Regarding diabetes self-management, Glasgow and associates
[68] demonstrated that in-person small group sessions
promoting physical activity, healthful eating, and weight
control could successfully be replicated using a DVD-based
format. Similarly, Kramer and colleagues [69] delivered an
adaptation of the DPP lifestyle intervention via DVD with
remote participant support. Their results suggested that a
diabetes prevention program delivered via DVD with remote
support may be an effective alternative [69]. Furthermore,
our previous work indicated that 83% of patients at risk for
diabetes would prefer the DVD over a class [42]. Consequently,
an interactive DVD targeting the promotion of physical
activity, healthy eating, and weight loss could be a viable way
to deliver diabetes prevention strategies. Given that well
over 88% of all households own a DVD player, a DVD-based
intervention could reach most US households [70]; in fact, in
one of our recent studies less than 10% of a low income
sample of patients at risk for diabetes were without a DVD
player [42]. Further, once the initial production costs are
realized, DVDs are fairly inexpensive to reproduce and are
always available for additional booster sessions. DVDs can
also store large quantities of high quality sound and video
graphics information allowing for further tailoring. Finally,
using DVD formats to deliver content similar to that being
offered in small group sessions in other diabetes prevention
interventions avoids costly training and issues with treatment
fidelity [18,71]. Thus a DVD format could be used to
deliver strategies that demonstrated efficacy within the DPP.