Effectiveness of digital and remote provision of the Healthier You: NHS Diabetes Prevention Programme during the COVID-19 pandemic

AIMS: To assess weight change in the Healthier You: NHS Diabetes Prevention Programme (NHS DPP) delivered via video conferencing (remote) sessions or delivered via specific digital interventions through apps or websites, during the COVID-19 pandemic compared to group-based face-to-face interventions, pre-pandemic./ METHODS: Prospectively collected national service-level data relating to individuals with non-diabetic hyperglycaemia (HbA1c 42-47mmol/mol (6.0-6.4%) or fasting plasma glucose 5.5-6.9mmol/l) referred to the NHS DPP from June 2016 to March 2022. / RESULTS: Between March 2020 and March 2022, 335,961 people were referred to the programme and were offered a choice of remote or digital intervention. This was preceded by 556,793 people referred into the face-to-face programme between June 2016 and February 2022. Uptakes to intervention sessions were 47% for those offered a choice and 39% for face-to-face. Remote and digital participants were significantly younger (60 and 56 vs 65 years) and heavier (86.1kg and 91.0kg vs 84.1kg) compared to face-to-face. Weight change was assessed for 42,407 remote, 7,699 digital and 97,205 face-to-face participants with sufficient time to have finished the programme and no missing data. Mean weight losses for participants attending at least one intervention session were: 2.40(2.36-2.44)kg, 2.59(2.49-2.68)kg and 2.01 (1.98-2.04)kg for remote, digital and face-to-face participants respectively. Corresponding mean weight losses for those who completed the programme were: 3.24(3.19-3.30)kg, 4.76(4.60-4.92)kg and 3.04(3.00-3.07)kg. There were no significant differences in weight change between interventions by ethnicity and deprivation./ CONCLUSIONS: Weight losses achieved through remote and digital interventions were greater than those previously achieved through face-to-face interventions, without evidence of exacerbation of health inequalities