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A digital health-supported Prediabetes Intervention, Management and Evaluation (PRIME) Program improves Healthy Eating Index score: A cluster randomized controlled trial

Year: 2025
Type: article
Abstract: • A digital health lifestyle intervention was conducted for diabetes prevention. • The intervention group received a mobile app with nutrition education. • The intervention group received peer support and personalized counseling. • Improvement was seen in dietary quality based on the healthy eating index score. • The intervention group had improved vegetables, refined grains, and sodium intake. There has been increasing interest in digital health-supported interventions to facilitate lifestyle change for diabetes prevention. In this secondary analysis of a digital health-supported Prediabetes Intervention, Management and Evaluation (PRIME) cluster randomized controlled trial, we hypothesized that PRIME can improve dietary outcomes among overweight/obese people with prediabetes in Malaysia ( n = 82). PRIME Program was only meant for the healthy population without any significant conditions other than prediabetes and metabolic syndrome. The intervention group received the PRIME mobile app equipped with nutrition education modules, online peer support for motivation, nutrition quizzes for reinforcement, and face-to-face personalized counseling sessions by health coaches, supported with real-time health data while control group received usual care. The outcomes included dietary quality, nutrient intake, and food group consumption. Adjusted mixed model analysis showed that the intervention group had a significant improvement in the total healthy eating index score (+7.69%, 95% CI: 3.53-11.85, P < .001), vegetables (+0.68 servings/d, 95% CI: 0.26-1.11, P = .002), refined grains (–0.61 servings/d, 95% CI: –1.01 to –0.21, P = .003) and sodium intake (–436.06 mg, 95% CI: –677.46 to –194.66, P < .001) when compared to the control group. The present study provided data to inform practice directed at supporting the implementation of a digital health-supported lifestyle intervention in complementing and augmenting existing strategies for diabetes prevention among high-risk groups in Malaysia. A digital health-supported Prediabetes Intervention, Management and Evaluation (PRIME) Program was conducted. Findings showed that the intervention group had significant improvement in the total Healthy Eating Index score, vegetables, refined grains, and sodium intake, thereby supporting diabetes prevention strategies.
DOI: 10.1016/j.nutres.2025.04.005
Authors: Choon Ming Ng, Kah Woon Teoh, Chun Wie Chong, Yi Ling Ng, J Simon Bell, Shaun Wen Huey Lee
Language: English
Open Access status: hybrid
Estimated APC paid: $4,090
OpenAlex ID: W4409413232
FWCI: 3.528
Cites: 44
Cited by: 3
Related to: 10