Reach of a Fully Digital Diabetes Prevention Program in Health Professional Shortage Areas

Abstract

The National Diabetes Prevention Program (NDPP) offers lifestyle change education to adults at risk for diabetes across the United States, but its reach is curbed due, in part, to limitations of traditional in-person programs. Diabetes Prevention Programs (DPPs) that are fully digital may increase reach by overcoming these barriers. The aim of this research was to examine the reach of Lark's DPP, a fully digital artificial-intelligence-powered DPP. This study assessed geographic features and demographic characteristics of a sample of Lark DPP commercial health plan members with complete data ( N = 16,327) and compared several demographic features with a large composite sample of members from DPPs across the nation (NDPP; N = 143,489) and a National Health Interview Survey (NHIS) sample of prediabetic adults in the United States (NHIS; N = 2118). Examination of the Lark DPP sample revealed that 24.4% of members lived in rural areas, 30.8% lived in whole county health professional shortage areas, and only 7.6% of members lived in a zip code with an in-person DPP. When comparing the Lark sample with the NDPP and NHIS samples, Lark DPP enrollees tended to be younger and have a higher body mass index (BMI) ( p' s < 0.001). Lark provides convenient access to a DPP for individuals living in hard-to-reach areas who may face barriers to participating in in-person or telephonic DPPs or who prefer a digital program. Compared with the NDPP sample, Lark is also reaching younger and higher BMI users, who are traditionally difficult to enroll and have a high need for intervention.

Feasibility and Comparative Effectiveness for the Delivery of the National Diabetes Prevention Program through Cooperative Extension in Rural Communities

“…The Facebook ® group utilized in the current trial, which involved minimal intervention by the lifestyle coach, is thus similar to the online delivery format that is currently eligible to receive approval for delivery of the NDPP through the CDC-NDPP recognition program [ 22 ]. Although the weight loss across 6 months in the Facebook ® group was small (−1.68 kg, −1.6%, 7% ≥5%) minimal lifestyle coach burden and the low cost of intervention delivery suggest that additional trials to evaluate strategies to improve the effectiveness Facebook ® for the delivery of the NDPP to rural residents may be warranted.…”

Adapting the Diabetes Prevention Program for Older Adults: Descriptive Study

“…The BRIDGE initiative will preserve the structural curriculum but will expand the number and quality of resources for older adults. This work will help inform the development of community and clinical programs, as currently less than 15% of rural counties and 48% of urban counties in the nation have a DPP site [ 17 ].…”

Predictors of program interest in a digital health pilot study for heart health

“…Moreover, individuals with very high BMI tend to delay or avoid healthcare visits and tend to have lower participation in lifestyle change programs, in part due to emotional barriers, such as perceived weight stigma from providers [33]. We have previously shown that AI-driven lifestyle change programs tend to enroll higher rates of users with high BMI compared to in-person programs [34], suggesting that AI-driven coaching may be more appealing to individuals with higher BMIs, as it reduces the possibility of experiencing provider stigma. This is crucial, given that a key objective for the Heart Health program is reaching and engaging potential users with high BMI.…”