THE EFFECTS OF A DIGITAL DIABETES PREVENTION PROGRAM ON PHYSICAL ACTIVITY AND DIET

Abstract

BACKGROUND: Lifestyle health behavior change that induces weight loss is the cornerstone of diabetes prevention programs (DPP); however, few DPPs report changes in physical activity and diet. Therefore, the purpose of this study was to evaluate the impact of a digital DPP (d-DPP) on physical activity and diet among patients with prediabetes. METHODS: In the Preventing Diabetes with Digital Health and Coaching for Translation and Scalability (PREDICTS) randomized control trial, 599 individuals with prediabetes were randomized to a d-DPP or a small group education (SGE) class. The d-DPP provided an weekly educational curriculum, lifestyle coaching, virtual peer support, and behavior tracking tools. Change in moderate to vigorous physical activity (MVPA) and change in total diet scores were measured using the self-reported Godin-Shephard Leisure-Time Physical Activity and Starting the Conversation (STC) food intake questionnaires. Analysis of covariance was used to assess changes in physical activity and diet from baseline to 12 months. Spearman correlation coefficients were used to examine the relationships among changes in physical activity and diet to changes in HbA1c and bodyweight. Spearman correlations were used to examine the relationship between total engagement and changes in physical activity and diet. An analysis of covariance was used to examine the role of engagement on change in physical activity and diet. RESULTS: Change in MVPA did not differ between interventions groups from baseline to 12 months (71.84 vs. 41.90 minutes/week, p=0.151). Change in total diet score significantly decreased for participants within the d-DPP from baseline to 12 months compared to the SGE (-1.97 vs. -1.27, p<0.001). Change in total diet score was significantly related to change in HbA1c (rs (452) = 0.23, p<0.001) and change in bodyweight (rs (450) = 0.31, p< 0.001). Change in MVPA was significantly related to change in bodyweight (rs (426) = -0.10; p=0.032). Engagement was significantly associated with a change in total diet score (rs (226) = -0.21, p=0.001) but was not significantly associated to change in MVPA (rs (216) = 0.07, p=0.333). CONCLUSION: The digital DPP improved total diet score for individuals with prediabetes. Change in total diet score was more related to change in HbA1c and bodyweight than physical activity and higher engagement with the intervention was related to greater change in total diet score.