There are currently five million people in England at high risk of developing Type 2 diabetes, which is largely preventable through lifestyle changes. If current trends persist, one in three people will be obese by 2034 and one in 10 will develop Type 2 diabetes. About 10 per cent of the entire NHS budget is spent treating complications from diabetes, or £10bn/yr. Reducing this would have a major impact both on people’s well-being and on resources. The current National Diabetes Prevention Programme achieves only a 20% completion rate, and so an engaging alternative is much needed.
We are piloting a new type of diabetes prevention programme, together with the NHS. Over 10 weeks we introduce people at risk of developing Type 2 diabetes to different types of physical activity, we offer information and learning about health, diet, lifestyle, connecting to locally offered services, exercise as well as peer support and some good healthy competition. The aim of the programme is to prevent the onset of Type 2 diabetes by supporting and encouraging people to make positive behaviour changes in a way that is engaging.
Working with the South West London Health and Care Partnership, who were successful in winning an Innovation Grant from the Health Innovation Network, we got to work developing and planning the Decathlon programme.
We knew we wanted to work with a small number of people in similar situations and in the same area. We thought it was important to create a peer group that could work together in a way that is common among diet and weight loss groups but that went beyond sitting in a community hall and was more active. We want people to encourage each other and share their successes and support each other a getting over barriers of behavioural change together.
Each week will feature one hour of learning and an hour of physical activity, all sessions being unique. Finding an exercise or activity that you like and that suits you can be difficult, especially if you’ve become overweight and don’t know where to start or don’t like the idea of going into a gym or a class on your own. We know that when people know more about their health and understand their diet and lifestyle choices they self-manage better.
We had a huge response to the Diabetes Prevention Decathlon and were fully booked with 33 participants signed up in the first week. We are already planning the next session.
Our product is an app on a smart phone that incentivises physical activity through rewarding users with products and services for achieving agreed targets. It’s like a supermarket loyalty card meets a step count. You get points, essentially prizes, for achieving physical activity targets that are monitored via your phone. Our objective is simple; trying to influence behaviour change in an engaging way.
Traditional behaviour change solutions struggle — gym memberships/fitbits are expensive, with gym memberships sitting unused by ‘Blue Monday’ in January, alongside Fitbits which have an average life of just 42 days.
Our product is a bespoke app tailored for specific demographics – in this project, we created a custom leaderboard for the participants, who were randomly placed in groups. Each group then has challenges and checklists to complete, related to physical activity, education, and participation.
Points for learning about low carb eating, attending the physical in-person session, or encouraging your fellow participant when they are feeling unmotivated.
Together with NHS Merton CCG, we also created a suite of rewards and prizes, that participants could claim with their sweatcoins, which are earned through steps. These were also linked to the theme the educational session - so if week 1 theme was at-home yoga exercises, our app offered yoga mats and equipment. The week 2 theme was walking football, so the app offered footballs and goalposts. These subtle nudges of rewards reinforce the learnings and enhance behaviour change.
There is also a community giving aspect to the app - people on the programme using the app can also donate their reward points to local charities.
The education and learning aspect of the programme has been digitised now too - videos are posted to the app summarising what the group learned that week, with the ability to participate in a quiz to earn that week’s reward.
Developing the digital innovation aspect to the Diabetes Prevention Decathlon has opened it up to be more accessible, more engaging and we expect it to be more rewarding for people on the programme.