Poupakis, Stavros;
Kolotourou, Maria;
MacMillan, Harry J;
Chadwick, Paul M;
(2023)
Attendance, Weight Loss, and Participation in a Behavioural Diabetes Prevention Programme.
International Journal of Behavioral Medicine
10.1007/s12529-022-10146-x.
(In press).
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Abstract
Background Weight loss in diabetes prevention programmes has been shown to be associated with participants’ age, socio-economic status, and ethnicity. However, little is known about how these differences relate to attendance and whether such differences can be mediated by other potentially modifiable factors. Differential effectiveness across these factors may exacerbate health inequalities. Method Prospective analysis of participant data collected by one provider of the standardised national NHS diabetes prevention programme in England. Mediation analysis was performed via a structural equation model to examine whether the number of attended sessions mediated the associations of age, socio-economic status, and ethnicity with follow-up weight. The group-level factor of number of attended sessions was examined using multiple linear regression as a benchmark; multilevel linear regression using three levels (venue, coach, and group); and fixed effects regression to account for venue-specific and coach-specific characteristics. Results The associations of age, socio-economic status, and ethnicity with follow-up weight were all mediated by the number of attended sessions. Group size was associated with attendance in an inverted ‘U’ shape, and the number of days between referral and group start was negatively associated with attendance. Time of day, day of the week, and the number of past groups led by the coach were not associated with attendance. Conclusion Most of the differences in weight loss initially attributed to socio-demographic factors are mediated by the attendance of the diabetes prevention programme. Therefore, targeted efforts to improve uptake and adherence to such programmes may help alleviate inequalities.
| Type: | Article |
|---|---|
| Title: | Attendance, Weight Loss, and Participation in a Behavioural Diabetes Prevention Programme |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s12529-022-10146-x |
| Publisher version: | https://doi.org/10.1007/s12529-022-10146-x |
| Language: | English |
| Additional information: | This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Diabetes prevention programme, Weight loss, Behavioural change, Health inequalities |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10163187 |
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