Translating the Diabetes Prevention Program Into a Virtual Lifestyle Management Program
Condition: Obesity; Diabetes; Cardiovascular Disease
MeSH terms: Cardiovascular Diseases; Diabetes Mellitus; Obesity
Study type: Interventional

Summary: 
      The objective of this study is to evaluate the effectiveness of Virtual Lifestyle Management
      (VLM) as a behavior modification tool to promote weight loss, healthy eating and physical
      activity patterns, in the interest of reducing risk and adverse outcomes for individuals at
      high risk of type 2 diabetes (T2D) and cardiovascular disease (CVD) in a military population.

      Specific Aim: To evaluate the effect of VLM on cardiovascular risk status in participants at
      high risk or individuals with T2D enrolled in the pilot study. The investigators hypothesize
      that participants will show greater improvement in weight as well as glucose, blood pressure,
      lipids, and self-reported diet and physical activity than will similar patients who are not
      enrolled in VLM.
    

Detailed description: 
      As the epidemic of obesity continues to grow in both the United States and military
      populations, innovative lifestyle interventions that fit into the schedules of a busy
      population are critical. The rising costs of obesity (direct medical costs as well as
      societal costs) are staggering, and left unaddressed, they will overwhelm the budgets of many
      employers. Additionally, the costs in terms of military readiness are critical. As more
      career soldiers choose separation over weight reduction, the loss of institutional knowledge
      and intellectual capital are consequences that will continue to be felt. A program that is
      successful, scaleable, and transferable to remote locations could help stem this tide. VLM
      will begin the process of allowing the internet to be used not only as an informational and
      communication tool, but also as a means of accessing a comprehensive and well-validated
      lifestyle program from the internet-access point of greatest convenience.

      Type 2 diabetes (T2D) affects 18 million Americans(2) and costs $132 billion in expenditures
      and lost productivity.(3) Treatment and prevention are essential, yet current
      recommendations,(4) combining medical care with self-care, are difficult to implement.
      Furthermore, strong evidence supports the use of comprehensive, intensive lifestyle
      interventions for obesity among primary care patients. While such programs may help reduce
      the risk of T2D onset, assist with glucose management among individuals who have T2D, and
      benefit other obesity-related health problems, such programs are commonly lacking in clinical
      practice.

      This pilot study will test a model for the implementation of a VLM program that utilizes the
      internet to address good nutrition, safe weight loss methods and the importance of physical
      activity with the "virtual" support of a lifestyle coaching team to sustain participants in
      their weight loss and physical activity efforts. The focus of this initiative is to promote
      weight loss and healthy diet and exercise patterns, in the interest of preventing and
      treating T2D, and minimizing the risk of CVD in the military community. The study will be
      open to individuals who receive medical care through Wilford Hall Medical Center (WHMC)
      clinics.
    

Intervention name(s): Virtual Lifestyle Management
Intervention type(s): Behavioral
Intervention description(s): The VLM online lifestyle intervention will include elements of a behavioral lifestyle program developed by the Diabetes Prevention Program (1). VLM will assist individual participants with establishing appropriate weight loss goals, implementing dietary recommendations (including analysis of current diet), and defining exercise programs.
Participants will be encouraged to complete 16 online, weekly lessons. The VLM curriculum provides standard information about healthy lifestyle, and behavioral techniques for integrating them into daily living. In each lesson, patients provide feedback about how they interpret the information, and ideas for integrating it into their lives. The VLM lifestyle coaching team will review these entries weekly, and provide support, feedback about progress, tips on how to problem-solve around lifestyle barriers, and guidance on how to use the "Keeping Track" functions of VLM (e.g. keeping track of weight, fat intake, calories or physical activity).
Other intervention name(s): Diabetes Prevention Program
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Diabetes; Internet; Obesity; Obesity with high cardiovascular risks