Purpose To translate the Diabetes Prevention Program (DPP) lifestyle intervention into a clinical setting and evaluate its effectiveness.
Methods The authors implemented a group-based version of the DPP lifestyle curriculum in a large academic medicine practice. It is delivered by a nurse educator over 12 weekly sessions with optional reenrollment, available on a self-pay basis, and implemented using existing clinical resources (eg, electronic medical record referrals, scheduling, conference rooms, communication technology). The program was evaluated using a controlled before-after design, including all patients referred between April 1, 2005, and February 1, 2007. Patients with a body mass index (BMI) ≥25 kg/m2 were eligible if their primary care providers felt the program was medically appropriate and safe. Change in weight (kg) and frequency of achieving ≥7% weight loss were examined.
Results Referred patients were primarily female (84%), with an average age of 49.91 years (SE, 1.46) and average BMI of 39.65 kg/m2 (SE, 0.73). Among eligible patients, 93% of enrollees and 80% of nonenrollees had follow-up weights recorded within the evaluation window. Over 1 year, mean weight change was —5.19 kg (95% confidence interval [CI], —7.71 to —2.68) among enrollees and +0.21 kg (CI, —1.0 to 1.93) among nonenrollees (P < .001). A ≥7% loss was found for 27% of enrollees and 6% of nonenrollees ( P = .001).
Conclusions An evidence-based lifestyle intervention can be effectively translated into the clinical setting. Use of existing resources may facilitate patient flow and minimize cost. This provider-integrated preventive care approach may provide a model for incorporating knowledge from behavioral science into clinical care.
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