Tannaz Moin1, Laura J Damschroder2, Mona AuYoung2, Matthew L Maciejewski3, Santanu K Datta3, Jane E Weinreb4, Nanette I Steinle5, Charles Billington6, Maria Hughes2, Fatima Makki2, Robert G Holleman2, H Myra Kim7, Amy S Jeffreys8, Linda S Kinsinger9, Jennifer A Burns2, Caroline R Richardson10. 1. Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California; VA Health Services Research and Development (HSR&D) Center for Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles, California. Electronic address: tannaz.moin@va.gov. 2. Ann Arbor VA Center for Clinical Management Research, Ann Arbor, Michigan. 3. Department of Medicine, Durham VA Medical Center, Durham, North Carolina; Department of Medicine, Duke University School of Medicine, Durham, North Carolina. 4. Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California. 5. Department of Medicine, Baltimore VA Medical Center, Baltimore, Maryland; Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. 6. Department of Medicine, Minneapolis VA Healthcare System, Minneapolis, Minnesota; Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota. 7. Ann Arbor VA Center for Clinical Management Research, Ann Arbor, Michigan; Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, Michigan. 8. Department of Medicine, Durham VA Medical Center, Durham, North Carolina. 9. VHA National Center for Health Promotion and Disease Prevention, Durham, North Carolina. 10. Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Family Medicine, University of Michigan, Ann Arbor, Michigan; VA Diabetes QUERI, Ann Arbor, Michigan.
Abstract
INTRODUCTION: This clinical demonstration trial compared the effectiveness of the Veterans Affairs Diabetes Prevention Program (VA-DPP) with an evidence-based usual care weight management program (MOVE!®) in the Veterans Health Administration health system. DESIGN: Prospective, pragmatic, non-randomized comparative effectiveness study of two behavioral weight management interventions. SETTING/PARTICIPANTS: Obese/overweight Veterans with prediabetes were recruited from three geographically diverse VA sites between 2012 and 2014. INTERVENTION: VA-DPP included 22 group-based intensive lifestyle change sessions. MAIN OUTCOME MEASURES: Weight change at 6 and 12 months, hemoglobin A1c (HbA1c) at 12 months, and VA health expenditure changes at 15 months were assessed using VA electronic health record and claims data. Between- and within-group comparisons for weight and HbA1c were done using linear mixed-effects models controlling for age, gender, race/ethnicity, baseline outcome values, and site. Analyses were conducted in 2015-2016. RESULTS: A total of 387 participants enrolled (273 VA-DPP, 114 MOVE!). More VA-DPP participants completed at least one (73.3% VA-DPP vs 57.5% MOVE! p=0.002); four (57.5% VA-DPP vs 42.5% MOVE!, p=0.007); and eight or more sessions (42.5% VA-DPP vs 31% MOVE!, p=0.035). Weight loss from baseline was significant at both 6 (p<0.001) and 12 months (p<0.001) for VA-DPP participants, but only significant at 6 months for MOVE! participants (p=0.004). Between groups, there were significant differences in 6-month weight loss (-4.1 kg VA-DPP vs -1.9 kg MOVE!, p<0.001), but not 12-month weight loss (-3.4 kg VA-DPP vs -2.0 kg MOVE!, p=0.16). There were no significant differences in HbA1c change or outpatient, inpatient, and total VA expenditures. CONCLUSIONS: VA-DPP participants had higher participation rates and weight loss at 6 months, but similar weight, HbA1c, and health expenditures at 12 months compared to MOVE! PARTICIPANTS: Features of VA-DPP may help enhance the capability of MOVE! to reach a larger proportion of the served population and promote individual-level weight maintenance. Published by Elsevier Inc.
INTRODUCTION: This clinical demonstration trial compared the effectiveness of the Veterans Affairs Diabetes Prevention Program (VA-DPP) with an evidence-based usual care weight management program (MOVE!®) in the Veterans Health Administration health system. DESIGN: Prospective, pragmatic, non-randomized comparative effectiveness study of two behavioral weight management interventions. SETTING/PARTICIPANTS: Obese/overweight Veterans with prediabetes were recruited from three geographically diverse VA sites between 2012 and 2014. INTERVENTION: VA-DPP included 22 group-based intensive lifestyle change sessions. MAIN OUTCOME MEASURES: Weight change at 6 and 12 months, hemoglobin A1c (HbA1c) at 12 months, and VA health expenditure changes at 15 months were assessed using VA electronic health record and claims data. Between- and within-group comparisons for weight and HbA1c were done using linear mixed-effects models controlling for age, gender, race/ethnicity, baseline outcome values, and site. Analyses were conducted in 2015-2016. RESULTS: A total of 387 participants enrolled (273 VA-DPP, 114 MOVE!). More VA-DPPparticipants completed at least one (73.3% VA-DPP vs 57.5% MOVE! p=0.002); four (57.5% VA-DPP vs 42.5% MOVE!, p=0.007); and eight or more sessions (42.5% VA-DPP vs 31% MOVE!, p=0.035). Weight loss from baseline was significant at both 6 (p<0.001) and 12 months (p<0.001) for VA-DPPparticipants, but only significant at 6 months for MOVE! participants (p=0.004). Between groups, there were significant differences in 6-month weight loss (-4.1 kg VA-DPP vs -1.9 kg MOVE!, p<0.001), but not 12-month weight loss (-3.4 kg VA-DPP vs -2.0 kg MOVE!, p=0.16). There were no significant differences in HbA1c change or outpatient, inpatient, and total VA expenditures. CONCLUSIONS:VA-DPPparticipants had higher participation rates and weight loss at 6 months, but similar weight, HbA1c, and health expenditures at 12 months compared to MOVE! PARTICIPANTS: Features of VA-DPP may help enhance the capability of MOVE! to reach a larger proportion of the served population and promote individual-level weight maintenance. Published by Elsevier Inc.
Authors: Tannaz Moin; Laura J Damschroder; Mona AuYoung; Matthew L Maciejewski; Kathryn Havens; Kristyn Ertl; Elena Vasti; Jane E Weinreb; Nanette I Steinle; Charles J Billington; Maria Hughes; Fatima Makki; Bradley Youles; Robert G Holleman; H Myra Kim; Linda S Kinsinger; Caroline R Richardson Journal: Am J Prev Med Date: 2018-09-24 Impact factor: 5.043
Authors: Stephanie L Fitzpatrick; Meghan Mayhew; Chris L Catlin; Alison Firemark; Inga Gruß; Denis B Nyongesa; Maureen O'Keeffe-Rosetti; Andreea M Rawlings; David H Smith; Ning Smith; Victor J Stevens; William M Vollmer; Stephen P Fortmann Journal: Perm J Date: 2021-12-13
Authors: Pearl G Lee; Laura J Damschroder; Robert Holleman; Tannaz Moin; Caroline R Richardson Journal: Diabetes Care Date: 2018-10-30 Impact factor: 19.112
Authors: Michael E Bowen; Julie A Schmittdiel; Jeffrey T Kullgren; Ronald T Ackermann; Matthew J O'Brien Journal: Curr Diab Rep Date: 2018-09-19 Impact factor: 4.810
Authors: Jeffrey P Haibach; Katherine D Hoerster; Lindsey Dorflinger; Lisa M McAndrew; Daniel G Cassidy; David E Goodrich; Jill E Bormann; Julie Lowery; Steven M Asch; Susan D Raffa; Tannaz Moin; Alan L Peterson; Michael G Goldstein; Tracy Neal-Walden; Gerald W Talcott; Christopher L Hunter; Sara J Knight Journal: Transl Behav Med Date: 2021-03-16 Impact factor: 3.046
Authors: Emily VanDerBrink; Soheir Boshra; Samantha M Harden; Krisann K Oursler; Richard Winett; Brenda Davy Journal: Transl J Am Coll Sports Med Date: 2020-03
Authors: Kimberly D Brunisholz; Jaewhan Kim; Lucy A Savitz; Mia Hashibe; Lisa H Gren; Sharon Hamilton; Kelly Huynh; Elizabeth A Joy Journal: Prev Chronic Dis Date: 2017-07-20 Impact factor: 2.830