title: Factors related to lifestyle goal achievement in a diabetes prevention program dissemination study.
abstract: The U.S. Diabetes Prevention Program (DPP) showed that lifestyle participants who achieved ≥7% weight loss and ≥150 min/week physical activity experienced the greatest reduction in type 2 diabetes incidence. Demographic, clinical, and program factors that are related to achieving both these lifestyle goals have seldom been explored in community-delivered DPP programs. The purpose of this investigation is to examine factors associated with concurrent achievement of weight loss and physical activity goals in a 12-month community DPP lifestyle intervention. Adults [n = 223; age = 58.4 (SD = 11.5); BMI = 33.8 (SD = 6.0)] with glucose or HbA1c values in the pre-diabetes range and/or metabolic syndrome risk factors enrolled from one worksite and three community centers in the Pittsburgh, PA metropolitan area between January 2011 and January 2014. Logistic regression analyses determined the demographic, clinical and program adherence factors related to goal achievement at 6, 12, and 18 months. Participants achieving both intervention goals at 6 months (n = 57) were more likely to attend sessions [Adjusted Odds Ratio (AOR) =1.48], self-weigh (AOR = 1.19), and self-monitor behaviors (AOR = 1.18) than those meeting neither goal (n = 35; all p < 0.05). Baseline BMI (AOR = 0.87, p < 0.01), elevated glycemic status (AOR = 0.49, p < 0.05), and female sex (AOR = 0.52, p < 0.05) were inversely related to goal achievement at 6 months. Meeting either lifestyle goal at 6 months had the strongest association with meeting both goals at 12 and 18 months. Our study supports the importance of early engagement, regular attendance, self-monitoring, and self-weighing for goal achievement. Dissemination efforts should consider alternative approaches for those not meeting goals by 6 months to enhance long-term success.
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA. y.eaglehouse.phd@gmail.com.|Division of Cancer Prevention and Population Sciences, University of Pittsburgh Cancer Institute, 5150 Centre Avenue, Pittsburgh, PA, 15232, USA. y.eaglehouse.phd@gmail.com.|, 11300 Rockville Pike, Suite 1120, Rockville, MD, 20852, USA. y.eaglehouse.phd@gmail.com.
authors.forename: Yvonne L
authors.initials: YL
authors.lastname: Eaglehouse
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA.|Department of Psychiatry, University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA, 15261, USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Venditti
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
authors.forename: M Kaye
authors.initials: MK
authors.lastname: Kramer
authors.affiliation: Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
authors.forename: Vincent C
authors.initials: VC
authors.lastname: Arena
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA.|Montana Department of Public Health and Human Services, 111 North Sanders, Helena, MT, 59601, USA.
authors.forename: Karl K
authors.initials: KK
authors.lastname: Vanderwood
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
authors.forename: Bonny
authors.initials: B
authors.lastname: Rockette-Wagner
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Kriska
mesh_terms: D001786:Blood Glucose; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000517:prevention & control*; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006040:Goals; D000070497:Healthy Lifestyle; D006801:Humans; D033181:Information Dissemination; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000517:prevention & control / Q000628:therapy; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance; D011236:Prediabetic State / Q000097:blood / Q000628:therapy; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Physical activity; behavior change; community health; weight loss