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      Weight loss efficacy of a novel mobile Diabetes Prevention Program delivery platform with human coaching

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          Abstract

          Objective

          To evaluate the weight loss efficacy of a novel mobile platform delivering the Diabetes Prevention Program.

          Research Design and Methods

          43 overweight or obese adult participants with a diagnosis of prediabetes signed-up to receive a 24-week virtual Diabetes Prevention Program with human coaching, through a mobile platform. Weight loss and engagement were the main outcomes, evaluated by repeated measures analysis of variance, backward regression, and mediation regression.

          Results

          Weight loss at 16 and 24 weeks was significant, with 56% of starters and 64% of completers losing over 5% body weight. Mean weight loss at 24 weeks was 6.58% in starters and 7.5% in completers. Participants were highly engaged, with 84% of the sample completing 9 lessons or more. In-app actions related to self-monitoring significantly predicted weight loss.

          Conclusions

          Our findings support the effectiveness of a uniquely mobile prediabetes intervention, producing weight loss comparable to studies with high engagement, with potential for scalable population health management.

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          Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management.

          John D. Piette, Justin List, Gurpreet Rana … (2015)
          We examined evidence on whether mobile health (mHealth) tools, including interactive voice response calls, short message service, or text messaging, and smartphones, can improve lifestyle behaviors and management related to cardiovascular diseases throughout the world. We conducted a state-of-the-art review and literature synthesis of peer-reviewed and gray literature published since 2004. The review prioritized randomized trials and studies focused on cardiovascular diseases and risk factors, but included other reports when they represented the best available evidence. The search emphasized reports on the potential benefits of mHealth interventions implemented in low- and middle-income countries. Interactive voice response and short message service interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. Interactive voice response and short message service-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multimodal interventions including Web-based communication with clinicians and mHealth-enabled clinical monitoring with feedback also have shown benefits. The evidence regarding the potential benefits of interventions using smartphones and social media is still developing. Studies of mHealth interventions have been conducted in >30 low- and middle-income countries, and evidence to date suggests that programs are feasible and may improve medication adherence and disease outcomes. Emerging evidence suggests that mHealth interventions may improve cardiovascular-related lifestyle behaviors and disease management. Next-generation mHealth programs developed worldwide should be based on evidence-based behavioral theories and incorporate advances in artificial intelligence for adapting systems automatically to patients' unique and changing needs.
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            A Novel Diabetes Prevention Intervention Using a Mobile App: A Randomized Controlled Trial With Overweight Adults at Risk.

            Yoshimi Fukuoka, Caryl Gay, Kevin Joiner … (2015)
            Mobile phone technology may be a cost-effective and convenient way to deliver proven weight-loss interventions and thereby prevent or delay onset of type 2 diabetes. The purpose of this study was to examine the feasibility and efficacy of a diabetes prevention intervention combined with a mobile app and pedometer in English-speaking overweight adults at risk for type 2 diabetes.
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              Translating the Diabetes Prevention Program into an Online Social Network: Validation against CDC Standards.

              S Cameron Sepah, Luohua Jiang, Anne Peters (2014)
              The purpose of this study was to evaluate the efficacy of Prevent, an online social network-based translation of the Diabetes Prevention Program (DPP) lifestyle intervention, against the Centers for Disease Control and Prevention (CDC) Diabetes Prevention and Recognition Program (DPRP) outcome standards and weight loss outcomes of other DPP translations. Two hundred twenty participants previously diagnosed with prediabetes were recruited online and enrolled in Prevent, a DPP-based group lifestyle intervention that integrates a private online social network, weekly lessons, health coaching, and a wireless scale and pedometer. Participants underwent a core 16-week intensive lifestyle change intervention and were then offered to continue with a post-core lifestyle change maintenance intervention, with the entire intervention (core plus post-core) totaling 12 months. One hundred eighty-seven participants met inclusion criteria for the core program and achieved an average of 5.0% and 4.8% weight loss at 16 weeks and 12 months, respectively. They also had a 0.37% reduction in their A1C level at final measurement. One hundred forty-four of these same participants also met inclusion criteria for the post-core program and achieved an average of 5.4% and 5.2% weight loss at 16 weeks and 12 months, respectively, and a 0.40% reduction in A1C at final measurement. Results indicate that Prevent meets CDC DPRP outcome standards for diabetes prevention programs and performs favorably to other DPP translations. Considering national initiatives to address the obesity and diabetes epidemics, online delivery platforms like Prevent offer an effective and scalable solution. © 2014 The Author(s).
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMJ Open Diabetes Res Care
                Journal ID (iso-abbrev): BMJ Open Diabetes Res Care
                Journal ID (hwp): bmjdrc
                Journal ID (publisher-id): bmjdrc
                Title: BMJ Open Diabetes Research & Care
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Electronic): 2052-4897
                Publication date Collection: 2016
                Publication date (Electronic): 5 September 2016
                Volume: 4
                Issue: 1
                Electronic Location Identifier: e000264
                Affiliations
                Noom, Inc., New York, New York, USA
                Author notes
                [Correspondence to ] Dr Andreas Michaelides; andreas@ 123456noom.com
                Author information
                http://orcid.org/0000-0003-4153-3316
                Article
                Publisher ID: bmjdrc-2016-000264
                DOI: 10.1136/bmjdrc-2016-000264
                PMC ID: 5020857
                SO-VID: 55241677-ad6d-453b-a17d-fa77afc39082
                Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
                License:

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                Date received : 4 May 2016
                Date revision received : 19 July 2016
                Date accepted : 11 August 2016
                Categories
                Subject: Clinical Care/Education/Nutrition/Psychosocial Research
                Subject: 1506
                Subject: 1866

                Keywords: behavioral interventions,body weight,pre-diabetes,telemedicine
                Data availability:
                Keywords: behavioral interventions, body weight, pre-diabetes, telemedicine

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