Project Details
Description
Globally 374 million people are at increased risk of developing type 2 DIABETES (T2D), one of the fastest growing health issues in the 21st century. The prevalence of T2D in Portugal is currently one of the highest in Europe and is estimated that about a quarter of the Portuguese population has pre-diabetes. In addition to its burden on health and well-being, health expenditures associated with diabetes grew globally 316% over the last 15 years; in Portugal diabetes related costs account for about 8% of the health expenditure and roughly 0.8% of the gross domestic product.
There is compelling evidence that in-person programmes focused on diet and physical activity can halt the progression to T2D in high-risk individuals. However, implementation at scale of these programmes is notoriously challenging, due to the intensive resources required, low uptake and poor retention. This led countries such as the USA and the UK to supplement in-person national diabetes prevention programmes with DIGITAL diabetes prevention interventions (DPIs).
Meta-research has demonstrated the effectiveness of DIGITAL DPIs, albeit there is heterogeneity in results and modalities of delivery. More studies on the effectiveness of DIGITAL DPIs are needed, particularly with a robust design (well-powered RCTs), trialling AUTOMATED intervention leveraging on novel technology, and conducted in non-US settings. There is a knowledge gap on the effectiveness of automated virtual human coaches (VHC) for diabetes prevention; this revolutionary technology has shown benefit in other target populations. A second knowledge gap is the lack of implementation data of DIGITAL DPIs, to understand how effective interventions can be adopted in real world settings. Finally, there is a scarcity of cost-effectiveness evaluation of DIGITAL DPIs. VAPrevention will address the scientific challenge of preventing T2D and these 3 critical knowledge gaps, relevant nationally and internationally, by:
Developing a DIGITAL DPI via a VHC, from previous consortium work (VASelfCare, Train4Health)
Evaluating its effectiveness and implementation, via a well-powered hybrid effectiveness-implementation RCT and qualitative research, drawing on experience in prior projects (e.g. NoHoW, SEURO)
Evaluating cost-effectiveness resorting to economic evaluation skills in preventive interventions (e.g. SILNE-R project)
The VAPrevention web app will target 2 core behaviours in T2D prevention - diet and physical activity. It will be composed of a VHC, designed to simulate face-to- face behaviour change support, and a dashboard, displaying features associated with positive effect in DIGITAL DPIs. Primary users (persons with high risk of T2D) will be given the choice to share the dashboard with health professionals and their network, such as relatives (secondary users).
To address our AIM - evaluating the effectiveness, implementation and cost-effectiveness of this novel person-centred digital intervention to prevent T2D in high risk adults - we will resort to a BEHAVIOURAL FRAMEWORK, CO-PRODUCTION WITH USERS, DESIGN-FOR-SCALE PRINCIPLES, HEALTH SOFTWARE DEVELOPMENT GUIDANCE, MIXED METHODS AND ECONOMIC EVALUATION. Our work capitalises on the strong interdisciplinary expertise of the team and on a track record of joint work in national and European funded projects. VAPrevention’s key METHODOLOGICAL INNOVATION is its robust and coherent interdisciplinary approach, highly replicated by those tackling scientific challenges hard to solve through fragmented capabilities.
The MAIN EXPECTED RESULTS of VAPrevention are a TRL7 web app prototype, a report on the evaluation of the intervention, and an exploitation and sustainability roadmap. These will further the state-of-the-art by transferring knowledge on:
Effectiveness of the web app with a VHC (whether it works)
Implementation of this DIGITAL DPI (why and how it may work in these settings)
Cost-effectiveness (whether this DIGITAL DPI merits to be prioritised in terms of resource allocation) Go-to-market strategy (how can this intervention be rolled-out)
A key SOCIETAL IMPACT of the VAPrevention project is capacity for the prevention of T2D in high risk adults, through an accessible, scalable, sustainable and easily integrated intervention.
Implementation of the VAPrevention intervention is expected to have a positive ECONOMIC IMPACT, by reducing the clinical burden associated with T2D, and improving prevention efficiency.
An envisaged TECHNOLOGICAL IMPACT of VAPrevention is reducing the gap between academia and business, through business modelling, as part of the exploitation and sustainability roadmap, and connections with the health tech community.
There is compelling evidence that in-person programmes focused on diet and physical activity can halt the progression to T2D in high-risk individuals. However, implementation at scale of these programmes is notoriously challenging, due to the intensive resources required, low uptake and poor retention. This led countries such as the USA and the UK to supplement in-person national diabetes prevention programmes with DIGITAL diabetes prevention interventions (DPIs).
Meta-research has demonstrated the effectiveness of DIGITAL DPIs, albeit there is heterogeneity in results and modalities of delivery. More studies on the effectiveness of DIGITAL DPIs are needed, particularly with a robust design (well-powered RCTs), trialling AUTOMATED intervention leveraging on novel technology, and conducted in non-US settings. There is a knowledge gap on the effectiveness of automated virtual human coaches (VHC) for diabetes prevention; this revolutionary technology has shown benefit in other target populations. A second knowledge gap is the lack of implementation data of DIGITAL DPIs, to understand how effective interventions can be adopted in real world settings. Finally, there is a scarcity of cost-effectiveness evaluation of DIGITAL DPIs. VAPrevention will address the scientific challenge of preventing T2D and these 3 critical knowledge gaps, relevant nationally and internationally, by:
Developing a DIGITAL DPI via a VHC, from previous consortium work (VASelfCare, Train4Health)
Evaluating its effectiveness and implementation, via a well-powered hybrid effectiveness-implementation RCT and qualitative research, drawing on experience in prior projects (e.g. NoHoW, SEURO)
Evaluating cost-effectiveness resorting to economic evaluation skills in preventive interventions (e.g. SILNE-R project)
The VAPrevention web app will target 2 core behaviours in T2D prevention - diet and physical activity. It will be composed of a VHC, designed to simulate face-to- face behaviour change support, and a dashboard, displaying features associated with positive effect in DIGITAL DPIs. Primary users (persons with high risk of T2D) will be given the choice to share the dashboard with health professionals and their network, such as relatives (secondary users).
To address our AIM - evaluating the effectiveness, implementation and cost-effectiveness of this novel person-centred digital intervention to prevent T2D in high risk adults - we will resort to a BEHAVIOURAL FRAMEWORK, CO-PRODUCTION WITH USERS, DESIGN-FOR-SCALE PRINCIPLES, HEALTH SOFTWARE DEVELOPMENT GUIDANCE, MIXED METHODS AND ECONOMIC EVALUATION. Our work capitalises on the strong interdisciplinary expertise of the team and on a track record of joint work in national and European funded projects. VAPrevention’s key METHODOLOGICAL INNOVATION is its robust and coherent interdisciplinary approach, highly replicated by those tackling scientific challenges hard to solve through fragmented capabilities.
The MAIN EXPECTED RESULTS of VAPrevention are a TRL7 web app prototype, a report on the evaluation of the intervention, and an exploitation and sustainability roadmap. These will further the state-of-the-art by transferring knowledge on:
Effectiveness of the web app with a VHC (whether it works)
Implementation of this DIGITAL DPI (why and how it may work in these settings)
Cost-effectiveness (whether this DIGITAL DPI merits to be prioritised in terms of resource allocation) Go-to-market strategy (how can this intervention be rolled-out)
A key SOCIETAL IMPACT of the VAPrevention project is capacity for the prevention of T2D in high risk adults, through an accessible, scalable, sustainable and easily integrated intervention.
Implementation of the VAPrevention intervention is expected to have a positive ECONOMIC IMPACT, by reducing the clinical burden associated with T2D, and improving prevention efficiency.
An envisaged TECHNOLOGICAL IMPACT of VAPrevention is reducing the gap between academia and business, through business modelling, as part of the exploitation and sustainability roadmap, and connections with the health tech community.
Status | Active |
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Effective start/end date | 9/03/23 → 8/03/26 |
UN Sustainable Development Goals
In 2015, UN member states agreed to 17 global Sustainable Development Goals (SDGs) to end poverty, protect the planet and ensure prosperity for all. This project contributes towards the following SDG(s):
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