@article {Cieminse000515, author = {Elizabeth L Ciemins and Patricia J Coon and Nicholas C Coombs and Barbara L Holloway and Elizabeth J Mullette and William N Dudley}, title = {Intent-to-treat analysis of a simultaneous multisite telehealth diabetes prevention program}, volume = {6}, number = {1}, elocation-id = {e000515}, year = {2018}, doi = {10.1136/bmjdrc-2018-000515}, publisher = {BMJ Specialist Journals}, abstract = {Objective Determine the effectiveness of a 16-week modified diabetes prevention program (DPP) administered simultaneously to multiple rural communities from a single urban site, as compared with a similar face-to-face intervention. A 12-week intervention was evaluated to consider minimization of staff costs in communities where resources are limited.Research design and methods A prospective cohort study compared DPP interventions implemented in rural (via telehealth technology) and urban (face-to-face) communities using an intent-to-treat analysis. Primary outcome measures included 5\% and 7\% body weight loss. Logistic regression analyses were used to determine predictors of intervention success and included a variable for treatment effect.Results Between 2010 and 2015, up to 667 participants were enrolled in the study representing one urban and 15 rural communities across Montana. The 16-week urban and rural interventions were comparable; 33.5\% and 34.6\% of participants lost 7\% body weight, respectively; 50\% and 47\% lost 5\% (p=0.22). Participants who were male (OR=2.41; 95\% CI 1.32 to 4.40), had lower baseline body mass index (OR=1.03; 95\% CI 1.01 to 1.07), attended more sessions (OR=1.33; 95\% CI 1.11 to 1.58), and more frequently reported (OR=3.84; 95\% CI 1.05 to 14.13) and met daily fat gram (OR=4.26; 95\% CI 1.7 to 10.6) and weekly activity goals (OR=2.46; 95\% CI 1.06 to 5.71) were more likely to meet their 7\% weight loss goal. Predictors of meeting weight loss goals were similar for participants enrolled in the 12-week intervention.Conclusions Using telehealth technology to administer a modified DPP to multiple rural communities simultaneously demonstrated weight loss results comparable to those in a face-to-face intervention. Given the limitation of resources, linking rural areas to urban centers using telemedicine may increase access to much needed services to prevent or delay progression to diabetes.}, URL = {https://drc.bmj.com/content/6/1/e000515}, eprint = {https://drc.bmj.com/content/6/1/e000515.full.pdf}, journal = {BMJ Open Diabetes Research and Care} }