Effectiveness of digital and remote provision of the Healthier You: NHS Diabetes Prevention Programme during the COVID-19 pandemic
Barron E., Bradley D., Safazadeh S., McGough B., Bakhai C., Young B., Khunti K., Murray E., Wareham N., Jebb S., Valabhji J.
Aims: To assess weight change in the Healthier You: NHS Diabetes Prevention Programme (NHS DPP) delivered via video conferencing (remote) sessions or delivered via specific digital interventions through apps or websites, during the COVID-19 pandemic compared to group-based face-to-face interventions, pre-pandemic. Methods: Prospectively collected national service-level data relating to individuals with non-diabetic hyperglycaemia (HbA1c 42–47 mmol/mol (6.0%–6.4%) or fasting plasma glucose 5.5–6.9 mmol/L) referred to the NHS DPP from June 2016 to March 2022. Results: Between March 2020 and March 2022, 335,961 people were referred to the programme and were offered a choice of remote or digital intervention. This was preceded by 556,793 people referred to the face-to-face programme between June 2016 and February 2022. Uptakes to intervention sessions were 47% for those offered a choice and 39% for face-to-face. Remote and digital participants were significantly younger (60 and 56 vs. 65 years) and heavier (86.1 kg and 91.0 kg vs. 84.1 kg) compared to face-to-face. Weight change was assessed for 42,407 remote, 7699 digital and 97,205 face-to-face participants with sufficient time to have finished the programme and no missing data. Mean weight losses for participants attending at least one intervention session were: 2.40 (2.36–2.44) kg, 2.59 (2.49–2.68) kg and 2.01 (1.98–2.04) kg for remote, digital and face-to-face participants respectively. Corresponding mean weight losses for those who completed the programme were: 3.24 (3.19–3.30) kg, 4.76 (4.60–4.92) kg and 3.04 (3.00–3.07) kg. There were no significant differences in weight change between interventions by ethnicity and deprivation. Conclusions: Weight losses achieved through remote and digital interventions were greater than those previously achieved through face-to-face interventions, without evidence of exacerbation of health inequalities.