JMIR Publications

ABSTRACT

Background:

The Diabetes Prevention Program (DPP) reduces the risk of developing Type 2 Diabetes, however enrollment is very low.

Objective:

The goal of this project was to pilot test the efficacy of two brief, immersive mobile phone videos (presented either in virtual reality or 360 video) on risk perceptions and enrollment in the DPP.

Methods:

Adults with prediabetes were recruited at a clinic serving a low income Hispanic community. After consenting, participants completed a baseline survey that collected demographics and risk perceptions based on the tripartite model of risk perceptions.. They were then informed that they had prediabetes and provided with a link to an educational website that explains: what prediabetes and Type 2 Diabetes (T2DM) are, how lifestyle affects risk of T2DM, what the DPP is, and where to enroll. Participants then viewed two videos using their smartphone ; either with a cardboard VR headset (VR) or their smartphone alone (360 video), per random assignment. Two weeks later a follow-up survey collected measures of: enrollment in the DPP, risk perceptions, health literacy, the importance of contextual factors related to the DPP in their decision of whether or not to enroll in the DPP (e.g. distance to the class ), and qualitative feedback on the interventions. We used logistic regression to determine whether enrollment in the DPP differed by intervention mode, while accounting for heath literacy and contextual factors related to the DPP. We used unpaired t-tests to examine differences in change in risk perceptions between groups. We used paired t-tests to examine within-subject changes in risk perceptions.

Results:

116 participants provided complete data. Most participants were middle-aged (mean age= 44.6 yrs.; SD= 11.9) Hispanic (114/116), female (79/116), with low health literacy (mean score =12.3/20; SD=3.4). Enrollment in the DPP was 44/116 overall (37.9% ) but did not differ by group ( OR for enrolling in VR group= 1.78 ; 95% CI: 0.75-4.3, p=0.19) . Individuals who rated t the distance needed to travel to attend the DPP as more important were less likely to enroll in the DPP (OR = 0.56, 95% CI:0.33-0.92; p=0.03) Risk perceptions did not differ by group ( mean change in 360 video group = -0.07, mean change in VR group = 0.03, t==0.6, p= 0.54) and did not change within subjects ( mean 0.02, t=0.21, p=0.83). Participants feedback suggested that the videos are emotionally engaging and educational.

Conclusions:

We present a pilot test of immersive mobile phone videos which appear to be efficacious in promoting enrollment in the DPP. Further work to determine the replicability of these findings, the mechanism of action of the videos, and potential moderators of the efficacy of these videos is discussed.