Currently submitted to: JMIR Diabetes
Date Submitted: Jun 26, 2019
Open Peer Review Period: Jul 2, 2019 - Jul 30, 2019
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note “no longer under consideration” will appear above).
Peer-review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a “Peer-Review Me” button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed “version of record” (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Exploring the impact of a digital technology for facilitating lifestyle change in obese and type 2 diabetes populations; a service evaluation of real-world data
The prevalence of type 2 diabetes and obesity is increasing, and the way people interact with healthcare is evolving. Services aimed at supporting people to improve their nutrition, physical activity or learn more about the self-management of type 2 diabetes have traditionally been delivered in a face-to-face setting. These services have a strong evidence base, but they have limitations for reaching certain groups of people. The development of digital interventions could provide a new model, helping people to access health-education and behaviour change support, but long-term data supporting these programmes is limited.
The purpose of this service evaluation was to analyse the efficacy of OurPath, a UK-based digital lifestyle change programme that combines a private online social network, daily structured educational content, health coaching, digital weighing scales, and an activity tracker, in people living with obesity and type 2 diabetes.
Participants had a mean (±SD) age of 50±11.5, BMI 34±6.3kg/m2, were 20% male and either self-referred (commercial – self paid) or referred by a GP (NHS – free to the user) to the digital behaviour change programme. Participants underwent a core 3-month intensive lifestyle change intervention, with additional follow up support provided to help people to maintain health changes. HbA1c change after 6-months and weight change after 3, 6, 9, 12-months were primary outcome measures. Changes in weight after 24-months and differences in weight loss between participant demographics were further analysed as secondary outcome measures.
Participants had a mean (±SD) starting BMI of 34±6.3kg/m2. Those with available data had a mean baseline HbA1c level of 66.2±20.5mmol/mol. Data from 1820 participants at 6-months showed a change in mean weight of -6.6kg (-6.9±6.92%; P<0.01). Data from 705 participants at 12-months showed a sustained change in mean weight when compared to baseline of -5.7kg (-5.9±5.9%; P<0.01). For 105 participants with available data at 24-months, the average sustained weight change was -5.5kg (-5.9±6.0%; p<0.01). This weight change was significant for both 63 commercial participants (mean -4.5kg; -5.0±8.9%; P<0.01) and 42 NHS participants (mean -5.7kg; -6.2±8.8%; P<0.01). 47% of these participants achieved >5% weight loss and 24% achieved >10% weight loss. The proportion of males that took part in the programme following NHS referral was 43%, compared with 10% in commercial programme.
This service evaluation demonstrates significant sustained weight loss can be achieved for participants. A higher male uptake ratio was also achieved when referred by an NHS HCP. With ongoing challenges of uptake and attendance at traditional weight-loss programmes, a digitally delivered intervention may offer a more convenient solution for some people.
Request queued. Please wait while the file is being generated. It may take some time.
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.