Effectiveness of a lifestyle intervention program among persons at high risk for cardiovascular disease and diabetes in a rural community.

PURPOSE: To evaluate the feasibility of translating the Diabetes Prevention Program (DPP) lifestyle intervention into practice in a rural community. METHODS: In 2008, the Montana Diabetes Control Program worked collaboratively with Holy Rosary Healthcare to implement an adapted group-based DPP lifestyle intervention. Adults at high risk for diabetes and cardiovascular disease were recruited and enrolled (N = 101). Participants set targets to reduce fat intake and increase physical activity (> or = 150 mins/week) in order to achieve a 7% weight loss goal. FINDINGS: Eighty-three percent (n = 84) of participants completed the 16-session core program and 65 (64%) participated in 1 or more after-core sessions. Of those completing the core program, the mean participation was 14.4 +/- 1.6 and 3.9 +/- 1.6 sessions during the core and after core, respectively. Sixty-five percent of participants met the 150-min-per-week physical activity goal during the core program. Sixty-two percent achieved the 7% weight loss goal and 78% achieved at least a 5% weight loss during the core program. The average weight loss per participant was 7.5 kg (range, 0 to 19.7 kg), which was 7.5% of initial body weight. At the last recorded weight in the after core, 52% of participants had met the 7% weight loss goal and 66% had achieved at least a 5% weight loss. CONCLUSION: Our findings suggest that it is feasible to implement a group-based DPP in a rural community and achieve weight loss and physical goals that are comparable to those achieved in the DPP.

Adapted diabetes prevention program lifestyle intervention can be effectively delivered through telehealth.

PURPOSE: The purpose of this study was to assess the feasibility of delivering an adapted group-based version of the Diabetes Prevention Program's (DPP) lifestyle intervention through telehealth video conferencing. METHODS: In 2009, the Montana Department of Public Health and Human Services in collaboration with Holy Rosary Heathcare implemented the DPP lifestyle intervention, which was provided to an on-site group in 1 community and simultaneously through telehealth to a second group in a remote frontier community. Participants obtained medical clearance from their primary care physician and were eligible if they were overweight and had 1 or more of the following risk factors: prediabetes, impaired glucose tolerance/impaired fasting glucose (IGT/IFG), a history of gestational diabetes (GDM) or the delivery of an infant >9 pounds, hypertension, or dyslipidemia. RESULTS: A total of 13 and 16 eligible adults enrolled in the on-site and the telehealth program, and 13 (100%) and 14 (88%) participants completed the 16-week program, respectively. Both the on-site and telehealth groups achieved high levels of weekly physical activity and there were no significant differences between groups. Over 45% of on-site and telehealth participants achieved the 7% weight loss goal with the average weight loss per participant greater than 6.4 kg in both groups. CONCLUSIONS: Our findings suggest that it is feasible to deliver an adapted group-based DPP lifestyle intervention through telehealth resulting in weight loss outcomes similar to the original DPP.