What behaviour change technique content is offered to service users of the nationally implemented English NHS Digital Diabetes Prevention Programme: Analysis of multiple sources of intervention content

Hawkes, Rhiannon E; Miles, Lisa; French, David P.

doi:10.1016/j.pmedr.2023.102112

Cited by 9 publications

(11 citation statements)

References 32 publications

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“…Using existing data and quasi‐experimental methods we confirmed that the digital NHS DPP could achieve broadly equivalent results to the conventional model 12,38 . Replicating our earlier work, we demonstrated that digital providers faced many similar challenges in ensuring fidelity 39‐41 . We also explored decisions about taking up the digital offer and found that these were based on similar issues to the conventional format (such as self‐efficacy) as well as unique features of the digital interventions such as enhanced accessibility 42 .…”

Section: Digital Nhs Dppsupporting

confidence: 73%

“…12,38 Replicating our earlier work, we demonstrated that digital providers faced many similar challenges in ensuring fidelity. [39][40][41] We also explored decisions about taking up the digital offer and found that these were based on similar issues to the conventional format (such as self-efficacy) as well as unique features of the digital interventions such as enhanced accessibility. 42 We also found that professional support remained important even with digital delivery.…”

Section: Digital Nhs Dppmentioning

confidence: 99%

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Diabetes prevention at scale: Narrative review of findings and lessons from the DIPLOMA evaluation of the NHS Diabetes Prevention Programme in England

Bower,

Soiland‐Reyes,

Heller

et al. 2023

Diabet Med

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AimsThe NHS Diabetes Prevention Programme (NHS DPP) is a large‐scale, England‐wide behaviour change programme for people at high risk of progressing to type 2 diabetes. We summarise the findings of our six‐year DIPLOMA evaluation of its implementation and impact and highlight insights for future programmes.MethodsUsing qualitative interviews, document analysis, observation, surveys and large dataset analysis, eight interlinked work packages considered: equity of access; implementation; service delivery and fidelity; programme outcomes; comparative effectiveness and cost‐effectiveness in reducing diabetes incidence; and patient decision making and experience.ResultsDelivery of the NHS DPP encountered barriers across many aspects of the programme, and we identified inequalities in terms of the areas, organisations and patient populations most likely to engage with the programme. There was some loss of fidelity at all stages from commissioning to participant understanding. Despite these challenges, there was evidence of significant reductions in diabetes incidence at individual and population levels. The programme was cost‐effective even within a short time period.ConclusionsDespite the challenge of translating research evidence into routine NHS delivery at scale, our findings suggest that an individual‐level approach to the prevention of type 2 diabetes in a ‘high‐risk’ population was more effective than usual care. By embedding evaluation with programme delivery and working closely with the NHS DPP team, we provided actionable insights for improving communications with potential participants, supporting primary care referral, honing the delivery model with better provider relationships and more patient choice, increasing understanding of behaviour change techniques, and enriching the educational and health coaching content.

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Section: Digital Nhs Dppsupporting

confidence: 73%

Section: Digital Nhs Dppmentioning

confidence: 99%

Diabetes prevention at scale: Narrative review of findings and lessons from the DIPLOMA evaluation of the NHS Diabetes Prevention Programme in England

Bower,

Soiland‐Reyes,

Heller

et al. 2023

Diabet Med

View full text Add to dashboard Cite

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“…The first three months of the NHS-DPP are considered the ‘core’ phase of the programme, and months 4–9 the ‘maintenance’ phase where support gradually tapers off. Further information on the NHS-DDPP is provided elsewhere ( Miles et al, 2023a ; Hawkes et al, 2023 ).…”

Section: Methodsmentioning

confidence: 99%

“…Subsequently, a digital pathway was introduced to the programme in 2019 ( NHS England, 2019 ), with four independent providers commissioned to deliver the digital service in localities across England. The four NHS-DDPP providers designed their own versions of the digital intervention in line with evidence reviews ( Hawkes et al, 2022a ), which was offered via modalities including apps, educational platforms and health coach support to help people make changes to their diet and activity behaviours ( Miles et al, 2023a ; Hawkes et al, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

“…Thus it is possible that, when rolled out, many people who are referred to the NHS-DDPP may use it only briefly or not at all, thereby limiting its effectiveness. Previous research on the NHS-DDPP has found variation in the number and types of BCTs that are offered via app, educational articles and health coach support ( Hawkes et al, 2023 ). For example, if people do not engage with the articles containing educational content, they could miss key BCTs in the programme.…”

Section: Introductionmentioning

confidence: 99%

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Engagement with a nationally-implemented digital behaviour change intervention: Usage patterns over the 9-month duration of the National Health Service Digital Diabetes Prevention Programme

Hawkes

Miles

Ainsworth

et al. 2023

Internet Interventions

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Unintended Consequences of Digital Behavior Change Interventions

Pan,

Urban,

Schüz

2024

European Journal of Health Psychology

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Background: Digital Behavior Change Interventions (DBCIs) offer substantial potential to widely disseminate prevention and health promotion content. One key issue remains the absence of high-quality evidence of the effects of DBCIs for long-term health outcomes and unintended consequences. Here, we argue that in addition to better-quality evidence for effects on health, a more consideration of unintended consequences of DBCIs on multiple levels is warranted. Objectives: We suggest a multilevel perspective on unintended consequences of DBCIs building on a socio-ecological understanding of health promotion and prevention. Methods: Narrative literature review. Results: Unintended consequences of DBCIs can be located on the level of the individual engaging with DBCIs, on a level of social interactions, and on the level of health services, in multiple domains from health-related, behavior modification, affective aspects to data privacy and financial implications. Implications: Our proposed social–ecological perspective improves the classification of unintended consequences of DBCIs. This could facilitate building a cumulative evidence base to support the development of more effective and inclusive DBCIs.

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What behaviour change technique content is offered to service users of the nationally implemented English NHS Digital Diabetes Prevention Programme: Analysis of multiple sources of intervention content

Cited by 9 publications

References 32 publications

Diabetes prevention at scale: Narrative review of findings and lessons from the DIPLOMA evaluation of the NHS Diabetes Prevention Programme in England

Diabetes prevention at scale: Narrative review of findings and lessons from the DIPLOMA evaluation of the NHS Diabetes Prevention Programme in England

Engagement with a nationally-implemented digital behaviour change intervention: Usage patterns over the 9-month duration of the National Health Service Digital Diabetes Prevention Programme

Unintended Consequences of Digital Behavior Change Interventions

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