A randomized comparative effectiveness trial for preventing type 2 diabetes

R.T. Ackermann, D.T. Liss, E.A. Finch, K.K. Schmidt, L.M. Hays, D.G. Marrero and C. Saha

American Journal of Public Health, 2015, vol. 105, issue 11, 2328-2334

Abstract: Objectives. We evaluated the weight loss effectiveness of a YMCA model for the Diabetes Prevention Program (DPP) lifestyle intervention. Methods. Between July 2008 and November 2010, we individually randomized 509 overweight or obese, low-income, nondiabetic adults with elevated blood glucose in Indianapolis, Indiana, to receive standard care plus brief lifestyle counseling or be offered a group-based YMCA adaptation of the DPP (YDPP). Primary outcome was mean weight loss difference at 12 months. In our intention-to-treat analyses, we used longitudinal linear or logistic regression, multiply imputing missing observations. We used instrumental variables regression to estimate weight loss effectiveness among participants completing 9 or more intervention lessons. Results. In the YDPP arm, 161 (62.6%) participants attended ≥ 1 lesson and 103 (40.0%) completed 9 or more lessons. In intention-to-treat analysis, mean 12-month weight loss was 2.3 kilograms (95% confidence interval [CI] = 1.1, 3.4 kg) more for the YDPP arm than for standard care participants. In instrumental variable analyses, persons attending 9 or more lessons had a 5.3-kilogram (95% CI = 2.8, 7.9 kg) greater weight loss than did those with standard care alone. Conclusions. The YMCA model for DPP delivery achieves meaningful weight loss at 12 months among low-income adults.

Keywords: glucose blood level, adult; body mass; comparative study; controlled study; counseling; Diabetes Mellitus, Type 2; female; glucose blood level; health behavior; human; Indiana; lifestyle; male; middle aged; obesity; organization and management; Overweight; poverty; randomized controlled trial; single blind procedure; weight loss program; weight reduction, Adult; Blood Glucose; Body Mass Index; Counseling; Diabetes Mellitus, Type 2; Female; Health Behavior; Humans; Indiana; Life Style; Male; Middle Aged; Obesity; Overweight; Poverty; Single-Blind Method; Weight Loss; Weight Reduction Programs (search for similar items in EconPapers)
Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2015.302641_4

DOI: 10.2105/AJPH.2015.302641

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