Absence of conflict of interest.
Citation
Highlights
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The study's objective was to examine the impact of My Unlimited Potential, a lifestyle modification intervention, on cardiometabolic risk factors including body mass index (BMI) and glycated hemoglobin (HbA1c) levels among a group of individuals with diabetes.
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The study used an interrupted time series design to compare cardiometabolic risk measures before, during, and after participation in the intervention.
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The study suggested that participation in My Unlimited Potential was associated with decreases in BMI (by 1.5) and decreases in glycated hemoglobin levels (by 0.6 percentage points) from before to after the intervention.
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The quality of causal evidence presented in this report is low because the authors did not account for trends in outcomes before the intervention. This means we are not confident that the estimated effects are attributable to the My Unlimited Potential program; other factors are likely to have contributed.
Intervention Examined
My Unlimited Potential
Features of the Intervention
Type 2 diabetes is a significant public health concern, affecting nearly ten percent of Americans and may pose significant economic costs for employers. Workplace lifestyle interventions are one potential approach to improving health outcomes for employees with type 2 diabetes. My Unlimited Potential is a year-long worksite lifestyle modification program for employees at high-risk for cardiometabolic health issues. In its initial 12-week intensive phase, participants are paired with both a Registered Dietician and an Advanced registered nurse practitioner and commit to 6 hours of meetings each week. This includes 3 hours spent exercising with the assistance of an Exercise Physiologist. During both the initial phase and the rest of the year, participants attend regular check-ins and measurement assessments and participate in home visits, grocery store tours, and food demonstrations.
Features of the Study
The authors compared the outcomes of participants before the intervention to outcomes collected during and after participating in the My Unlimited Potential program. Study participants were 93 adult employees at a large health-care organization in Miami, Florida, with a reported history of type 2 diabetes or a baseline HbA1c percentage greater than 6.5 percent (the clinical threshold for a type 2 diabetes diagnosis). These participants had regular check-ins and measurement assessments which included Body Mass Index and glycated hemoglobin levels (HbA1c). The authors examined three comparisons: between baseline and 3-month outcomes (at the end of the intensive intervention phase), baseline and 6-month outcomes (halfway through the total intervention period), and baseline and 12-month outcomes (after the end of the intervention).
Findings
Health and safety
- The study suggested that participants in the My Unlimited Potential program had declines in both Body Mass Index and glycated hemoglobin levels (HbA1c) from the start of the program to 3, 6, and 12 months later.
Considerations for Interpreting the Findings
The authors compared the outcomes of participants measured before, during, and after they participated in the My Unlimited Potential program. CLEAR’s guidelines require that the authors must observe outcomes for multiple periods before the intervention to rule out the possibility that participants had increasing or decreasing trends in the outcomes examined before enrollment in the program. For example, if participants who had decreasing cardiometabolic risk factors tended to enroll in the program, we would anticipate further decreases over time, even if they didn’t participate in the program. Without knowing the trends before program enrollment, we cannot rule this out. Therefore, the study is not eligible for a moderate causal evidence rating, the highest rating available for nonexperimental designs.
Causal Evidence Rating
The quality of causal evidence presented in this report is low because the authors did not account for trends in outcomes before the intervention. This means we are not confident that the estimated effects are attributable to the My Unlimited Potential program; other factors are likely to have contributed.