Translating the diabetes prevention program into a hospital-based weight loss program.

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Abstract
Objective: Intensive lifestyle interventions have established efficacy, but translation to real-world settings has not been well demonstrated. Using the diffusion of innovations model, we describe the adoption of the Diabetes Prevention Program (DPP) Lifestyle Intervention into a hospital-based program and report feasibility, acceptability, and outcomes. Design: Patients (N = 118; 72% female, mean age = 48.8, mean baseline body mass index = 43.3) were enrolled into 16 weeks of DPP. Main Outcome Measure: Weight loss (kg) was measured at baseline and after treatment. Results: Mean weight loss after 16 weeks was 5.57 kg (SD = 4.6) or 4.6% of baseline weight, and 30% met the 7% weight loss goal. Outcomes are compared with those reported in the DPP trial. Most participants (90.4%) were satisfied with the service; however, only 56% were satisfied with their weight loss. Conclusion: The DPP was successfully translated into a real-world clinic with some protocol modifications. Weight loss was modest among heavier patients with more comorbidities than the original DPP sample. Diffusion of innovations theory provides a useful framework for adopting evidence-based programs in the clinical setting.