Characteristics and associated weight-loss responses to the diabetes prevention program for adults with acquired brain injury: secondary analysis of two randomized control trials.

Abstract

Examine the association and temporal relationship between weight-loss and participant characteristics in a sample of community-dwelling adults with acquired brain injury (ABI), including cerebral vascular accident (CVA) and traumatic brain injury (TBI). Secondary data analysis of a wait-list control assessor-blinded randomized control trial (RCT) and parallel-group assessor-blinded RCT. Community-based interventions through in-person and telehealth delivery. 69 participants (45 CVA; 24 TBI) with 12-month follow-up assessments. 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). 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). 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. 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 GLB outcomes.