Obesity is related to the rising incidence of type 2 diabetes and interventions leading to sustained weight loss are needed. Most weight loss trials have been implemented in academic centers under tightly controlled conditions with limited follow-up. The need for translation of successful interventions is clear. Since patients have regular contact with their primary care physicians (PCPs), an intervention that can be delivered through primary care practices could have better long-term outcomes. The Diabetes Prevention Program (DPP) is a model for a successful weight loss intervention, yet no programs to date have successfully adapted the DPP to a long-term primary care-based intervention. The study is a 5 year randomized controlled trial of 2 active treatment interventions based on the DPP model that will be delivered at primary care sites.
The specific aims are to evaluate the effects of two interventions that are translations of the DPP Lifestyle Balance program, and are delivered through primary care practices, on the primary medical outcome of weight loss, secondary medical outcomes of blood pressure, fasting lipids and glycemia, and psychosocial outcomes of health behaviors and health-related quality of life. Secondary aims are to determine whether the DPP translation is more effective and/or cost effective delivered in a group format. Subjects will be recruited from 4 diverse primary care practices. There will be 2 active treatment groups, both based on the DPP Lifestyle Balance Program. All subjects will have contact with a primary care nurse and a behavioral weight loss "coach." During the first year, in one group, the nurse will present the 12 DPP topics during phone calls (weekly for first 5 weeks, monthly thereafter) and the coach will make 3 phone contacts per month to promote adherence to behavioral weight loss strategies. In the second group, the nurse will facilitate group conference calls (weekly for first 5 weeks, monthly thereafter) to present the DPP material and foster peer support, and the coach will have 3 weekly phone contacts for the individualized aspects of the intervention. A second year of continued contact is included. The study is significant because a primary care based, telephone weight loss intervention will be able to reach more people, may be more effective, and could be easily adopted by primary care physicians, helping them help their patients lose weight successfully and maintain their weight loss. Interventions leading to sustained weight loss are needed to improve the public health and reverse the alarming rise in diabetes, its cardiovascular complications and other obesity-related illnesses.

Public Health Relevance

Obesity is related to the rising incidence of type 2 diabetes and interventions leading to sustained weight loss are needed. The study is significant because a primary care based, telephone-delivered weight loss intervention will be able to reach more people, may be more effective, and could be easily adopted by primary care physicians, helping them help their patients lose weight successfully and maintain their weight loss. Interventions leading to sustained weight loss are needed to improve the public health and reverse the alarming rise in diabetes, its cardiovascular complications and other obesity-related illnesses.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
5R18DK078553-05
Application #
8302435
Study Section
Special Emphasis Panel (ZDK1-GRB-1 (M1))
Program Officer
Kuczmarski, Robert J
Project Start
2008-09-15
Project End
2014-08-31
Budget Start
2012-09-01
Budget End
2014-08-31
Support Year
5
Fiscal Year
2012
Total Cost
$505,460
Indirect Cost
$183,511
Name
Upstate Medical University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
058889106
City
Syracuse
State
NY
Country
United States
Zip Code
13210
Trief, Paula M; Cibula, Donald; Delahanty, Linda M et al. (2014) Depression, stress, and weight loss in individuals with metabolic syndrome in SHINE, a DPP translation study. Obesity (Silver Spring) 22:2532-8
Trief, Paula M; Weinstock, Ruth S; Cibula, Donald et al. (2014) Sustained weight loss one year after group telephone intervention: 3-year results from the SHINE study. Diabetes Res Clin Pract 106:e74-8
Weinstock, Ruth S; Trief, Paula M; Cibula, Donald et al. (2013) Weight loss success in metabolic syndrome by telephone interventions: results from the SHINE Study. J Gen Intern Med 28:1620-8