# Assessing Barriers and Facilitators for Participating Structured Lifestyle Intervention and its Real-world Effectiveness and Cost-Effectiveness among US Veterans

> **NIH ALLCDC U18** · UNIVERSITY OF FLORIDA · 2022 · $570,000

## Abstract

Project Summary
The US Diabetes Prevention Program (DPP) has shown that a structured lifestyle intervention (SLI) can
prevent or delay progression to type 2 diabetes (T2D). In 2010, Congress authorized CDC to establish and
manage DPP-like SLI programs nationwide through the National DPP (NDPP), and these programs soon
expanded to Medicare in 2016. However, the enrollment and completion rates of existing NDPPs were
significantly lower than observed in the original DPP study, especially in minority groups. Barriers and
facilitators that determine the individuals’ NDPP enrollment and completion remain unclear. Also, studies
assessing the long-term effectiveness of NDPP in reducing cardiovascular disease (CVD) risk factors and
incident T2D were lacking. The cost-effectiveness of NDPP in the overall enrollees and enrollee subgroups
was also unknown. Filling these knowledge gaps is critical to improving the implementation of NDPP.
The Veterans Health Administration (VA) MOVE! program is the largest DPP-like SLI program in the US. The
program was initiated in 2005 with a curriculum developed based on the original US DPP trial and CDC’s
NDPP curriculum. We have already established a large longitudinal cohort of MOVE! program enrollees
(N=50,000) with electronic health records (EHR) and linked insurance claims data and the MOVE! program
providers' data with a follow-up length of up to 15 years. Through this unique data source, combined with one
of the most advanced diabetes microsimulation models in the US --the BRAVO diabetes model, developed by
our group, we will identify barriers and facilitators to the enrollment and completion of the MOVE! program, and
evaluate its long-term effectiveness and cost-effectiveness.
The specific aims of the proposed study are: 1) Aim 1: Assess barriers and facilitators of enrollment
and completion of MOVE! program; 2) Aim 2: Assess the long-term effectiveness of the MOVE!
program; 3) Aim 3: Evaluate the long-term economic impact and cost-effectiveness of the MOVE!
program. By achieving all three aims, we will be able to identify the most effective and cost-effective strategy
to implement and expand the NDPP in the US.
The proposed research is significant because it will fill the critical knowledge gaps in implementing the NDPP
in the US. The Veteran population is a unique population and a vital piece to this nationwide NDPP research
network. This study is innovative because our large SLI cohort with EHR-claims-linked data will allow us to
apply cutting-edge ML methods and simulation models to tackle a series of challenging research questions.

## Key facts

- **NIH application ID:** 10554732
- **Project number:** 1U18DP006711-01
- **Recipient organization:** UNIVERSITY OF FLORIDA
- **Principal Investigator:** LAWRENCE S PHILLIPS
- **Activity code:** U18 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2022
- **Award amount:** $570,000
- **Award type:** 1
- **Project period:** 2022-09-01 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10554732

## Citation

> US National Institutes of Health, RePORTER application 10554732, Assessing Barriers and Facilitators for Participating Structured Lifestyle Intervention and its Real-world Effectiveness and Cost-Effectiveness among US Veterans (1U18DP006711-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10554732. Licensed CC0.

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