Patient-Centered Goal-Setting in the National Diabetes Prevention Program: A Pilot Study.

Abstract

OBJECTIVE:

Difficulty achieving preset goals (e.g., ≥5% weight loss, ≥150 min of weekly physical activity) in the yearlong National Diabetes Prevention Program (NDPP) can prompt dropout and diminish benefits. We piloted a more patient-centered NDPP adaptation (NDPP-Flex) that promotes a variety of attainable and individually tailored goals to reduce diabetes risks, along with flexibility to adjust goals each week as needed.

RESEARCH DESIGN AND METHODS:

Retention, physical activity, weight, and glycated hemoglobin (HbA1c) were evaluated among diverse participants with diabetes risks who received our pilot of NDPP-Flex beginning in January and July 2018 (n = 95), with a planned comparison with standard NDPP delivery in preceding cohorts that launched between September 2016 and October 2017 (n = 245). Both the standard NDPP and NDPP-Flex interventions were 1 year in duration and implemented in phases (i.e., nonrandomized).

RESULTS:

Average adjusted retention (e.g., 158.90 ± 15.20 vs. 166.71 ± 9.38 days; P = 0.674), physical activity (157.97 ± 11.91 vs. 175.64 ± 7.54 weekly min; P = 0.231), and weight loss (1.46 ± 0.38% vs. 1.90 ± 0.24%; P = 0.396) were similar between NDPP-Flex versus standard NDPP. However, NDPP-Flex participants had greater HbA1c reduction on average (0.22 ± 0.05% vs. 0.06 ± 0.03%; P = 0.018) and were more likely to have normoglycemia at follow-up (odds ratio 4.62; P = 0.013 [95% CI 1.38-15.50]) than participants in the standard NDPP.

CONCLUSIONS:

An adapted, more patient-centered NDPP that focuses on flexible, self-selected goals may be a promising strategy to improve glycemia even in the absence of substantial weight loss.

• Authors: Natalie D Ritchie, Katherine A Sauder, Peter G Kaufmann, Leigh Perreault
• Journal: Diabetes care (Diabetes Care) Vol. 44 Issue 11 Pg. 2464-2469 (11 2021) ISSN: 1935-5548 [Electronic] United States
• PMID: 34404739 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)
• Copyright: © 2021 by the American Diabetes Association.

Chemical References

• Glycated Hemoglobin A

Topics

• Diabetes Mellitus, Type 2 (prevention & control)
• Glycated Hemoglobin (analysis)
• Goals
• Humans
• Patient-Centered Care
• Pilot Projects