Earle C Chambers1,2, Jeffrey S Gonzalez2,3,4,5, Melinda E Marquez6, Amanda Parsons6, Colin D Rehm2,6. 1. Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York. 2. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York. 3. Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York. 4. Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, New York. 5. The Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, Bronx, New York. 6. Office of Community and Population Health, Montefiore Health System, Bronx, New York.
Abstract
PURPOSE: The purpose of this study was to identify patient and program delivery characteristics associated with engagement and weight loss in a Diabetes Prevention Program (DPP) implemented in an urban hospital system. METHODS: Patient and program delivery data were collected between July 2015 and December 2017. DPP eligibility was determined based on age, body mass index (BMI), and hemoglobin A1C data via the electronic health record. Engagement was measured at 3 levels: ≤3 sessions, 4 to 8 sessions, and ≥9 sessions. Weight was measured at each DPP session. RESULTS: Among the eligible patients (N = 31 524), referrals and engagement were lower in men than women, in Spanish speakers than English speakers, in younger (18-34 years) and middle-aged (35-54 years) than older adults, and in patients receiving Medicaid than other patients. Referral and engagement were higher in patients with higher BMIs and those prescribed ≥5 medications. Current smokers were less frequently engaged. Prior health care provider contact was associated with higher engagement. Overall, 28% of DPP participants achieved ≥5% weight loss; younger and middle-aged patients and those who gained weight in the prior 2 years were less likely to lose weight. CONCLUSION: This assessment identified characteristics of patients with lower levels of referral and engagement. The DPP staff may need to increase outreach to address barriers to referral and during all points of engagement among men, younger patients, and Spanish speakers. Future research is needed to increase understanding with regard to why referrals and engagement are lower among these groups.
PURPOSE: The purpose of this study was to identify patient and program delivery characteristics associated with engagement and weight loss in a Diabetes Prevention Program (DPP) implemented in an urban hospital system. METHODS:Patient and program delivery data were collected between July 2015 and December 2017. DPP eligibility was determined based on age, body mass index (BMI), and hemoglobin A1C data via the electronic health record. Engagement was measured at 3 levels: ≤3 sessions, 4 to 8 sessions, and ≥9 sessions. Weight was measured at each DPP session. RESULTS: Among the eligible patients (N = 31 524), referrals and engagement were lower in men than women, in Spanish speakers than English speakers, in younger (18-34 years) and middle-aged (35-54 years) than older adults, and in patients receiving Medicaid than other patients. Referral and engagement were higher in patients with higher BMIs and those prescribed ≥5 medications. Current smokers were less frequently engaged. Prior health care provider contact was associated with higher engagement. Overall, 28% of DPPparticipants achieved ≥5% weight loss; younger and middle-aged patients and those who gained weight in the prior 2 years were less likely to lose weight. CONCLUSION: This assessment identified characteristics of patients with lower levels of referral and engagement. The DPP staff may need to increase outreach to address barriers to referral and during all points of engagement among men, younger patients, and Spanish speakers. Future research is needed to increase understanding with regard to why referrals and engagement are lower among these groups.
Authors: William C Knowler; Elizabeth Barrett-Connor; Sarah E Fowler; Richard F Hamman; John M Lachin; Elizabeth A Walker; David M Nathan Journal: N Engl J Med Date: 2002-02-07 Impact factor: 91.245
Authors: Sandhya Mehta; Michelle Mocarski; Tami Wisniewski; Karin Gillespie; K M Venkat Narayan; Kathleen Lang Journal: BMJ Open Diabetes Res Care Date: 2017-08-11
Authors: Earle C Chambers; Judith Wylie-Rosett; Arthur E Blank; Judy Ouziel; Nicole Hollingsworth; Rachael W Riley; Peter A Selwyn Journal: Prev Chronic Dis Date: 2015-11-05 Impact factor: 2.830
Authors: Kunthea Nhim; Tamkeen Khan; Stephanie M Gruss; Gregory Wozniak; Kate Kirley; Patricia Schumacher; Elizabeth T Luman; Ann Albright Journal: Am J Prev Med Date: 2018-06-20 Impact factor: 5.043