Weight Loss Through Living Well

2009; SAGE Publishing; Volume: 35; Issue: 2 Linguagem: Inglês

10.1177/0145721709332815

ISSN

1554-6063

Autores

Kathleen M. McTigue, Molly B. Conroy, Lori Bigi, Cynthia Miller Murphy, Melissa McNeil,

Tópico(s)

Diabetes Management and Education

Resumo

To translate the Diabetes Prevention Program (DPP) lifestyle intervention into a clinical setting and evaluate its effectiveness.The authors implemented a group-based version of the DPP lifestyle curriculum in a large academic medicine practice. It is delivered by a nurse educator over 12 weekly sessions with optional reenrollment, available on a self-pay basis, and implemented using existing clinical resources (eg, electronic medical record referrals, scheduling, conference rooms, communication technology). The program was evaluated using a controlled before-after design, including all patients referred between April 1, 2005, and February 1, 2007. Patients with a body mass index (BMI) >or=25 kg/m(2) were eligible if their primary care providers felt the program was medically appropriate and safe. Change in weight (kg) and frequency of achieving >or=7% weight loss were examined.Referred patients were primarily female (84%), with an average age of 49.91 years (SE, 1.46) and average BMI of 39.65 kg/m(2) (SE, 0.73). Among eligible patients, 93% of enrollees and 80% of nonenrollees had follow-up weights recorded within the evaluation window. Over 1 year, mean weight change was -5.19 kg (95% confidence interval [CI], -7.71 to -2.68) among enrollees and +0.21 kg (CI, -1.0 to 1.93) among nonenrollees (P < .001). A >or=7% loss was found for 27% of enrollees and 6% of nonenrollees (P = .001).An evidence-based lifestyle intervention can be effectively translated into the clinical setting. Use of existing resources may facilitate patient flow and minimize cost. This provider-integrated preventive care approach may provide a model for incorporating knowledge from behavioral science into clinical care.

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