individuals to participate in such programs, this study examined direct monetary costs to participants in the Group Lifestyle Balance (GLB) DPP. Older adults (n = 134, mean age 62.8 years) with body mass index (BMI) ≥24 kg/m2 and prediabetes and/or metabolic syndrome participated in this GLB intervention, with two-thirds randomized to begin the intervention immediately and one-third functioning as a control for 6 months before receiving the entire intervention. Food and activity time and costs borne by participants were measured by self-report at baseline and after 6 months. Significant improvements in clinical metabolic measures, weight, and physical activity levels were achieved after 6 months in the intervention group compared both with baseline and the controls. Food costs did not increase among intervention participants. Costs related to physical activity did not change consistently over the course of the intervention. This DPP-GLB lifestyle intervention was effective in reducing risk factors for Type 2 diabetes mellitus among a diverse group of older participants without significantly increasing their out-of-pocket costs for food or physical activity over the course of the intervention. These results should help reduce concerns of individuals who are hesitant to participate in similar programs due to costs. The clinical trial registration number of this study is NCT01050205.
糖尿病预防计划（DPP）及其转化适应已被证明是有效的。然而，个体层面的经济影响，如参与者因参与这些计划而产生的自付费用，尚未得到一致和全面的评估。由于成本是一个重要的考虑因素，将影响个人参与这些计划的意愿，本研究检查了团体生活方式平衡（GLB）DPP 计划中参与者的直接货币成本。身体质量指数（BMI）≥24 kg/m2 的患有前驱糖尿病和/或代谢综合征的老年人（n=134，平均年龄 62.8 岁）参与了这种 GLB 干预，其中三分之二随机立即开始干预，三分之一在接受完整干预前作为对照组进行 6 个月。参与者的食物和活动时间和费用通过自我报告在基线和 6 个月后进行测量。与基线和对照组相比，干预组在 6 个月后在临床代谢指标、体重和身体活动水平方面取得了显著改善。干预参与者的食物成本没有增加。与身体活动相关的成本在干预过程中没有持续变化。这项 DPP-GLB 生活方式干预在减少不同年龄组参与者的 2 型糖尿病风险因素方面是有效的，而在干预过程中，他们的食物或身体活动自付费用并没有显著增加。这些结果应该有助于减少由于成本而犹豫不决参加类似计划的个人的担忧。本研究的临床试验注册号为 NCT01050205。
