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Title: Development of a videoconference-adapted version of the community Diabetes Prevention Program, and comparison of weight loss with in-person program delivery

Author
item TAETZSCH, AMY - JEAN MAYER HUMAN NUTRITION RESEARCH CENTER ON AGING AT TUFTS UNIVERSITY
item GILHOOLY, CHERYL - JEAN MAYER HUMAN NUTRITION RESEARCH CENTER ON AGING AT TUFTS UNIVERSITY
item BUKHARI, ASMA - WALTER REED ARMY MEDICAL CENTER
item DAS, SAI KRUPA - JEAN MAYER HUMAN NUTRITION RESEARCH CENTER ON AGING AT TUFTS UNIVERSITY
item MARTIN, EDWARD - JEAN MAYER HUMAN NUTRITION RESEARCH CENTER ON AGING AT TUFTS UNIVERSITY
item HATCH, ADRIENNE - U.S. ARMY RESEARCH INSTITUTE OF ENVIRONMENTAL MEDICINE
item SILVER, RACHEL - JEAN MAYER HUMAN NUTRITION RESEARCH CENTER ON AGING AT TUFTS UNIVERSITY
item MONTAIN, SCOTT - U.S. ARMY RESEARCH INSTITUTE OF ENVIRONMENTAL MEDICINE
item ROBERTS, SUSAN - JEAN MAYER HUMAN NUTRITION RESEARCH CENTER ON AGING AT TUFTS UNIVERSITY

Submitted to: Military Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/7/2019
Publication Date: 4/24/2019
Citation: Taetzsch, A.G., Gilhooly, C., Bukhari, A., Das, S., Martin, E., Hatch, A.M., Silver, R., Montain, S.J., Roberts, S. 2019. Development of a videoconference-adapted version of the community Diabetes Prevention Program, and comparison of weight loss with in-person program delivery. Military Medicine. https://doi.org/10.1093/milmed/usz069.
DOI: https://doi.org/10.1093/milmed/usz069

Interpretive Summary: The prevalence of adults with overweight and obesity in the United States remains alarmingly high and affects not only civilians but also military families. Military families face many unique challenges that make weight loss and maintenance challenging. Our study describes an adaptation of the in-person community Diabetes Prevention Program (DPP) to a videoconference platform in military dependents and evaluated use of the two interventions over 12 weeks. We found that military dependents enrolled in the videoconference DPP program did not differ in weight loss or attendance over a 12 week period and had better retention compared to those enrolled in the in-person DPP program. This data is the first of its kind, and provides evidence that videoconference weight loss programs are a viable and scalable option for future weight loss and management efforts across military services.

Technical Abstract: Introduction: There is an urgent need for an effective, standardized, and easily accessible weight management program among military beneficiaries. Videoconference interventions have the potential for widespread scaling and offer real time interaction and flexibility in delivery times and standardized program content regardless of location, but have not been evaluated for use in military families. Materials and Methods: The data presented here is part of a larger weight loss trial and covers specifics of one of the two weight loss interventions. This study adapted the Group Lifestyle Balance (GLB) program, a community Diabetes Prevention Program intervention, for videoconference delivery and compared weight loss and meeting attendance between in-person and videoconference interventions over 12 weeks in adult family members of military service members. Forty-three participants were enrolled from two military installations and received either the videoconference-adapted or an in-person GLB program in a non-randomized trial design. Differences in program attendance and percent weight lost at 12 weeks were compared by independent samples t-tests and nonparametric methods. Group differences in the percentage of weight lost over the 12-week period were analyzed using a linear mixed model. Results: All GLB intervention components were successfully delivered by videoconference with minor adaptations for the different delivery mechanism. Participant retention was 70% and 96% in the in-person and videoconference groups, respectively (P=0.04). Completing participants in both groups lost a significant percent body weight over the 12 week intervention (P <0.001) and there was no difference in percent body weight between the two groups over time (P=0.14) and after 12 weeks of intervention (6.2+/-3.2% and 5.3 +/-3.4% for in-person and videoconference at 12 weeks, respectively; P=0.60). Conclusion: This study demonstrates a successful videoconference adaption of the GLB program for military families. Attrition was lower (4% vs 30%) in the videoconference group, and there were a similar levels of weight loss trend noted in both groups regardless of delivery modality. Videoconference weight loss interventions are effective and feasible for scaling to support healthy weight management in military as well as civilian populations.