A mobile platform delivering the National Diabetes Prevention Program (NDPP) intervention, combined with coaching, helped patients diagnosed with prediabetes with weight loss, comparable to traditional in-person programs, according to a recent study.
According to the study authors, lifestyle interventions, including the NDPP intervention, have proven effective in preventing type 2 diabetes, and some studies have used a mobile app in conjunction with an in-person curriculum to deliver the NDPP intervention, which resulted in weight loss for the study participants. The goal of this study, which was published in the British Medical Journal, was to evaluate the weight loss efficacy of a mobile platform delivering the structured NDPP intervention.
“Mobile health poses a promising means of delivering pre-chronic and chronic care, and provides a scalable, convenient, and accessible method to deliver the NDPP,” the study authors wrote.
For the study, the research team observed 43 overweight or obese adult participants with a diagnosis of prediabetes who signed up for a 24-week virtual diabetes prevention program, with weight loss and participant engagement as the main outcomes.
The study focused on employees at a large Northeast-based insurance company who were offered free access to Noom Health, a mobile app that delivers structured curricula with human coaches. Potential participants were selected based on an elevated HbA1c status found in their medical records, reflecting a diagnosis of prediabetes. Interested participants were assigned to a virtual Centers for Disease Control and Prevention (CDC)-recognized NDPP master’s level coach.
During the study, participants received daily diabetes prevention program content, articles and interactive challenges, and were asked to log their weight, meals, and physical activity in-app on a weekly basis. The NDPP coach communicated with the participants daily via in-app private and group messages, and brief telephone calls approximately two times per month. Coaches securely monitored participant progress through a dashboard. T
The research team found that weight loss among the participants at 16 and 24 weeks was significant, with 56 percent of starters and 64 percent of completers losing over 5 percent body weight. Starters were participants were started the program, but did not complete it.
In addition, mean weight loss at 24 weeks was 6.58 percent in starters and 7.5 percent in completers. Participants were highly engaged, with 84 percent of the sample completing 9 lessons or more, the study authors wrote, and also noted that in-app actions related to self-monitoring significantly predicted weight loss.
“This pilot study, designed to evaluate weight loss by means of a novel NDPP intervention delivered entirely through a smartphone platform, showed 6-month weight loss comparable to the original NDPP and traditional in-person programs,” the study authors wrote. “Completers represented 84 percent of the sample and lost 7.01 kg (15.45 lbs, 7.50%) body weight at 24 weeks, surpassing 5 to 7 percent weight loss recommended by the CDC, and showing a high level of acceptance and program feasibility. Completers also showed a trend toward higher general engagement and weight loss.”
Furthermore, the study authors concluded that mobile health implementation of NDPP appears to be comparable to current community-based programs and more flexible than web-based implementations.
“It addresses the major barriers facing the widespread translation of the NDPP in the community setting; including high fixed overhead, fixed locations, and lower levels of engagement and weight loss,” the study authors wrote.
The study authors also recommended a larger clinical trial of mobile DPP with an in-person NDPP control group to establish intervention efficacy, identify behaviors that increase participant engagement, and assess physiological markers of diabetes risk longitudinally.
“In conclusion, this pilot demonstrates scalability and feasibility of a novel mobile NDPP intervention with weight loss comparable to online and gold standard in-person core and postcore interventions,” the study authors wrote.