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Formagini T, Brooks JV, Jacobson LT, Roberts AW. Reimbursement Policies for Diabetes Prevention Program (DPP): Implications for Racial and Ethnic Health Disparities. Kans J Med 2021; 14:234-237. [PMID: 34540140 PMCID: PMC8415384 DOI: 10.17161/kjm.vol1415125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/30/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Taynara Formagini
- Department of Population Health, University of Kansas School of Medicine, Kansas City, KS
| | - Joanna V Brooks
- Department of Population Health, University of Kansas School of Medicine, Kansas City, KS
- University of Kansas Cancer Center, Kansas City, KS
| | - Lisette T Jacobson
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Andrew W Roberts
- Department of Population Health, University of Kansas School of Medicine, Kansas City, KS
- University of Kansas Cancer Center, Kansas City, KS
- Department of Anesthesiology, University of Kansas School of Medicine, Kansas City, KS
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2
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Berkley-Patton J, Bowe Thompson C, Bauer AG, Berman M, Bradley-Ewing A, Goggin K, Catley D, Allsworth JE. A Multilevel Diabetes and CVD Risk Reduction Intervention in African American Churches: Project Faith Influencing Transformation (FIT) Feasibility and Outcomes. J Racial Ethn Health Disparities 2020; 7:1160-1171. [PMID: 32329033 PMCID: PMC7581562 DOI: 10.1007/s40615-020-00740-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/27/2020] [Accepted: 03/02/2020] [Indexed: 12/30/2022]
Abstract
Wide-reaching health promotion interventions are needed in influential, accessible community settings to address African American (AA) diabetes and CVD disparities. Most AAs are overweight/obese, which is a primary clinical risk factor for diabetes/CVD. Using a faith-community-engaged approach, this study examined feasibility and outcomes of Project Faith Influencing Transformation (FIT), a diabetes/CVD screening, prevention, and linkage to care pilot intervention to increase weight loss in AA church-populations at 8 months. Six churches were matched and randomized to multilevel FIT intervention or standard education control arms. Key multilevel religiously tailored FIT intervention components included: (a) individual self-help materials (e.g., risk checklists, pledge cards); (b) YMCA-facilitated weekly group Diabetes Prevention Program (DPP) weight loss classes; (c) church service activities (e.g., sermons, responsive readings); and (d) church-community text/voice messages to promote healthy eating and physical activity. Health screenings (e.g., weight, blood pressure, blood glucose) were held during church services to identify participants with diabetes/CVD risks and refer them to their church's DPP class and linkage to care services. Participants (N = 352 church members and community members using churches' outreach ministries) were primarily female (67%) and overweight/obese (87%). Overall, FIT intervention participants were significantly more likely to achieve a > 5 lb weight loss (OR = 1.6; CI = 1.24, 2.01) than controls. Odds of intervention FIT-DPP participants achieving a > 5 lb weight loss were 3.6 times more than controls (p < .07). Exposure to sermons, text/email messages, brochures, commitment cards, and posters was significantly related to > 5 lb. weight loss. AA churches can feasibly assist in increasing reach and impact of diabetes/CVD risk reduction interventions with intensive weight loss components among at risk AA church-populations.
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Affiliation(s)
- Jannette Berkley-Patton
- Department of Biomedical and Health Informatics, School of Medicine, and Psychology Department, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO, 64108, USA.
| | - Carole Bowe Thompson
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Alexandria G Bauer
- Department of Biomedical and Health Informatics, School of Medicine, and Psychology Department, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO, 64108, USA
| | - Marcie Berman
- The Institute for Community Research, Hartford, CT, USA
| | - Andrea Bradley-Ewing
- Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Kathy Goggin
- Health Services and Outcomes Research, Children's Mercy Kansas City; Schools of Medicine and Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City; Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Jenifer E Allsworth
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
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Ritchie ND, Baucom KJW, Sauder KA. Current Perspectives on the Impact of the National Diabetes Prevention Program: Building on Successes and Overcoming Challenges. Diabetes Metab Syndr Obes 2020; 13:2949-2957. [PMID: 32903871 PMCID: PMC7445538 DOI: 10.2147/dmso.s218334] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/08/2020] [Indexed: 12/11/2022] Open
Abstract
To address the public health and economic burden of type 2 diabetes, the Centers for Disease Control and Prevention (CDC) began dissemination of the National Diabetes Prevention Program (NDPP) in the United States in 2010. Based on the intensive lifestyle intervention from a large efficacy trial, the NDPP aims to reduce incidence through lifestyle change and weight loss. This narrative review summarizes evidence on reach, effectiveness, and sustainability of the NDPP, while highlighting opportunities to overcome challenges in these areas. Major successes include reaching hundreds of thousands of at-risk individuals across the nation, with notable effectiveness upon full participation and widespread insurance coverage. Yet, more work is needed to ensure greater public health impact, particularly among priority populations at heightened risk who also experience disparities in program outcomes. Preliminary evidence suggests a number of strategies may improve reach and effectiveness of the NDPP, often with more rigorous study needed prior to widespread uptake. Updating the NDPP to better match the current evidence-base may also be important, such as directly targeting glycemia with a patient-centered approach and promoting metformin as an adjunct or second-line treatment. Finally, revisiting pay-for-performance reimbursement models may be critical to sustainability by ensuring adequate availability of suppliers and ultimately reducing diabetes prevalence.
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Affiliation(s)
- Natalie D Ritchie
- Ambulatory Care Services, Denver Health and Hospital Authority, Denver, CO, USA
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
- University of Colorado College of Nursing, Aurora, CO, USA
- Correspondence: Natalie D Ritchie Denver Health and Hospital Authority Email
| | | | - Katherine A Sauder
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado, Aurora, CO, USA
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4
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Ehrhardt N, Al Zaghal E. Behavior Modification in Prediabetes and Diabetes: Potential Use of Real-Time Continuous Glucose Monitoring. J Diabetes Sci Technol 2019; 13:271-275. [PMID: 30066574 PMCID: PMC6399786 DOI: 10.1177/1932296818790994] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Real-time continuous glucose monitoring (RT-CGM) provides real time glucose readings to participants wearing the device. The ability to see changes in glucose has the potential to provide immediate feedback to users on food choices and physical activity. The National Diabetes Prevention Program is currently the only reimbursable intervention for diabetes prevention and weight loss. The purpose of this article is to review the CGM literature on measurements other than Hemoglobin A1c (HbA1c) changes and hypoglycemia and discuss RT-CGM potential use as a behavior modification tool for lifestyle changes and weight reduction in people with prediabetes and type 2 diabetes (T2D).
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Affiliation(s)
- Nicole Ehrhardt
- Division of Endocrinology, George Washington University, Washington, DC, USA
- Nicole Ehrhardt, MD, Division of Endocrinology, George Washington University, Medical Faculty Associates GWU, 2300 M St, NW, Washington, DC 20037, USA.
| | - Enas Al Zaghal
- Division of Endocrinology, George Washington University, Washington, DC, USA
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Phillips SM, Collins LM, Penedo FJ, Courneya KS, Welch W, Cottrell A, Lloyd GR, Gavin K, Cella D, Ackermann RT, Siddique J, Spring B. Optimization of a technology-supported physical activity intervention for breast cancer survivors: Fit2Thrive study protocol. Contemp Clin Trials 2018; 66:9-19. [PMID: 29330081 PMCID: PMC5828903 DOI: 10.1016/j.cct.2018.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/05/2018] [Accepted: 01/08/2018] [Indexed: 11/23/2022]
Abstract
Fit2Thrive is a theory-guided physical activity promotion trial using the Multiphase Optimization Strategy (MOST) to test efficacy for improving physical activity of five technology-supported physical activity promotion intervention components among breast cancer survivors. This trial will recruit 256 inactive breast cancer survivors nationwide. All participants will receive the core intervention which includes a Fitbit and standard self-monitoring Fit2Thrive smartphone application which will be downloaded to their personal phone. Women will be randomized to one of 32 conditions in a factorial design involving five factors with two levels: support calls (No vs. Yes), app type (standard vs. deluxe), text messaging (No vs. Yes), online gym (No vs. Yes) and Fitbit Buddy (No vs. Yes). The proposed trial examines the effects of the components on physical activity at 12 and 24weeks. Results will support the selection of a final package of intervention components that has been optimized to maximize physical activity and is subject to an upper limit of cost. The optimized intervention will be tested in a future trial. Fit2Thrive is the first trial to use the MOST framework to develop and test a physical activity promotion intervention in breast cancer survivors and will lead to an improved understanding of how to effectively change survivors' physical activity. These findings could result in more scalable, effective physical activity interventions for breast cancer survivors, and, ultimately, improve health and disease outcomes.
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Affiliation(s)
- Siobhan M Phillips
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Drive, Chicago, IL, USA.
| | - Linda M Collins
- The Methodology Center and Department of Human Development & Family Studies, The Pennsylvania State University, 435 Health and Human Development Building, University Park, PA, USA
| | - Frank J Penedo
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 633 N. Saint Clair Street, Chicago, IL 60611, USA
| | - Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, 1-113 University Hall, Van Vliet Complex, Alberta, Canada
| | - Whitney Welch
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Drive, Chicago, IL, USA
| | - Alison Cottrell
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Drive, Chicago, IL, USA
| | - Gillian R Lloyd
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Drive, Chicago, IL, USA
| | - Kara Gavin
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Drive, Chicago, IL, USA
| | - David Cella
- The Methodology Center and Department of Human Development & Family Studies, The Pennsylvania State University, 435 Health and Human Development Building, University Park, PA, USA
| | - Ronald T Ackermann
- Department of Medicine, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, Chicago, IL, USA
| | - Juned Siddique
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Drive, Chicago, IL, USA
| | - Bonnie Spring
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Drive, Chicago, IL, USA
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Ritchie ND, Kaufmann P, Sauder KA. Comment on Ely et al. A National Effort to Prevent Type 2 Diabetes: Participant-Level Evaluation of CDC's National Diabetes Prevention Program. Diabetes Care 2017;40:1331-1341. Diabetes Care 2017; 40:e161-e162. [PMID: 29061591 DOI: 10.2337/dc17-1242] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Natalie D Ritchie
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO .,Ambulatory Care Services, Denver Health and Hospital Authority, Denver, CO
| | | | - Katherine A Sauder
- Section of Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
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