TY - JOUR
T1 - The Reach of an Urban Hospital System-Based Diabetes Prevention Program
T2 - Patient Engagement and Weight Loss Characteristics
AU - Chambers, Earle C.
AU - Gonzalez, Jeffrey S.
AU - Marquez, Melinda E.
AU - Parsons, Amanda
AU - Rehm, Colin D.
N1 - Funding Information:
This assessment identified characteristics of patients with lower levels of referral and engagement. The DPP staff may need to increase outreach to address barriers to referral and during all points of engagement among men, younger patients, and Spanish speakers. Future research is needed to increase understanding with regard to why referrals and engagement are lower among these groups. National Institute of Diabetes and Digestive and Kidney Diseases https://doi.org/10.13039/100000062 K01HL125466 National Institute of Diabetes and Digestive and Kidney Diseases https://doi.org/10.13039/100000062 P30 DK020541 National Institute of Diabetes and Digestive and Kidney Diseases https://doi.org/10.13039/100000062 P30 DK111022 National Institute of Diabetes and Digestive and Kidney Diseases https://doi.org/10.13039/100000062 R01 DK104845 National Institute of Diabetes and Digestive and Kidney Diseases https://doi.org/10.13039/100000062 R03 HL140265 National Institute of Diabetes and Digestive and Kidney Diseases https://doi.org/10.13039/100000062 R18 DK098742 edited-state corrected-proof Funding: This study was supported by the New York Regional Center for Diabetes Translation Research (P30 DK111022) and the Einstein-Mount Sinai Diabetes Research Center (P30 DK020541), each funded by the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases (NIH/NIDDK). Dr Chambers also was supported by NIH/NHLBI grants K01HL125466 and R03 HL140265. Dr Gonzalez was supported by NIH/NIDDK grants R01 DK104845 and R18 DK098742. ORCID iD Earle C. Chambers https://orcid.org/0000-0001-8940-0884
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Purpose: The purpose of this study was to identify patient and program delivery characteristics associated with engagement and weight loss in a Diabetes Prevention Program (DPP) implemented in an urban hospital system. Methods: Patient and program delivery data were collected between July 2015 and December 2017. DPP eligibility was determined based on age, body mass index (BMI), and hemoglobin A1C data via the electronic health record. Engagement was measured at 3 levels: ≤3 sessions, 4 to 8 sessions, and ≥9 sessions. Weight was measured at each DPP session. Results: Among the eligible patients (N = 31 524), referrals and engagement were lower in men than women, in Spanish speakers than English speakers, in younger (18-34 years) and middle-aged (35-54 years) than older adults, and in patients receiving Medicaid than other patients. Referral and engagement were higher in patients with higher BMIs and those prescribed ≥5 medications. Current smokers were less frequently engaged. Prior health care provider contact was associated with higher engagement. Overall, 28% of DPP participants achieved ≥5% weight loss; younger and middle-aged patients and those who gained weight in the prior 2 years were less likely to lose weight. Conclusion: This assessment identified characteristics of patients with lower levels of referral and engagement. The DPP staff may need to increase outreach to address barriers to referral and during all points of engagement among men, younger patients, and Spanish speakers. Future research is needed to increase understanding with regard to why referrals and engagement are lower among these groups.
AB - Purpose: The purpose of this study was to identify patient and program delivery characteristics associated with engagement and weight loss in a Diabetes Prevention Program (DPP) implemented in an urban hospital system. Methods: Patient and program delivery data were collected between July 2015 and December 2017. DPP eligibility was determined based on age, body mass index (BMI), and hemoglobin A1C data via the electronic health record. Engagement was measured at 3 levels: ≤3 sessions, 4 to 8 sessions, and ≥9 sessions. Weight was measured at each DPP session. Results: Among the eligible patients (N = 31 524), referrals and engagement were lower in men than women, in Spanish speakers than English speakers, in younger (18-34 years) and middle-aged (35-54 years) than older adults, and in patients receiving Medicaid than other patients. Referral and engagement were higher in patients with higher BMIs and those prescribed ≥5 medications. Current smokers were less frequently engaged. Prior health care provider contact was associated with higher engagement. Overall, 28% of DPP participants achieved ≥5% weight loss; younger and middle-aged patients and those who gained weight in the prior 2 years were less likely to lose weight. Conclusion: This assessment identified characteristics of patients with lower levels of referral and engagement. The DPP staff may need to increase outreach to address barriers to referral and during all points of engagement among men, younger patients, and Spanish speakers. Future research is needed to increase understanding with regard to why referrals and engagement are lower among these groups.
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U2 - 10.1177/0145721719880503
DO - 10.1177/0145721719880503
M3 - Article
C2 - 31608798
AN - SCOPUS:85074363433
VL - 45
SP - 616
EP - 628
JO - Diabetes Educator
JF - Diabetes Educator
SN - 0145-7217
IS - 6
ER -