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NHS Diabetes Prevention Programme
Digital Stream
Diane Powell (National Prevention Lead - Digital)
What are we doing with Digital to support Improvements in Diabetes Outcomes?
Implementing digital behaviour change interventions aimed at
preventing Type 2 diabetes in those already identified to be at
high risk and evaluate their effectiveness;
Improving the provision of information to support self-
management and care of people living with Type 1 diabetes;
Scaling digital flexible learning resources to support
management and self-care for people living with diabetes.
Background – Digital Pilot Partnerships with 8 Local
Health Economies (LHEs)
North East London STP Digital only
Humber Coast & Vale STP Digital only
Somerset STP Digital only
Salford CCG Digital only
Bristol, North Somerset, South
Gloucester STP
Choice
Lancashire & South Cumbria STP Choice
Buckinghamshire, Oxfordshire,
Berkshire STP
Choice
Central London, West London,
Hammersmith & Fulham, Hounslow &
Ealing
Refused face to
face
5,000 places on Digital Behaviour Change Interventions (DBCI)
• Tender exercise led to contract with
Our Mobile Health to undertake App
assessment.
• 87 EOIS, 30 digital interventions
reviewed against the NHS Digital
Assessment Framework.
• 14 digital interventions longlisted for
consideration for pilot, 5 chosen to use
for in-service evaluation.
• Open tender exercise led to contract
with RSM the Delivery and Evaluation
Partner to work alongside LHE’s.
• MoUs with LHEs.
• RSM - sub-contracts with 5 final DBCI
providers.
• RSM - sub-contract with Lloyds
pharmacy.
High Level Timeline
Activity Date
Contract in place with a delivery and evaluation
partner
19 June 2017
• Mobilisation and implementation plans
• DBCIs identified to be used in pilot
End of August 2017
Contracts with digital service providers in place 30 October 2017
Referrals to digital services commence By 30 November 2017
Data collection and activity reporting commence Jan/Feb 2018
Interim findings report October 2018
Final output report(s) assured and published September 2019
Site Provider
North East London STP
• Liva
Central London, West London,
Hammersmith & Fulham, Hounslow &
Ealing
• Oviva
London Region Pilot Sites
North East London Area 3 CCGs
15 GP practices
Total population – 750,000
Cohort Total - 1,100 uptake
• NDH – 625
• Overweight/obese - 495
Providers Digital only
• Liva Healthcare (1,100)
Mobilisation • Mobilising GP practices to make referrals
• Operational work with Liva – health coaches
• Communications & marketing
• Go live Jan 18
CWHHE Area 5 CCGs
Total population – 1.4m
Cohort Total - 500 uptake
• NDH – 500
Providers Refusal
• Oviva (500)
Mobilisation • Operational work with Oviva – health coaches
& ICS
• Communications & marketing
• Referrals via ICS commenced 9 Dec
• First Clinic 18 Dec
Liva Healthcare (1 year programme)
Recruitment
Referral from GP or PR, brochures
or other recruitment
Meeting
One-on-one introductory meeting (or digital meeting)
Goal setting/plan
Goals/plans are set and a relationship is established
Customisation
Platform is customised to the individual
Tracking
Daily tracking and registrations
Personal interaction: coaching/social interaction
Healthcare professional Other patients
Z
Y
X
Lifestyle change: Diabetes prevention
1 2 3
4 5 6
Digital Provider - Oviva
Frequent support and coaching offered by a dietitian for up to 6 months
Support offered via: phone calls, text-message chat, smartphone app
and online learning.
Personalised nutrition and activity plan designed by dietitian.
Goal Setting, Nutrition, Activity and Weight Tracked.
Digital Diabetes In-Service Evaluation
• Objectives: Provide DBCIs to reduce the risk of people developing type 2 diabetes.
• Aims: To test the effectiveness of DBCIs in reducing the risk of the user group
developing type 2 diabetes, through encouraging behaviour change (dietary change,
increased physical activity and weight loss).
• Target population: People (18+) identified at risk of developing type 2 diabetes
where they meet any of the eligibility criteria:
– Present with non-diabetic hyperglycaemia (NDH) HbA1c of 42 – 47 mmol/mol
(6.0 – 6.4%) or an FPG of 5.5 – 6.9 mmol/l
– Overweight BMI is equal to or over 25.
Primary Objectives of the In-Service Evaluation
• Are digital interventions effective in supporting behaviour change in those with non-diabetic hyperglycaemia
(measured by reduction in weight and/or lowering of blood glucose as a minimum at 6 months and 12 months)?
• Are those same digital interventions effective in supporting behaviour change in overweight and or obese
individuals who have not been diagnosed with NDH (measured by reduction in weight as a minimum at 6 months
and 12 months)?
• What potential effect do these DBCI’s have on health inequalities though:
a) Access to the interventions and;
b) Outcomes achieved as a result of receiving the interventions and;
• Can any conclusions be drawn about which groups would most benefit from the introduction of DBCI’s?
• What are the potential costs of implementation and delivery of digital interventions and to where do costs accrue?
• What lessons can be learnt (positive and negative) about how the interventions have been implemented?
Secondary Objectives of the In-Service Evaluation
• What are the characteristics of digital interventions which appear to be the most
effective/ have the most potential? And are any characteristics more or less effective
for particular groups?
• How do the costs of different characteristics relate to the outcomes achieved?
The following areas are not in scope of this project:
- Comparisons of DBCIs to face to face interventions or comparisons of
specific products
- A comprehensive health economics assessment of the interventions.
Qualitative data
In-depth explanatory data
from a small sample
Understanding human behaviour
Data will be coded and analysed by
themes
Illustrative explanations
Face to face interviews with
incentivisation for participants
50 participant interviews on qualitative research questions, such as understanding
personal experiences, key barriers, issues experienced, enablers etc.
Finally…. Three areas have commenced referrals:
• CWHHE into Oviva
• Humber coast and Vale into LIVA & OurPath
• Bristol OurPath
Remaining areas looking to start referrals asap for individuals to commence
services in January.