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Engagement and outcomes in a digital Diabetes Prevention Program: 3-year update
  1. S Cameron Sepah1,2,
  2. Luohua Jiang3,
  3. Robert J Ellis2,
  4. Kelly McDermott4,
  5. Anne L Peters5
  1. 1 Department of Psychiatry, University of California, San Francisco, California, USA
  2. 2 Medical Affairs, Omada Health, San Francisco, California, USA
  3. 3 Department of Epidemiology, School of Medicine, University of California, Irvine, California, USA
  4. 4 Health Sciences and Global Public Health, Dominican University of California, San Rafael, California, USA
  5. 5 Keck School of Medicine, University of Southern California, Los Angeles, California, USA
  1. Correspondence to S Cameron Sepah; cameron.sepah{at}ucsf.edu

Abstract

Objective Translations of the Diabetes Prevention Program (DPP) have proliferated in recent years, with increasing expansion to digital formats. Although these DPP translations have consistently shown favorable clinical outcomes, long-term data for digital formats are limited. This study’s objective was to examine clinical outcomes up to 3 years post-baseline and the relationship between program engagement and clinical outcomes in a digital DPP.

Research design and methods In a single-arm, non-randomized trial, 220 patients previously diagnosed with prediabetes were enrolled in the Omada Health Program, a commercially available, 16-week DPP-based weight loss intervention followed by an ongoing weight maintenance intervention. Changes in body weight and A1c were assessed annually. Relationships between program engagement during the first year and clinical outcomes across 3 years were examined.

Results Participants were socioeconomically diverse (62% women, 50.2% non-Hispanic white, 51.7% college educated or higher). From baseline to 3 years, those participants who completed four or more lessons and nine or more lessons achieved significant sustained weight loss (–3.0% and –2.9%, respectively) and an absolute reduction in A1c (–0.31 and –0.33, respectively) with an average remission from the prediabetes range to the normal glycemic range. Factor analysis of engagement metrics during the first year revealed two underlying dimensions, one comprising lesson completion and health behavior tracking consistency, and the other comprising website logins and group participation. When these two factors were used to predict weight loss, only the logins and group participation factor was a significant predictor of weight loss at 16 weeks and 1 year.

Conclusions This study demonstrates significant long-term reductions in body weight and A1c in a digital DPP and identifies patterns of program engagement that predict weight loss.

  • health behavior
  • prediabetes
  • obesity
  • weight loss program

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors The conceptual design of the study and continuity with prior studies was led by SCS. Data collection was performed by SCS and KM. Raw data were provided unmodified to LJ, who independently conducted data analysis. Manuscript writing was led by SCS and RJE, with input from all other authors.

  • Competing interests The authors declare the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: SCS was employed by Omada Health and received salary and stock options. LJ was a statistical consultant of Omada Health and was paid a salary. RJE was employed by Omada Health and received salary and stock options. KM was employed by Omada Health and received salary and stock options. ALP was a scientific advisor for Omada Health and received stock options.

  • Patient consent Obtained.

  • Ethics approval Western Institutional Review Board.

  • Provenance and peer review The research activity was reviewed and approved for exemption by the Western Institutional Review Board for use of de-identified data.

  • Data sharing statement No additional data are available.

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