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. 2019 May 9:7:2050312119841986.
doi: 10.1177/2050312119841986. eCollection 2019.

Behavior stages of a physician- and coach-supported cloud-based diabetes prevention program for people with prediabetes

Pallavi Srivastava  1 , Ashish Verma  2 , Christine Geronimo  3 , Terry M Button  2   4
Affiliations

Behavior stages of a physician- and coach-supported cloud-based diabetes prevention program for people with prediabetes

Pallavi Srivastava et al. SAGE Open Med. .

Abstract

Introduction: Centers for Disease Control and Prevention Diabetes Prevention Program recognition requires successful program completion by a cohort of at least five people with prediabetes. Such programs have generally been "in-person" and provided by a qualified coach from a recognized program. A cohort of 10 patients with prediabetes was enrolled in a physician's office to use the cloud-based Type II Diabetes Prevention Module in an effort to achieve recognition. Module use was supported by the physician and a qualified coach. The purpose of this article is to evaluate Module performance relative to behavior stages associated with long-term behavior modification.

Methods: The Module employs a web application supporting diabetes prevention education and a mobile application that is an electronic diary and virtual coach. A dashboard allows an efficient review of user performance and the ability to send users notifications of support from the user's coach or physician. The cohort of 10 patients with prediabetes was offered Module use upon diagnosis of prediabetes.

Results: All 10 patients with prediabetes offered Module use agreed participation. Six have completed educational sessions, made diary entries, and have met the 5% Centers for Disease Control and Prevention Diabetes Prevention Program weight loss target prior to 6 months of Module use. This high success rate (60%) is contrary to behavior stages often associated with long-term behavior modification.

Conclusion: The strength of the physician-patient relationship appears to allow patients with prediabetes to skip or advance rapidly through behavioral stages in the process of lifestyle modification.

Keywords: Diabetes Prevention Program; Prediabetes; behavior change; dashboard; mobile application; notifications.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared the potential conflicts of interest in the disclosure below with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Example of a “Question of the Day.”
Figure 2.
Figure 2.
Selecting the Education tab allows the user to view Educational Sessions, Educational Sessions Completed, and Action Plans Filed.
Figure 3.
Figure 3.
Notification reminder from the virtual coach to eat a health AM snack is shown: (a) the notification results in the EBMapps icon; selecting the icon results in the message shown in (b); selecting the message results in the AM snack screen to enter the number of food servings into the diary shown in (c).
Figure 4.
Figure 4.
Options screen on mobile application.
Figure 5.
Figure 5.
Sample daily and weekly (two-page) summaries.
Figure 6.
Figure 6.
Dashboard for user notifications.
Figure 7.
Figure 7.
Sample physician notification to the user with prediabetes.
Figure 8.
Figure 8.
A screenshot of one of the onboarding screens.
See this image and copyright information in PMC

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