Diabetes Prevention Program (DPP) - General Information

Program Manual VP Card

Description:

Achieving weight or physical activity outcome measures to support clients in decreasing the risk of diabetes by targeting sustainable weight loss through lifestyle changes focuses on increasing physical activity and eating healthier

1. Background: based on the evidence-based DPP program developed by the CDC. 
   1. Primarily a weight loss program with an emphasis on activity and nutrition.
2. Purpose: decrease the incidence of diabetes in our clients by targeting behavior change in individuals at risk

Type of Provider For This Program:

• Health Coaches

Target Population:

Clients with prediabetes or at risk for diabetes

Inclusion 

Screens positive for risk (≥5) on ADA screening tool

Has a recent (past year) prediabetic-range A1C value (5.7-6.4%). Per CDC guidelines, self-reported is OK. Alternatives that can also qualify a candidate program participant:

• Fasting glucose of 100-125 mg/dL
• 2 hr oral glucose tolerance test of 140-199 mg/dL
• Per CDC guidelines, self-reported, past-year values are OK for FG or OGTT as well.
• Weight loss is goal
• BMI > 25 or > 23 if Asian descent
• Cannot have Diabetes Type 1 or Type 2  
• Cannot be taking any medication for diabetes (including metformin)
• Most recent HbA1c < 6.4

Exclusion

• Does not want to lose weight
• Weight is not elevated (BMI < 25, or < 23 if Asian American)
• Diabetes type 1 or Type 2 (most recent HbA1c > 6.4 or taking any medication for diabetes including metformin)
• Diabetes type 2 (email erica.freem@vida.com and cc: jakob@vida.com, aarathi.venkatesan@vida.com, and manpreet.kaur@vida.com if a member receives a new diagnosis or otherwise becomes ineligible during the program)
• Does have chest pain when getting rest, wash, get dressed, or exercise.
• Restricted from physical activity by their doctor
• Currently pregnant
• Under 18

Durability:

• Clients will complete 24 lessons and consultations over the course of one year.
  • 16 core lessons during the first 6 months of the program
  • If the user completes 16 core lessons before 6 months of program participation, the coach may send maintenance lessons early, during program months 5 and 6.
  • In this case, please be careful to pace the remaining content so that the member does not finish before month 9.
  • Core sessions are sent automatically through the dash. 
  • 6 or more maintenance lessons were chosen by the coach out of 9 available.
  • Can be sent in any order. Coach chooses based on relevance to members.
  • If the coach doesn’t choose a lesson by 20 days from former lesson completion, the Clinical Operations Associates will send the next in the sequence. (Can be  sent out as early as months 5 or 6 if the client has already completed weekly core lessons 1-16)
• 16 “Weekly” lessons and consultations: 
• Monthly consultations and lessons for the remainder of the year: 
• For CDC purposes, the program starts the day they complete the first lesson, and lasts 365 days. Lessons completed after that date do not count, and therefore neither do weight values.
• Coach creates a tailored wellness plan
• Lessons sent automatically(see chart below)
  • Device ordering tools will be sent automatically after they complete the first lesson, if applicable
• The first lesson “Welcome to Diabetes Prevention” is sent when the program starts.
• Please send the A1C tool ASAP if applicable
• Review member’s recent responses to the content before each call and discuss it with the client. Focus on good motivational interviewing techniques and supporting change talk and softening sustain talk. Member responses to lessons can also be a good inspiration for engagement in chat in between calls.

Goal(s):

Weight. The goal of losing at least 5-7% of total body weight. 

• • 1. • Baseline weight is the weight closest to the date the first lesson was completed. (ideally logged on the same day)!
       • For the end outcome, the CDC cares about their last weight that’s associated with a lesson. That means:
         1. Between 9 months and 12 months
         2. Within 3 days of the day the last lesson was completed

A1C if available (not official CDC outcome)