Sonia I. Betancourt, DNP, MSN, RN, FNP-C

Abstract:

Background: Prediabetes places individuals at higher risk of developing type 2 diabetes (T2DM), cardiovascular disease, and stroke. One-third of US adults have prediabetes. Nationwide, there have been missed opportunities where eligible patients were not screened, diagnosed, or treated for prediabetes. The Diabetes Prevention Program(DPP) is a highly effective intervention for diabetes prevention, yet attendance at DPP is often incomplete. This dissertation builds on DPP with an intervention that promotes prediabetes awareness through telephone outreach and encourages DPP attendance, called DODGE© Diabetes (DODGE©- Drink water-avoid sugary drinks; Optimize sleep; Daily mindfulness; Get active: 150 minutes per week; and Enjoy more fruits and vegetables). DODGE© compliments the existing DPP through group classes on prediabetes, weekly text reminders, and monthly one-on-one coaching. Objectives: DODGE© aims to increase awareness in adults with prediabetes (hemoglobin A1Cbetween 5.7%to 6.4%) and promote attendance at DPP. Methods: In a clinic in California, adults with a body mass index (BMI) greater than 25 kg/m2 and prediabetes were outreached through a telephone call and invited to DODGE©.Fourteen adults participated in DODGE©. The intervention included getting additional information about prediabetes, attending the existing 16 weekly DPP, receiving weekly reminders to attend the DPP, and monthly one-on-one calls. DODGE© implemented the Transtheoretical Model (TTM) by promoting lifestyle behavior change to participants and evaluating the five stages of change experienced by the DODGE© participants. A quasi-experimental design with pre-and post-measurement was collected to compare DODGE© and non-DODGE©DPP participants. Descriptive statistics characterized variable distributions; t-tests and Chi-Square were used to evaluate group differences. Results: On average, the fourteen DODGE© participants attended 80% of the weekly Healthy Balance (DPP) classes compared to non-DODGE© of 55% (p-value= 0.02). Participants reported that text messages were helpful reminders to attend the DPP classes. Thirteen DODGE© participants progressed in the TTM from the contemplation to the action phases, and one continued in the maintenance phase. Conclusion: Telephone outreach and additional education increased prediabetes awareness. The prediabetes education group classes, weekly text reminders, and monthly calls promoted DPP attendance and adherence.

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