Computer Assisted Support to Reduce Risks of Diabetes

DESCRIPTION (provided by applicant): Approximately 8% of adults in the U.S. suffer from type 2 diabetes. Treatment prevents some of its devastating complications, but does not usually restore normal glycemia or eliminate adverse consequences. Hence, prevention is preferable. Evidence from two large, well-controlled trials indicates that type 2 diabetes can be delayed, and possibly prevented, through lifestyle interventions. Nutrition and exercise to achieve a healthy weight are key behavioral interventions in preventing diabetes. However, this evidence has not diffused well into clinical practice. Clinic-based weight management programs are expensive, difficult to deliver on a population basis and are not typically structured to meet the unique needs of medically underserved and Hispanic populations. (Prevalence of diabetes is especially high among Hispanic adults.) The goal of this proposal is to test the efficacy of a practical and easily delivered intervention for weight management in a balanced randomized controlled trial, involving 150 people in each of two study arms (control group and intervention group) for a total of 300 patients. This study will target medically underserved patients with a risk for diabetes. The primary outcomes will be to reduce their weight and improve glucose metabolism. The intervention will utilize an interactive computer-based software program to tailor the intervention to the unique needs of each patient. This system was developed under a Phase I SBIR award (1 R43- DK066711-01A1). Evidence-based behavioral models that hold promise for helping individuals make changes to better manage body weight will be applied. This system is designed to operate on clinic-based personal computers and will provide individual assessment and tailored, real-time and feedback reports to patients and physician reports outlining key areas for patient improvement and counseling suggestions for practitioners.