Preventing diabetes with digital health and coaching for translation and scalability (PREDICTS): A type 1 hybrid effectiveness-implementation trial protocol.


Journal

Contemporary clinical trials
ISSN: 1559-2030
Titre abrégé: Contemp Clin Trials
Pays: United States
ID NLM: 101242342

Informations de publication

Date de publication:
01 2020
Historique:
received: 31 07 2019
revised: 29 10 2019
accepted: 30 10 2019
pubmed: 5 11 2019
medline: 27 5 2021
entrez: 5 11 2019
Statut: ppublish

Résumé

Diabetes prevention remains a top public health priority; digital approaches are potential solutions to existing scalability and accessibility challenges. There remains a gap in our understanding of the relationship between effectiveness, costs, and potential for sustained implementation of digital diabetes prevention strategies within typical healthcare settings. To describe the methods and design of a type 1 hybrid effectiveness-implementation trial of a digital diabetes prevention program (DPP) using the iPARIHS and RE-AIM frameworks. The trial will contrast the effects of two DPP interventions: (1) small group, in-person class, and (2) a digital DPP consisting of small group support, personalized health coaching, digital tracking tools, and weekly behavior change curriculum. Each intervention includes personal action planning with a focus on key elements of the lifestyle intervention from the CDC National DPP. Adults at risk for diabetes (BMI ≥25 and 5.7% ≤ HbA1c ≤ 6.4) will be randomly assigned to either the intervention group (n = 241) or the small group (n = 241). Assessment of primary (HbA1c) and secondary (weight loss, costs, cardiovascular risk factors) outcomes will occur at baseline, 4, and 12 months. Additionally, the trial will explore the potential for future adoption, implementation, and sustainability of the digitally-based intervention within a regional healthcare system based on key informant interviews and assessments of organizational administrators and primary care physicians. This trial of a digital DPP will allow the research team to determine the relationships between reach, effectiveness, implementation, and costs.

Sections du résumé

BACKGROUND
Diabetes prevention remains a top public health priority; digital approaches are potential solutions to existing scalability and accessibility challenges. There remains a gap in our understanding of the relationship between effectiveness, costs, and potential for sustained implementation of digital diabetes prevention strategies within typical healthcare settings.
PURPOSE
To describe the methods and design of a type 1 hybrid effectiveness-implementation trial of a digital diabetes prevention program (DPP) using the iPARIHS and RE-AIM frameworks.
METHODS
The trial will contrast the effects of two DPP interventions: (1) small group, in-person class, and (2) a digital DPP consisting of small group support, personalized health coaching, digital tracking tools, and weekly behavior change curriculum. Each intervention includes personal action planning with a focus on key elements of the lifestyle intervention from the CDC National DPP. Adults at risk for diabetes (BMI ≥25 and 5.7% ≤ HbA1c ≤ 6.4) will be randomly assigned to either the intervention group (n = 241) or the small group (n = 241). Assessment of primary (HbA1c) and secondary (weight loss, costs, cardiovascular risk factors) outcomes will occur at baseline, 4, and 12 months. Additionally, the trial will explore the potential for future adoption, implementation, and sustainability of the digitally-based intervention within a regional healthcare system based on key informant interviews and assessments of organizational administrators and primary care physicians.
CONCLUSION
This trial of a digital DPP will allow the research team to determine the relationships between reach, effectiveness, implementation, and costs.

Identifiants

pubmed: 31682941
pii: S1551-7144(19)30592-0
doi: 10.1016/j.cct.2019.105877
pii:
doi:

Substances chimiques

Glycated Hemoglobin A 0
hemoglobin A1c protein, human 0

Types de publication

Clinical Trial Protocol Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

105877

Informations de copyright

Copyright © 2019. Published by Elsevier Inc.

Auteurs

Fabio A Almeida (FA)

Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE 68198, United States; Center for Reducing Health Disparities, University of Nebraska Medical Center, Omaha, NE 68198, United States. Electronic address: Fabio.almeida@unmc.edu.

Tzeyu L Michaud (TL)

Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE 68198, United States; Center for Reducing Health Disparities, University of Nebraska Medical Center, Omaha, NE 68198, United States. Electronic address: tzeyu.michaud@unmc.edu.

Kathryn E Wilson (KE)

Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE 68198, United States. Electronic address: kathryn.wilson@unmc.edu.

Robert J Schwab (RJ)

Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, United States. Electronic address: rjschwab@unmc.edu.

Cody Goessl (C)

Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE 68198, United States. Electronic address: cody.goessl@unmc.edu.

Gwenndolyn C Porter (GC)

Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE 68198, United States. Electronic address: gwenndolyn.porter@unmc.edu.

Fabiana A Brito (FA)

Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE 68198, United States. Electronic address: fabiana.silva@unmc.edu.

Greg Evans (G)

Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States. Electronic address: gevans@wakehealth.edu.

Emily V Dressler (EV)

Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States. Electronic address: Emily.Dressler@wakehealth.edu.

Ashley E Boggs (AE)

Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109, United States. Electronic address: boggae17@wfu.edu.

Jeffrey A Katula (JA)

Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109, United States. Electronic address: katulaj@wfu.edu.

Cynthia Castro Sweet (CC)

Medical Affairs, Omada Health, Inc., San Francisco, CA 94111, United States. Electronic address: cynthia@omadahealth.com.

Paul A Estabrooks (PA)

Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE 68198, United States; Center for Reducing Health Disparities, University of Nebraska Medical Center, Omaha, NE 68198, United States. Electronic address: paul.estabrooks@unmc.edu.

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