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Research Summary
Analyzed using Evidence Intelligence™

Digital app improves retention and weight loss in diabetes prevention

Powered by the Dediabetes Evidence Intelligence™ framework

Last updated July 17, 2026

Key finding

Intervention participants reported higher retention than controls at 6 months (79.7% vs. 67.1%; OR=2.06; 95% CI=1.15–3.68; P =.01).

This study evaluated the effectiveness of a digital habit formation app combined with a standard lifestyle change program for diabetes prevention. It found improved retention rates and significant weight loss at 12 months.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

RCTs

Follow-up

Long-Term (1–5 y)

Risk of bias

Some Concerns

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Plain-language summary

What this paper says

A plain-language read of the study’s main message and where it applies.

Study focus

This study evaluated the effectiveness of a digital habit formation app combined with a standard lifestyle change program for diabetes prevention. It found improved retention rates and significant weight loss at 12 months.

Clinical relevance

These findings are significant as they suggest that incorporating digital tools into lifestyle change programs can enhance participant engagement and weight loss, which are crucial for preventing diabetes. Improved retention and weight loss rates may lead to better long-term health outcomes for individuals at risk of diabetes.

Keep in mind

Engagement levels were not significantly different between groups at either time point. No differences in weight loss were observed at 6 months. The study may not be generalizable to all populations at risk for diabetes.

Published in

Journal Reference

Publication details and source links for this paper.

Joshua WL, Michael JC, Yvonne M, et al. Improving Retention and Weight Loss in Diabetes Prevention: A Randomized Controlled Trial of a Digital Habit Formation App. BMC Digital Health. 2026;4(1):13. doi:10.1186/s44247-026-00247-y

View DOIView on PubMedView on PMC

Main Effects

Higher retention at 6 months in the intervention group (79.7% vs. 67.1%; P =.01).

Higher retention at 12 months in the intervention group (78.3% vs. 53.1%; P =.03).

Significantly more participants achieved ≥ 5% weight loss at 12 months in the intervention group (41.3% vs. 30.6%; P =.05).

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Standard LCP curriculum plus the Fresh Tri iterative mindset app and Engagement in lifestyle change program at 12 months, Number of lifestyle change program sessions attended at 6 months, Participant retention at 6 months, and 3 more.

This study contributes evidence to

Intervention

Standard LCP curriculum plus the Fresh Tri iterative mindset app

Outcome

Engagement in lifestyle change program at 12 months

Evidence topic

Treatment Adherence

Primary intervention

Standard LCP curriculum plus the Fresh Tri iterative mindset app

Primary outcomes

  • Engagement in lifestyle change program at 12 months
  • Number of lifestyle change program sessions attended at 6 months
  • Participant retention at 6 months

Evidence topics

Treatment AdherenceWeight Loss

Primary intervention

Standard LCP curriculum plus the Fresh Tri iterative mindset app

Primary outcomes

Engagement in lifestyle change program at 12 monthsNumber of lifestyle change program sessions attended at 6 monthsParticipant retention at 6 months

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

6
Evidence pairs
6
Relationships
2
Evidence topics
contributes_evidence

Editorial context

Why this study matters

See why this paper is useful beyond its individual results.

Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 68

2

Related topics

6

Evidence pairs

247

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 6 evidence relationships
  • Includes primary outcome data
  • Linked to 2 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

Add related evidence to your Evidence Tracker

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Primary evidence

Evidence topic

Treatment Adherence

matched_outcome

Related evidence

Evidence topic

Weight Loss

Save evidence

Core evidence

Study findings

The primary outcomes reported in this study.

Engagement in lifestyle change program at 12 months

Standard LCP curriculum plus the Fresh Tri iterative mindset app → Engagement in lifestyle change program at 12 months

Standard LCP curriculum plus the Fresh Tri iterative mindset app → Engagement in lifestyle change program at 12 months

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Number of lifestyle change program sessions attended at 6 months

Standard LCP curriculum plus the Fresh Tri iterative mindset app → Number of lifestyle change program sessions attended at 6 months

Standard LCP curriculum plus the Fresh Tri iterative mindset app → Number of lifestyle change program sessions attended at 6 months

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Participant retention at 6 months

Standard LCP curriculum plus the Fresh Tri iterative mindset app → Participant retention at 6 months

Standard LCP curriculum plus the Fresh Tri iterative mindset app → Participant retention at 6 months

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Proportion of participants achieving weight loss of ≥ 5% at 12 months

Standard LCP curriculum plus the Fresh Tri iterative mindset app → Proportion of participants achieving weight loss of ≥ 5% at 12 months

Standard LCP curriculum plus the Fresh Tri iterative mindset app → Proportion of participants achieving weight loss of ≥ 5% at 12 months

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
25
Negative
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Retention in lifestyle change program at 12 months

Standard LCP curriculum plus the Fresh Tri iterative mindset app → Retention in lifestyle change program at 12 months

Standard LCP curriculum plus the Fresh Tri iterative mindset app → Retention in lifestyle change program at 12 months

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Weight loss at 6 months

Standard LCP curriculum plus the Fresh Tri iterative mindset app → Weight loss at 6 months

Standard LCP curriculum plus the Fresh Tri iterative mindset app → Weight loss at 6 months

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Evidence Library

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evidence suggest

Evidence Suggest

  • Intervention group had 79.7% retention at 6 months compared to 67.1% in controls.
  • 41.3% of intervention participants lost ≥ 5% of their body weight at 12 months.
  • Retention rates were significantly higher at both 6 and 12 months for the intervention group.
who this applies

Who this applies to

  • Adults at risk of developing diabetes.
  • Individuals participating in lifestyle change programs.
keep in mind

Keep in Mind

  • The study focused on a specific population, limiting generalizability.
  • Engagement did not differ significantly, indicating potential areas for improvement.
  • Results may vary based on individual adherence to the app and program.
between the lines

Between the Lines

  • Engagement levels were not significantly different between groups at either time point.
  • No differences in weight loss were observed at 6 months.
  • The study may not be generalizable to all populations at risk for diabetes.

Evidence Library

Build your evidence library

Save research, organize studies, and quickly find important evidence again.

Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

Powered by the Dediabetes Evidence Intelligence™ framework

This study contributes to evidence on Standard LCP curriculum plus the Fresh Tri iterative mindset app and Engagement in lifestyle change program at 12 months, Standard LCP curriculum plus the Fresh Tri iterative mindset app and Number of lifestyle change program sessions attended at 6 months.

Related evidence relationships

Explore in Evidence Explorer

This study contributes to the evidence on the following intervention-outcome relationships.

Included in these evidence collections

Curated evidence collections and hubs this study is part of.

Engagement in lifestyle change program at 12 months Evidence Hub

All studies measuring Engagement in lifestyle change program at 12 months

1 studies
outcome_hub

Measures Engagement in lifestyle change program at 12 months as a key outcome.

Number of lifestyle change program sessions attended at 6 months Evidence Hub

All studies measuring Number of lifestyle change program sessions attended at 6 months

1 studies
outcome_hub

Measures Number of lifestyle change program sessions attended at 6 months as a key outcome.

Proportion of participants achieving weight loss of ≥ 5% at 12 months Evidence Hub

All studies measuring Proportion of participants achieving weight loss of ≥ 5% at 12 months

1 studies
outcome_hub

Measures Proportion of participants achieving weight loss of ≥ 5% at 12 months as a key outcome.

Standard LCP curriculum plus the Fresh Tri iterative mindset app Evidence Hub

All studies on Standard LCP curriculum plus the Fresh Tri iterative mindset app

1 studies
intervention_hub

Contributes to Standard LCP curriculum plus the Fresh Tri iterative mindset app evidence base.

Recent Diabetes Research

Latest published studies

recency_collection

Published within the last 2 years.

Explore more in Evidence Explorer

Jump to pre-filtered views in Evidence Explorer.

All studies on Standard LCP curriculum plus the Fresh Tri iterative mindset app and Engagement in lifestyle change program at 12 months

Intervention: Standard LCP curriculum plus the Fresh Tri iterative mindset appOutcome: Engagement in lifestyle change program at 12 months

1 results

All studies on Standard LCP curriculum plus the Fresh Tri iterative mindset app and Number of lifestyle change program sessions attended at 6 months

Intervention: Standard LCP curriculum plus the Fresh Tri iterative mindset appOutcome: Number of lifestyle change program sessions attended at 6 months

1 results

All studies on Standard LCP curriculum plus the Fresh Tri iterative mindset app

Intervention: Standard LCP curriculum plus the Fresh Tri iterative mindset app

1 results

All studies measuring Engagement in lifestyle change program at 12 months

Outcome: Engagement in lifestyle change program at 12 months

1 results

All studies measuring Number of lifestyle change program sessions attended at 6 months

Outcome: Number of lifestyle change program sessions attended at 6 months

1 results

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Does Standard LCP curriculum plus the Fresh Tri iterative mindset app improve participant retention at 6 months?

Emerging Evidence

Standard LCP curriculum plus the Fresh Tri iterative mindset app appears to improve Participant retention at 6 months.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Participant retention at 6 months

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
  • Consistency cannot yet be determined.
  • Population details are unavailable.
1 supporting studyUpdated: Jul 2026
View Full Evidence

Does Standard LCP curriculum plus the Fresh Tri iterative mindset app improve retention in lifestyle change program at 12 months?

Emerging Evidence

Standard LCP curriculum plus the Fresh Tri iterative mindset app appears to improve Retention in lifestyle change program at 12 months.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Retention in lifestyle change program at 12 months

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
  • Consistency cannot yet be determined.
  • Population details are unavailable.
1 supporting studyUpdated: Jul 2026
View Full Evidence

Does Standard LCP curriculum plus the Fresh Tri iterative mindset app improve engagement in lifestyle change program at 12 months?

Emerging Evidence

Current evidence does not show a clear benefit of Standard LCP curriculum plus the Fresh Tri iterative mindset app for Engagement in lifestyle change program at 12 months.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Engagement in lifestyle change program at 12 months

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
  • Consistency cannot yet be determined.
  • Population details are unavailable.
1 supporting studyUpdated: Jul 2026
View Full Evidence

Does Standard LCP curriculum plus the Fresh Tri iterative mindset app improve number of lifestyle change program sessions attended at 6 months?

Emerging Evidence

Current evidence does not show a clear benefit of Standard LCP curriculum plus the Fresh Tri iterative mindset app for Number of lifestyle change program sessions attended at 6 months.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Number of lifestyle change program sessions attended at 6 months

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
  • Consistency cannot yet be determined.
  • Population details are unavailable.
1 supporting studyUpdated: Jul 2026
View Full Evidence
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Next steps

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Evidence topics

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Treatment Adherence Evidence HubWeight Loss Evidence Hub

Explore in Evidence Explorer

Open broader Evidence Explorer views for this relationship.

All studies on Standard LCP curriculum plus the Fresh Tri iterative mindset app and Participant retention at 6 monthsAll studies on Standard LCP curriculum plus the Fresh Tri iterative mindset app and Proportion of participants achieving weight loss of ≥ 5% at 12 monthsAll studies on Standard LCP curriculum plus the Fresh Tri iterative mindset app and Retention in lifestyle change program at 12 monthsAll studies on Standard LCP curriculum plus the Fresh Tri iterative mindset app and Weight loss at 6 months

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