Weight loss and lifestyle change among high-risk individuals enrolled in a digital diabetes prevention program: A longitudinal study of private and public health insurance members in Western New York.

ABSTRACT

Weight loss is critical to reduce diabetes risk. Diabetes Prevention Programs (DPPs) are effective for weight loss, although less is known about digital DPPs. This study explores the association between Brook+, a 52-week digital DPP, and weight loss. This longitudinal observational study uses a sample of 5,516 private, Medicare, and Medicaid health insurance members from Western New York enrolled into Brook+ between December 2020 and December 2022. We used multivariable generalized linear regression models to estimate the association between completion of the Brook+ program, overall and stratified by health insurance type, and 5% weight loss using odds ratios (OR) and 95% confidence intervals (CI), adjusted for age and gender. We also estimated average weight loss from baseline associated with high engagement with the program using adjusted linear regression models. In the pooled sample, those who completed the Brook + program had 21% increased odds of 5% weight loss (OR = 1.21 95% CI (1.02 - 1.44)). Among users enrolled in private, Medicare, and Medicaid health insurance, program completion was associated with 21%, 33%, and 13% increased odds of 5% weight loss, compared to those who did not complete Brook+. Interacting with health coaches, increased physical activity, and meal logging were all significant predictors of weight loss. Our results suggest that digital DPPs are promising for large-scale diabetes prevention via weight loss and lifestyle change.