ABSTRACT
In 2020, the COVID-pandemic challenged the delivery of the National DPP and presented unique stressors for participants. Since 2008, Montana's DPP has maintained a registry to track participant retention, goal achievement, and changes in cardiometabolic (CM) risk. To measure effects of the COVID pandemic on DPP outcomes in Montana, we compared data from participants in 2020 to those in 2017 - 2019. Baseline, 6 and 12-month data were available for 522 participants from 2020 and 2,313 from 2017-2019. Changes in participation and measures of CM were compared using chi-square analysis, t-test and ANOVA analysis. The average number of sessions attended was lower in 2020, 13.6, than in 2017-2019, 14.4 (p=0.02) . The average percent of body weight lost was lower in 2020 at both six-months, 3.9%, and twelve-months, 3.7%, compared to the same measurements in 2017 to 2019, 4.4% (p=0.03) and 4.4% (p=0.01) . Among CM risk measurements, significant differences occurred only for increases in the HDL cholesterol levels measured in 2020, 52.9 mg/dL baseline, 54.7 at 6 months and 56.4 at 12 months, compared to those in 2017 to 2019, 53.6, 52.9 and 55.8 (p=0.00for 6 and p=0.0087 for 12-month) (Table) . During the COVID-pandemic DPP participants continued to lose weight and achieve significant improvements in overall CM risk despite slightly less weight loss compared to participants in previous years.
ABSTRACT
Geographic differences in infectious disease mortality rates have been observed among American Indian or Alaska Native (AI/AN) persons in the United States (1), and aggregate analyses of data from selected U.S. states indicate that COVID-19 incidence and mortality are higher among AI/AN persons than they are among White persons (2,3). State-level data could be used to identify disparities and guide local efforts to reduce COVID-19-associated incidence and mortality; however, such data are limited. Reports of laboratory-confirmed COVID-19 cases and COVID-19-associated deaths reported to the Montana Department of Public Health and Human Services (MDPHHS) were analyzed to describe COVID-19 incidence, mortality, and case-fatality rates among AI/AN persons compared with those among White persons. During March-November 2020 in Montana, the estimated cumulative COVID-19 incidence among AI/AN persons (9,064 cases per 100,000) was 2.2 times that among White persons (4,033 cases per 100,000).* During the same period, the cumulative COVID-19 mortality rate among AI/AN persons (267 deaths per 100,000) was 3.8 times that among White persons (71 deaths per 100,000). The AI/AN COVID-19 case-fatality rate (29.4 deaths per 1,000 COVID-19 cases) was 1.7 times the rate in White persons (17.0 deaths per 1,000). State-level surveillance findings can help in developing state and tribal COVID-19 vaccine allocation strategies and assist in local implementation of culturally appropriate public health measures that might help reduce COVID-19 incidence and mortality in AI/AN communities.