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The Effect of Virtual Versus In-Person Delivery on Behavior Changes Among Adults Enrolled in the Diabetes Prevention
Ghadir Helal Salsa1, Andrew E Springer2, Nalini Ranjit2
1Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health in Brownsville, Brownsville, Texas.
Introduction:
The COVID-19 pandemic posed challenges to traditional in-person methods used to deliver lifestyle-change programs. This comparative effectiveness study examined how virtual delivery of the Diabetes Prevention Program performed relative to established in-person delivery in real-world conditions, comparing changes in weight, fruit and vegetable consumption, and physical activity levels from baseline to program completion in the Rio Grande Valley, Texas.
Methods:
A secondary data analysis was conducted among adults enrolled in the Rio Grande Valley Coordinated Diabetes Prevention Program Project from 2018 to 2021. During this period, programs were delivered either in person or virtually. Covariate-adjusted regression models were used to evaluate 12-month changes in study outcomes by delivery mode. Data were analyzed in 2023 using STATA (Version 17).
Results:
There were 609 participants in the in-person group and 283 in the virtual group. After adjustment for baseline characteristics, participants with BMI ≥30 in the virtual group lost more weight (-8.19 lb vs. -5.19 lb, p<0.001). Across all participants, those in the virtual group had greater increases in physical activity (+575 MET minutes/week vs. -58, p<0.001) and fruit and vegetable consumption (+1.9 vs. +0.5 servings/day, p<0.001) compared with in-person participants.
Conclusions:
Virtual delivery of the Diabetes Prevention Program is a viable alternative to traditional in-person delivery, with both modes achieving meaningful improvements in weight, physical activity, and fruit and vegetable consumption among underserved adults at high risk for Type 2 diabetes. These findings support consideration of virtual Diabetes Prevention Program delivery for Hispanic and other underrepresented populations living with obesity and at risk for Type 2 diabetes mellitus.
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