From the Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA (JLS); General Internal Medicine, Department of Medicine, Medical College of Georgia, Augusta University (CH); Georgia Prevention Institute, Medical College of Georgia, Augusta University (CLD); Department of Family Medicine, Medical College of Georgia at Augusta University (CWL).
J Am Board Fam Med. 2022 May-Jun;35(3):548-558. doi: 10.3122/jabfm.2022.03.210415.
The objective of this study was to adapt the National Diabetes Prevention Program (N-DPP) into a pragmatic tool for primary care settings by using daily text messaging to deliver all N-DPP content, supplemented by Fitbit technology to provide behavioral strategies typically delivered by personnel in traditional programs. Test the mobile health (mHealth), technology-based N-DPP adaptation (DPPFit) in primary care patients with prediabetes using a remote intervention based on the traditional 16 core sessions of the DPP.
A pilot study with pre/post survey analysis of aggregate data were used to determine changes in weight, physical activity, sedentary behavior, and associated diabetes risk outcomes among study participants (n = 33). In this study, participants were issued Fitbit devices and provided the remote intervention over 16 weeks via automated text messaging technology, which followed the content of the DPP core education sessions.
Data analysis from baseline to 6-month follow-up demonstrate mean weight loss of 3.3 kg (95% CI: -6.2 to -0.5; = ), reduction in body mass index by 1.25 points (95% CI: -2.1 to -0.4; = ), a significant average increase of 2 days in self-reported physical activity per week (95% CI: 0.4 to 3.6; = ) and an average 10% decrease in sedentary time ( = ).
The remote DPPFit intervention demonstrates a promising and practical approach to the management of prediabetes in a primary care setting. The results support the use of the DPPFit program and application to achieve meaningful outcomes in a population with prediabetes. A randomized controlled trial with a larger sample is warranted.
本研究旨在通过使用日常短信传递所有 N-DPP 内容，并辅以 Fitbit 技术提供传统计划中人员通常提供的行为策略，将国家糖尿病预防计划（N-DPP）改编为适用于初级保健环境的实用工具。使用基于传统 DPP 的 16 个核心课程的远程干预，在患有前驱糖尿病的初级保健患者中测试基于移动健康（mHealth）的 N-DPP 改编（DPPFit）。
采用预/后调查分析综合数据的试点研究，以确定研究参与者（n=33）的体重、身体活动、久坐行为和相关糖尿病风险结果的变化。在这项研究中，参与者获得了 Fitbit 设备，并通过自动化短信技术在 16 周内接受远程干预，该技术遵循 DPP 核心教育课程的内容。
从基线到 6 个月随访的数据分析表明，体重平均减轻 3.3 公斤（95%CI：-6.2 至-0.5； = ），体重指数降低 1.25 点（95%CI：-2.1 至-0.4； = ），自我报告的每周身体活动量平均增加 2 天（95%CI：0.4 至 3.6； = ），久坐时间平均减少 10%（ = ）。
远程 DPPFit 干预为初级保健环境中前驱糖尿病的管理提供了一种有前途且实用的方法。结果支持使用 DPPFit 计划并应用于实现前驱糖尿病人群的有意义结果。需要进行更大样本的随机对照试验。
