Intensive lifestyle intervention goals can be achieved as effectively with large groups as with small groups.

The purpose of this study was to assess if group size is associated with weight loss outcomes among participants in an adapted diabetes prevention program. Adults at high-risk (N=841) for CVD and diabetes were enrolled in the lifestyle intervention in 2011. Multiple logistic regression analyses were used to identify if group size (smaller group<16 participants; larger group ≥16 participants) was independently associated with weight loss outcomes among participants. In the bivariate analyses, participants in the smaller groups compared to those in the larger groups were significantly more likely to have a higher baseline body mass index, to attend fewer intervention sessions, and less likely to self-monitor their fat intake for ≥14 weeks, and to have lost less weight during the core intervention (5.1 kg [SD 4.7] versus 5.8 kg [4.5]). However, analysis adjusting for age, sex, baseline BMI, achievement of the physical activity goal, number of weeks self-monitoring fat intake, and group size, found only two factors to be independently associated with achievement of the 7% weight loss goal: frequency of self-monitoring of fat intake and achievement of the physical activity goal. Our findings indicate that intensive lifestyle intervention goals can be achieved as effectively with large or small groups.

Brokaw SM ，Arave D ，Emerson DN ，Butcher MK ，Helgerson SD ，Harwell TS ，Montana Cardiovascular Disease and Diabetes Prevention Workgroup ... -  《-》

Effectiveness of an Adapted Diabetes Prevention Program Lifestyle Intervention in Older and Younger Adults.

To compare participation, self-monitoring behaviors, and weight loss outcomes in older and younger participants in an adapted Diabetes Prevention Program (DPP) lifestyle intervention. Pre- and postevaluation of outcomes in participants enrolled in the Montana Cardiovascular Disease (CVD) and DPP lifestyle intervention from 2008 through 2012. Community. Adults at high risk for CVD and type 2 diabetes mellitus (N = 3,804). Number of core (16 weekly sessions) and postcore (6 monthly sessions) intervention sessions attended, weekly self-monitoring of fat intake and minutes of physical activity, weight loss outcomes and achievement of the weight loss goal, and improvements in CVD-related risk factors. Participants aged 65 and older were significantly more likely to attend more intervention sessions, self-monitor their fat intake, and achieve the physical activity and weight loss goals than those younger than 65. Older and younger participants experienced significant improvements in CVD-related risk factors. Older adults at high risk of CVD and diabetes mellitus participating in an adapted DPP lifestyle intervention had higher participation and self-monitoring rates than younger participants, were more likely to achieve physical activity and weight loss goals, and achieved similar CVD risk reduction.

Brokaw SM ，Carpenedo D ，Campbell P ，Butcher MK ，Furshong G ，Helgerson SD ，Harwell TS ，Montana Cardiovascular Disease and Diabetes Prevention Workgroup ... -  《-》

Factors associated with achieving a weight loss goal among participants in an adapted Diabetes Prevention Program.

To assess the factors associated with achieving the 7% weight loss goal among participants enrolled in an adapted Diabetes Prevention Program (DPP). Adults at high-risk (N=989) for CVD and diabetes were enrolled in the lifestyle intervention. Multiple logistic regression analyses were used to identify factors associated with achieving the weight loss goal. Overall 37% of participants achieved the weight loss goal. Participants who were older, male, had a lower baseline BMI, self-monitored their fat and caloric intake more frequently, and who achieved higher levels of physical activity were more likely to achieve the weight loss goal compared to participants without these characteristics. In multivariate analyses more frequent self-monitoring of fat and caloric intake and higher levels of weekly physical activity were the only factors independently associated with participant achievement of the weight loss goal. In a real-world translation of the DPP lifestyle intervention participants who achieved the weight loss goal were more likely to have monitored their dietary intake frequently and increased their physical activity markedly both in a dose-response relationship. Our findings highlight the importance of supporting participants in lifestyle interventions to initiate and maintain dietary self-monitoring and increased levels of physical activity.

Harwell TS ，Vanderwood KK ，Hall TO ，Butcher MK ，Helgerson SD ，Montana Cardiovascular Disease and Diabetes Prevention Workgroup ... -  《-》

A primary care based healthy-eating and active living education session for weight reduction in the pre-diabetic population.

Many studies have demonstrated the effectiveness of primary prevention strategies in type 2 diabetes, however, questions remain around the feasibility of high resource, intensive interventions within a healthcare setting. We report the results of a dietitian-led pre-diabetes education session targeting healthy eating and active living as strategies for weight reduction. Participants were asked to complete a baseline questionnaire prior to completing the pre-diabetes education session and were sent follow-up questionnaires at 3 and 6 months. Differences between participants at baseline, 3 and 6 months were determined using χ(2), t-tests and ANOVA. Of the 211 participants asked to fill out baseline questionnaires, 45 participants completed questionnaires at baseline, 3 months and 6 months. Although we observed general trends towards improvements in diet, physical activity and weight related behaviours among the 45 completers, no significant changes were observed among participants between questionnaire periods. A "one-off", theory-guided group education session may be insufficient to support lifestyle modifications in the context of weight management in a pre-diabetic population. Further evaluation of the efficacy and feasibility of the PCN as a setting for lifestyle intervention is required.

Weir DL ，Johnson ST ，Mundt C ，Bray D ，Taylor L ，Eurich DT ，Johnson JA ... -  《-》

Translating the diabetes prevention program into practice in the general community: findings from the Montana Cardiovascular Disease and Diabetes Prevention Program.

Amundson HA ，Butcher MK ，Gohdes D ，Hall TO ，Harwell TS ，Helgerson SD ，Vanderwood KK ，Montana Cardiovascular Disease and Diabetes Prevention Program Workgroup ... -  《DIABETES EDUCATOR》