Characteristics and Associated Weight-Loss Responses to the Diabetes Prevention Program for Adults With Acquired Brain Injury: Secondary Analysis of Two Randomized Control Trials.

OBJECTIVE

To examine the association and temporal relationship between weight-loss and participant characteristics in a sample of community-dwelling adults with acquired brain injury, including cerebral vascular accident (CVA) and traumatic brain injury (TBI).

DESIGN

Secondary data analysis of a wait-list control assessor-blinded randomized control trial and parallel-group assessor-blinded randomized control trial.

SETTING

Community-based interventions through in-person and telehealth delivery.

PARTICIPANTS

Sixty nine participants (45 CVA; 24 TBI) with 12-month follow-up assessments.

INTERVENTIONS: The Diabetes Prevention Program Group Lifestyle Balance (DPP-GLB) program is a theoretically-grounded self-management intervention adapted for people with CVA (GLB-CVA) and TBI (GLB-TBI). Both interventions shared program goals of losing body weight through decreased caloric intake and increased physical activity (150 minutes/week).

MAIN OUTCOME MEASURES: Assessments for body weight completed at baseline, 3, 6, and 12 months, in addition to a range of biopsychosocial factors (demographic, injury-related, physiological, fitness-related, and self-reported outcomes).

RESULTS

Race and private/public insurance had statistically significant associations with change in weight. Associations between baseline measures, biomarkers, walk scales, self-report outcomes, and corresponding weight change from baseline to 12-months showed a significant association for 6-minute walk test (6MWT). Regression analysis demonstrated variables with a P<.05, including 8-year diabetes risk (8YDR) and 6MWT, showed a positive relationship with weight change.

CONCLUSIONS

Factors related to racial background and private/public insurance may correspond with weight-loss and further change after injury. Greater body weight associated with higher scores on 6MWT and/or 8YDR emphasize the need to examine associations between dimensions of fitness, diabetes predictors, and group lifestyle balance outcomes.