The program features a highly individualized website, Android and iPhone apps, tailored emails, an interactive voice response coaching program, and tailored mailed newsletters and is the outgrowth of previous work on prevention, said Torin Black, CEO of NutritionQuest.com, developer of the program.
“There have been multiple versions that we ahve been developing since about 2000 with a number of grants from NIH, CDC and the State of California Department of Health,” Black told NutraIngredients-USA.
“It has been tested in several trials and there is published data of the effect of the program in a randomised, placebo-controlled trial with employees of a Kaiser division in Northern California,” Black said. “We definitely saw statistically significant improvements in their health parameters.”
While the company has been working on tailored, personalized health coaching to help users improve their overall health metrics, this is the first attempt to take square aim at diabetes, Black said.
“The prior version of the program was about general wellenss. It wasn’t specifically targeting prediabetes. That’s one of the ways the current version differs. We’re all about prventing diabetes with this verison, and all of the content is now different,” he said.
Automated coaching
The program coaches pre-diabetics to adopt the lifestyle changes that are proven effective in reversing the progression to diabetes. It gathers detailed personal information at the start via a set of questionaires. Adding personalized genomic data is something the company is looking at for the future, Block said.
"The national Diabetes Prevention Program proved it's possible to slow the progression of pre-diabetes through face-to-face behavioral interventions," said Dr Gladys Block, lead developer of the program, Prof Emerita of Public Health at U.C. Berkeley (and mother of Torin). "With Alive-PD we hope to demonstrate that pre-diabetics can achieve significant behavior change via a highly individualized, yet completely automated program."
"Most people know that they need to change their behaviors, but they need coaching and support throughout the process to be successful," said Gladys Block.
The 36-week program uses a multimodal approach including e-mails, text and voice messages that automatically adapts intervention messages and program actions to reflect the level of user interaction. Those with successful interactions are rewarded and encouraged, while those who find behavior change more challenging receive specialized coaching.
Features of the program include personalized activity planning tools, individualized goal setting and reporting, performance logging, specific dietary and activity advice tailored to patients' self-reported behaviors, as well as engagement features including a points system, team play and challenges. The program promotes interaction via social media and the direct support of family and friends, and also includes traditional health education articles, infographics, and self-testing quizzes.
Nutritional advice
The program sets targets for users’ diet modifications. If, for example, a participant might show higher saturated fat intake than is desirable, the program might recommend a switch to lower fat milk if they are a milk drinker. The program sets similar targerts for fruit and vegetable intake and activity levels.
The program does at this point not recommend specific dietary supplements, Torin Black said.
“We are not so much focused on the micronutrients. We do discuss supplementation, and Gladys Block is a very big proponent of supplementation. Most of her research has been about vitamin C,” he said.
Another possible future development of the program concerns personal genetic data. While the questionaires give a broad picture of a patient’s overall health and habits, genetic data would add another level of granularity.
“We’ve had converstions with one company in Silicon Valley that offers a personalized genetic analysis. There is definitely a fit there,” Torin Black said.