title: Women veterans' experience with a web-based diabetes prevention program: a qualitative study to inform future practice.
abstract: BACKGROUND
  Diabetes prevention is a national goal and particularly important in the Veterans Health Administration (VHA) where 1 in 4 veterans has diabetes. There is growing evidence to support the use of Web-based diabetes prevention program (DPP) interventions, shown to be as effective and often more feasible than in-person interventions.
  
  
  OBJECTIVE
  Our primary objective was to qualitatively explore women veterans' early experiences with a Web-based DPP intervention. Our secondary objective was to estimate weight loss, participation, and engagement to provide context for our qualitative findings.
  
  
  METHODS
  We conducted and analyzed semistructured interviews and collected data on weight change, participation, and engagement. A total of 17 women veterans with prediabetes from a Midwest VA Women's Health Clinic were eligible to participate; 15 completed interviews.
  
  
  RESULTS
  Participants perceived the DPP program as an appealing way of initiating lifestyle changes and made them feel accountable in achieving their daily goals. The online program was convenient because it could be accessed at any time, and many found that it integrated well into daily life. However, some did not like the logging aspect and some found it to be too impersonal. Participants logged in a mean 76 times, posted a mean 46 group messages, and sent a mean 20.5 private messages to the health coach over 16 weeks. Participants lost 5.24% of baseline weight, and 82% (14/17) of participants completed at least 9 of 16 core modules.
  
  
  CONCLUSIONS
  Women veterans' early experiences with a Web-based DPP intervention were generally positive. Accountability and convenience were key enabling factors for participation and engagement. A Web-based DPP intervention appears to be a promising means of translating the DPP for women veterans with prediabetes.
authors.affiliation: VA Health Services Research and Development (HSR&D) Center for Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles, VA Greater Los Angeles Healthcare System, Los Angeles, CA, David Geffen School of Medicine, University of California, Los Angeles, CA, Los Angeles, CA, United States. TMoin@mednet.ucla.edu.
authors.forename: Tannaz
authors.identifier: http://orcid.org/0000-0002-5035-6641
authors.initials: T
authors.lastname: Moin
authors.forename: Kristyn
authors.identifier: http://orcid.org/0000-0001-8616-4070
authors.initials: K
authors.lastname: Ertl
authors.forename: Jessica
authors.identifier: http://orcid.org/0000-0002-8776-7647
authors.initials: J
authors.lastname: Schneider
authors.forename: Elena
authors.identifier: http://orcid.org/0000-0002-6271-0257
authors.initials: E
authors.lastname: Vasti
authors.forename: Fatima
authors.identifier: http://orcid.org/0000-0001-5790-2329
authors.initials: F
authors.lastname: Makki
authors.forename: Caroline
authors.identifier: http://orcid.org/0000-0002-1945-6046
authors.initials: C
authors.lastname: Richardson
authors.forename: Kathryn
authors.identifier: http://orcid.org/0000-0002-0948-3497
authors.initials: K
authors.lastname: Havens
authors.forename: Laura
authors.identifier: http://orcid.org/0000-0002-3657-8459
authors.initials: L
authors.lastname: Damschroder
mesh_terms: D000328:Adult; D001292:Attitude to Computers; D003920:Diabetes Mellitus / Q000517:prevention & control*; D019468:Disease Management; D005260:Female; D006801:Humans; D020407:Internet; D036301:Qualitative Research; D017216:Telemedicine; D014481:United States; D014728:Veterans
keywords: Internet; attitude to computers; computers; disease management; patient satisfaction; prediabetic state; program evaluation; risk reduction behavior