Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jul 6, 2023
Date Accepted: Sep 21, 2023
A Telehealth Diabetes Prevention Program for Adults with Prediabetes in an Academic Medical Center Setting: A Protocol for a Hybrid Type III Trial
ABSTRACT
Background:
Diabetes is a costly epidemic in the United States associated with both negative health and economic consequences. These consequences can be mitigated by participation in structured lifestyle change programs such as the National Diabetes Prevention Program (DPP) led by the Centers for Disease Control and Prevention. Mississippi consistently has among the highest rates of diabetes and prediabetes nationally. Implementing the National DPP through large healthcare systems can increase reach and accessibility for populations at the highest risk for diabetes. Translational research on the National DPP in Mississippi has not been studied.
Objective:
This study aims to evaluate the implementation and impact of the National DPP delivered using telehealth modalities at the University of Mississippi Medical Center in Jackson, Mississippi.
Methods:
An effectiveness-implementation hybrid type III research design is proposed. The study design is guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework and the Practical, Robust Implementation and Sustainability Model. Study participants include adult (≥18 years) patients eligible for the DPP with at least one encounter at one of three ambulatory clinic specialties (Lifestyle Medicine, Family Medicine, and Internal Medicine) between January 2019 and December 2023. National DPP eligibility criteria include a body mass index ≥25 and hemoglobin A1c between 5.7% and 6.4%.
Results:
The primary outcomes include patient referrals, participant enrollment, retention, and engagement, the incidence of diabetes, and healthcare resource utilization and costs. At baseline, 3,886 (14.9%) of 26,151 patients across three ambulatory clinic specialties had prediabetes. Of those patients with prediabetes, 1,025 (3.9%) were eligible for the National DPP. More than half (576, 56.2%) were aged 65 years or older, 79.8% (818) were Medicare beneficiaries, 65.7% (673) were females, and 70.7% (725) were obese.
Conclusions:
This is the first translational study of the National DPP in Mississippi. Findings will inform implementation strategies impacting the uptake and sustainability of the National DPP delivered in an academic medical setting using distance learning and telehealth modalities. Clinical Trial: ClinicalTrials.gov NCT04822480
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