C-C2-05: Primary Care Web-Based Lifestyle Intervention for Type 2 Diabetes: Randomized Controlled Trial to Improve Knowledge and Self-Care

2 Life Med Media Background: Rapidly growing numbers of Type 2 Diabetics (T2D) in the US continues to escalate need for evidence-based primary care interventions to reduce complications and costs. Limited time, information, and lack of revenue for chronic disease management create gaps between national guidelines and primary care for diabetes. Methods: Of the over 20,000 diabetics were identified in Geisinger EPIC ® EHR, 3166 T2D with diagnosis on problem list or ICD-9 code had HgA1c>8.0%. Physician letters or emails were sent to invite them to call to Opt OUT if they did not want more information. After a 10 day period, staff called 1932 eligible T2D to invite them to a shared medical primary care visit to participate in a randomized controlled trial comparing a tailored 5-month web-based lifestyle intervention (dLifeG.com) to usual care. 166 Type 2 diabetics gave written informed consent and were randomized 1:2 to control group or intervention group. In 8.0 in a self-management lifestyle modification intervention. Importantly, the study also helped rates of 72.0% (175/243) in the group education intervention and 86.1% (211/245) in the individual treatment intervention. We sought to identify demographic, psychosocial and clinical characteristics that might explain non-completion. We hypothesized that, within each arm, baseline health status (SF-12 mental composite and physical composite scores), depression (PHQ9), personality type (TIPI Big 5; extraversion, agreeability, emotional stability, conscientiousness, and openness), and Hb A1c level were associated with completion. Results: In the group education arm, subjects scoring higher on the emotional stability scale were more likely to complete (p<0.05). Generally, demographic factors were more strongly associated with completion of group education than were psychosocial or clinical factors: women and older subjects were more likely to complete than men and younger subjects (gender, p=0.008; age, p=<0.0005). Within the individual education arm, completion was predicted by higher physical health score (SF12-PCS; p=0.005), higher mental health scales (SF12-MCS, p=0.008), lower depression score (PHQ9, p=0.002), and lower Hb A1c (p<0.05). However, neither gender nor age was associated with completion. Conclusions: Factors related to study completion appear to differ between the 2 diabetes educational interventions. These results may be relevant to diabetes educational programs considering strategies to improve "no show"