1097 — Implementing the Diabetes Prevention Program in the VA: Weight Outcomes from a Clinical Demonstration Project
Moin T, VA Greater Los Angeles Healthcare System and Health Services Research and Development (HSR&D) Center for Healthcare Innovation, Los Angeles, CA; Damschroder LJ, Ann Arbor VA Center for Clinical Management Research and VA Diabetes QUERI, Ann Arbor, MI; Makki F, Ann Arbor VA Center for Clinical Management Research, Ann Arbor, MI; Weinreb JE, VA Greater Los Angeles Healthcare System; Steinle N, Baltimore VA; Billington C, Minneapolis VA; Yancy W, Durham VA; Maciejewski ML, Durham VA; Kinsinger LS, A National Center for Health Promotion and Disease Prevention; Richardson C, Ann Arbor VA Center for Clinical Management Research and VA Diabetes QUERI, Ann Arbor, MI
In an effort to decrease incident diabetes amongst Veterans, the VA National Centers for Health Promotion and Disease Prevention (VA NCP) and the Diabetes Quality Enhancement Research Initiative (QUERI) partnered to conduct a pragmatic evaluation of the VA Diabetes Prevention Clinical Demonstration Project (VA DPP), to test implementation of a DPP intervention for Veterans with pre-diabetes. The objective was to compare weight loss among participants systematically assigned to either VA DPP or an established VHA weight loss known as MOVE!.
Obese and overweight Veterans were recruited from three VHA Medical Centers (VAMCs) with geographically and racially diverse populations using an established referral system for MOVE!. Veterans with pre-diabetes (defined by HbA1c 5.7-6.4% or FPG 100-125 mg/dL) who attended a MOVE! orientation and lived within one hour driving distance to the VAMC were eligible. Weight loss data was collected from the VA Corporate Data Warehouse.
Between August 2012 and January 2014, 1345 Veterans were screened and 252 met all eligibility criteria. Eligible Veterans were systematically assigned to VA DPP (n = 211) or MOVE! (n = 41). VA DPP participants were more likely to attend at least 9 sessions (39% vs. 29%, p = 0.055). VA DPP participants lost significantly more weight than MOVE! participants at 6 months (VA DPP lost 9.6 lbs and MOVE! lost 3.1lbs, p = .03).
Compared to usual care, an evidence based DPP intervention was associated with higher mean percent weight loss and uptake among obese/overweight Veterans with pre-diabetes.
Aligning MOVE! more closely to DPP or alternatively providing diabetes prevention specific interventions may help increase weight loss and reduce incident diabetes amongst Veterans.