A Novel Diabetes Prevention Intervention Using a Mobile App A Randomized Controlled Trial With Overweight Adults at Risk

Introduction: Mobile phone technology may be a cost-effective and convenient way to deliver proven weight-loss interventions and thereby prevent or delay onset of type 2 diabetes. The purpose of this study was to examine the feasibility and efficacy of a diabetes prevention intervention combined with a mobile app and pedometer in English-speaking overweight adults at risk for type 2 diabetes. Design: RCT. Participants: Participants included 61 overweight adults with a mean age (SD) of 55.2 (9.0) years. Seventy-seven percent were women, 48% were racial/ethnic minorities, and baseline BMI was 33.3 (6.0). Intervention: The curriculum was adapted from the Diabetes Prevention Program, with the frequency of in-person sessions reduced from 16 to six sessions and group exercise sessions replaced by a home-based exercise program. A study-developed mobile phone app and pedometer augmented the intervention and provided self-monitoring tools. Main outcome measure: Weight loss. Results: Data were collected in 2012 and 2013 and were analyzed in 2014. In intention-to-treat analyses, the intervention group (n=30) lost an average of 6.2 (5.9) kg (-6.8% [5.7%]) between baseline and 5-month follow-up compared to the control group's (n=31) gain of 0.3 (3.0) kg (0.3% [5.7%]) (p<0.001). The intervention group's steps per day increased by 2,551 (4,712) compared to the control group's decrease of 734 (3,308) steps per day (p<0.001). In comparison, the intervention group had greater reductions in hip circumference (p<0.001); blood pressure (p<0.05); and intake of saturated fat (p=0.007) and sugar-sweetened beverages (p=0.02). The intervention had no significant effect on fasting lipid or glucose levels. Conclusions: The significant weight loss resulting from this modified combined mobile app and pedometer intervention for overweight adults warrants further investigation in a larger trial. (C) 2015 American Journal of Preventive Medicine