Barriers and Facilitators of National Diabetes Prevention Program Engagement Among Women of Childbearing Age: A Qualitative Study

2020 ◽  
Vol 46 (3) ◽  
pp. 279-288 ◽  
Author(s):  
Caroline R. Harrison ◽  
Phoutdavone Phimphasone-Brady ◽  
Becky DiOrio ◽  
Silvia G. Raghuanath ◽  
Riley Bright ◽  
...  
Keyword(s):  
Young Women ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Safety Net ◽  
Barriers And Facilitators ◽  
Childbearing Age ◽  
Urban Safety ◽  
Perceived Weight ◽  
Supportive Program

Purpose The purpose of this study was to understand barriers and facilitators to engagement in a diabetes prevention program for young women at an urban safety-net health care system. Methods Individual semistructured interviews (N = 29) explored motivations, challenges, and successes regarding participation and suggestions for improvement among women aged 18 to 39 years who enrolled in the National Diabetes Prevention Program in the past 2 years. Participants were classified as nonattendees (n = 10), early-withdrawers (n = 9), or completers (n = 10). Interview transcriptions were analyzed using a grounded hermeneutic editing approach. Results Qualitative analysis revealed 4 main themes (enrollment, attendance, experience, and suggestions) with multiple subthemes. Most women were motivated to enroll for health and family concerns. Early-withdrawers and nonattendees reported confusion about the program’s aim and relevancy, logistical barriers, and lack of connection with fellow participants/coaches. Highly engaged women noted persistent motivation, perceived weight loss, and supportive program relationships. Conclusions Multiple barriers/facilitators for young women appear addressable in future adaptations. Additional research is needed to confirm these findings in other settings and explore implementation and effectiveness of adaptations, with a goal of reducing risks prior to conception.

899-P: Barriers and Facilitators to Implementation of the Group-Based Diabetes Prevention Program within a Large Health-Care System

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 899-P
Author(s):  
MEGHAN HALLEY ◽  
CATHERINE NASRALLAH ◽  
NINA K. SZWERINSKI ◽  
JOHN P. PETERSEN ◽  
ROBERT J. ROMANELLI ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Barriers And Facilitators ◽  
Large Health Care System ◽  
Care System

scholarly journals Adaptation and Feasibility Study of a Digital Health Program to Prevent Diabetes among Low-Income Patients: Results from a Partnership between a Digital Health Company and an Academic Research Team

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Valy Fontil ◽  
Kelly McDermott ◽  
Lina Tieu ◽  
Christina Rios ◽  
Eliza Gibson ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Low Income ◽  
Prevention Program ◽  
Technology Implementation ◽  
Diabetes Prevention ◽  
Digital Health ◽  
Academic Research ◽  
Diabetes Prevention Program ◽  
Safety Net ◽  
Reading Level

Background. The feasibility of digital health programs to prevent and manage diabetes in low-income patients has not been adequately explored. Methods. Researchers collaborated with a digital health company to adapt a diabetes prevention program for low-income prediabetes patients at a large safety net clinic. We conducted focus groups to assess patient perspectives, revised lessons for improved readability and cultural relevance to low-income and Hispanic patients, conducted a feasibility study of the adapted program in English and Spanish speaking cohorts, and implemented real-time adaptations to the program for commercial use and for a larger trial of in multiple safety net clinics. Results. The majority of focus group participants were receptive to the program. We modified the curriculum to a 5th-grade reading level and adapted content based on patient feedback. In the feasibility study, 54% of eligible contacted patients expressed interest in enrolling (n=23). Although some participants’ computer access and literacy made registration challenging, they were highly satisfied and engaged (80% logged in at least once/week). Conclusions. Underserved prediabetic patients displayed high engagement and satisfaction with a digital diabetes prevention program despite lower digital literacy skills. The collaboration between researchers and a digital health company enabled iterative improvements in technology implementation to address challenges in low-income populations.

scholarly journals Barriers and Facilitators to Enrollment and Retention in the National Diabetes Prevention Program: Perspectives of Women and Clinicians Within a Health System

2021 ◽  
Vol 2 (1) ◽  
pp. 133-141
Author(s):  
Katherine Jane Williams Baucom ◽  
Mandy L. Pershing ◽  
Kaitlyn M. Dwenger ◽  
Michelle Karasawa ◽  
Jessica N. Cohan ◽  
...  
Keyword(s):  
Health System ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Barriers And Facilitators

706-P: Enrollment in a Diabetes Prevention Program in the San Francisco Safety Net

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 706-P
Author(s):  
STEPHANIE KIM ◽  
AUDREY H. TANG ◽  
CHARLOTTE KUO ◽  
REBECA S. GARCIA ◽  
SARAH KIM ◽  
...  
Keyword(s):  
San Francisco ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Safety Net

2378-PUB: Barriers and Facilitators to National Diabetes Prevention Program Engagement by Women of Peak Child-Bearing Age

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 2378-PUB
Author(s):  
CAROLINE HARRISON ◽  
PHOUTDAVONE PHIMPHASONE-BRADY ◽  
BECKY DIORIO ◽  
NATALIE RITCHIE ◽  
KATHERINE A. SAUDER
Keyword(s):  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Barriers And Facilitators ◽  
Child Bearing ◽  
Program Engagement

scholarly journals Supplemental Text Message Support With the National Diabetes Prevention Program: Pragmatic Comparative Effectiveness Trial (Preprint)

2019 ◽  
Author(s):  
Natalie D Ritchie ◽  
Silvia Gutiérrez-Raghunath ◽  
Michael Josh Durfee ◽  
Henry Fischer
Keyword(s):  
Weight Loss ◽  
Prevention Program ◽  
Text Messaging ◽  
Diabetes Prevention ◽  
Text Message ◽  
Diabetes Prevention Program ◽  
Safety Net ◽  
Text Messages ◽  
Modest Weight Loss ◽  
Weight Loss Outcomes

BACKGROUND The evidence-based National Diabetes Prevention Program (NDPP) is now widely disseminated, yet strategies to increase its effectiveness are needed, especially for underserved populations. The yearlong program promotes lifestyle changes for weight loss and can be offered in-person, online, via distance learning, or a combination of modalities. Less is known about which delivery features are optimal and may help address disparities in outcomes for subgroups. We previously demonstrated the efficacy of a stand-alone text messaging intervention based on the NDPP (SMS4PreDM) in a randomized controlled trial in a safety net health care system. Upon broader dissemination, we then showed that SMS4PreDM demonstrated high retention and modest weight loss at a relatively low cost, suggesting the potential to improve in-person NDPP delivery. OBJECTIVE In this study, we aim to compare the effectiveness of in-person NDPP classes with and without supplementary SMS4PreDM on attendance and weight loss outcomes to determine whether text messaging can enhance in-person NDPP delivery for a safety net patient population. METHODS From 2015 to 2017, patients with diabetes risks were identified primarily from provider referrals and enrolled in NDPP classes, SMS4PreDM, or both per their preference and availability. Participants naturally formed three groups: in-person NDPP with SMS4PreDM (n=236), in-person NDPP alone (n=252), and SMS4PreDM alone (n=285). This analysis compares the first two groups to evaluate whether supplemental text messaging may improve in-person NDPP outcomes. Outcomes for SMS4PreDM-only participants were previously reported. NDPP classes followed standard delivery guidelines, including weekly-to-monthly classes over a year. SMS4PreDM delivery included messages promoting lifestyle change and modest weight loss, sent 6 days per week for 12 months. Differences in characteristics between intervention groups were assessed using chi-square and t tests. Differences in NDPP attendance and weight loss outcomes were analyzed with multivariable linear and logistic regressions. RESULTS The mean age was 50.4 years (SD 13.9). Out of a total of 488 participants, 76.2% (n=372) were female and 59.0% (n=288) were Hispanic. An additional 17.2% (n=84) were non-Hispanic white and 12.9% (n=63) were non-Hispanic black. A total of 48.4% (n=236) of participants elected to receive supplemental text message support in addition to NDPP classes. Participants who chose supplemental text message support were on average 5.7 (SD 1.2) years younger (<i>P</i>&lt;.001) than the 252 participants who preferred in-person classes alone. Relatively more women and Hispanic individuals enrolled in the NDPP with supplemental text messages than in NDPP classes alone, 83.9% (n=198) vs 69.0% (n=174, <i>P</i>&lt;.001) and 68.6% (n=162) vs 50.0% (n=126, <i>P</i>=.001), respectively. Attendance and weight loss outcomes were comparable between groups. CONCLUSIONS Despite its appeal among priority populations, supplemental text messaging did not significantly increase attendance and weight loss for the in-person NDPP. Further research is needed to identify optimal strategies to improve the effectiveness of the NDPP.

Presessions to the National Diabetes Prevention Program May be a Promising Strategy to Improve Attendance and Weight Loss Outcomes

2018 ◽  
Vol 33 (2) ◽  
pp. 289-292 ◽  
Author(s):  
Natalie D. Ritchie ◽  
Peter G. Kaufmann ◽  
R. Mark Gritz ◽  
Katherine A. Sauder ◽  
Jodi Summers Holtrop
Keyword(s):  
Health Care ◽  
Weight Loss ◽  
Health Care System ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Safety Net ◽  
Analysis Of Covariance ◽  
Weight Loss Outcomes ◽  
Care System

Purpose: The National Diabetes Prevention Program (NDPP) is a widely disseminated lifestyle intervention. Attendance is problematic, leading to suboptimal weight loss, especially among racial/ethnic minority participants. We conducted a novel “presession” protocol to improve engagement of diverse NDPP candidates, comparing NDPP participants who attended a presession to those who did not on attendance and weight loss outcomes. Design: Longitudinal cohort study. Setting: A safety net health-care system. Participants: A total of 1140 patients with diabetes risks (58.9% Hispanic, 19.8% non-Hispanic black, 61.8% low income). Intervention: The NDPP has been delivered in a Denver, Colorado health-care system since 2013. The program included 22 to 25 sessions over 1 year. Beginning September 2016, individuals were required to attend a presession before enrollment that focused on (1) increasing risk awareness, (2) motivational interviewing to participate in the NDPP, and (3) problem-solving around engagement barriers. Measures: Duration and intensity of NDPP attendance and weight loss. Analysis: Outcomes of 75 presession participants who enrolled in the NDPP were compared to 1065 prior participants using analysis of covariance and multivariable logistic regression. Results: Presession participants stayed in the NDPP 99.8 days longer ( P < .001) and attended 14.3% more sessions ( P < .001) on average than those without a presession. Presession participants lost 2.0% more weight ( P < .001) and were 3.5 times more likely to achieve the 5% weight loss target ( P < .001). Conclusion: Presessions may improve NDPP outcomes for individuals from diverse backgrounds. A full-scale trial is needed to determine whether presessions reliably improve NDPP effectiveness.

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