Translation, Health Education, and Evaluation Branch, Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
CyberData Technologies, Inc., Herndon, VA.
Diabetes Care. 2020 Sep;43(9):2042-2049. doi: 10.2337/dc19-2366. Epub 2020 Jul 2.
To assess retention in the National Diabetes Prevention Program (DPP) lifestyle change program, which seeks to prevent type 2 diabetes in adults at high risk.
We analyzed retention among 41,203 individuals who enrolled in Centers for Disease Control and Prevention (CDC)-recognized in-person lifestyle change programs at organizations that submitted data to CDC's Diabetes Prevention Recognition Program during January 2012-February 2017.
Weekly attrition rates were typically <1-2% but were between 3.5% and 5% at week 2 and at weeks 17 and 18, where session frequency typically transitions from weekly to monthly. The percentage of participants retained through 18 weeks varied by age (45.9% for 18-29 year olds, 53.4% for 30-44 year olds, 60.2% for 45-54 year olds, 66.7% for 55-64 year olds, and 67.6% for ≥65 year olds), race/ethnicity (70.5% for non-Hispanic whites, 60.5% for non-Hispanic blacks, 52.6% for Hispanics, and 50.6% for other), mean weekly percentage of body weight lost (41.0% for ≤0% lost, 66.2% for >0% to <0.25% lost, 72.9% for 0.25% to <0.5% lost, and 73.9% for ≥0.5% lost), and mean weekly physical activity minutes (12.8% for 0 min, 56.1% for >0 to <60 min, 74.8% for 60 to <150 min, and 82.8% for ≥150 min) but not by sex (63.0% for men and 63.1% for women).
Our results demonstrate the need to identify strategies to improve retention, especially among individuals who are younger or are members of racial/ethnic minority populations and among those who report less physical activity or less early weight loss. Strategies that address retention after the first session and during the transition from weekly to monthly sessions offer the greatest opportunity for impact.
评估国家糖尿病预防计划(DPP)生活方式改变计划的保留率,该计划旨在预防高危成年人的 2 型糖尿病。
我们分析了在 2012 年 1 月至 2017 年 2 月期间,向疾病预防控制中心(CDC)糖尿病预防认可计划提交数据的组织中参加 CDC 认可的以人群为基础的生活方式改变计划的 41203 名参与者的保留率。
每周的损耗率通常<1-2%,但在第 2 周和第 17、18 周时为 3.5%至 5%,此时的课程频率通常从每周转为每月。通过 18 周保留下来的参与者比例因年龄而异(18-29 岁为 45.9%,30-44 岁为 53.4%,45-54 岁为 60.2%,55-64 岁为 66.7%,≥65 岁为 67.6%),种族/民族(非西班牙裔白人占 70.5%,非西班牙裔黑人占 60.5%,西班牙裔占 52.6%,其他种族占 50.6%),每周平均体重百分比(体重损失≤0%为 41.0%,体重损失>0%至<0.25%为 66.2%,体重损失 0.25%至<0.5%为 72.9%,体重损失≥0.5%为 73.9%)和每周平均体力活动分钟数(0 分钟为 12.8%,0 至<60 分钟为 56.1%,60 至<150 分钟为 74.8%,≥150 分钟为 82.8%),但与性别无关(男性为 63.0%,女性为 63.1%)。
我们的结果表明,需要确定提高保留率的策略,尤其是在年龄较小或属于少数种族/族裔群体的人群中,以及在体力活动或早期体重减轻较少的人群中。在第一阶段之后和从每周过渡到每月阶段期间解决保留率问题的策略具有最大的影响机会。