Evaluating Evidence-Based Strategies to Build and Support Lifestyle Change Programs for People at High Risk for Type 2 Diabetes

This study discusses preliminary outcomes from a subset of national grantees implementing evidence-based engagement strategies to scale the National Diabetes Prevention Program (National DPP) and reach people at risk for type 2 diabetes, including population subgroups who experience health or socioeconomic disparities. Quantitative and qualitative analyses were conducted using progress reports submitted in years 1 and 2 by grantees (health departments in 17 states and 4 large cities). Evaluation reports were analyzed using MAXQDA software to identify facilitators and barriers to implementing these strategies. Grantees worked to increase prediabetes screening, testing, referral, and enrollment among vulnerable, high-risk participants. Major strategies implemented included (1) developing tailored marketing plans to reach and engage persons with prediabetes, (2) implementing culturally tailored media campaigns, and (3) funding lifestyle coach trainings and professional development opportunities on motivational interviewing. Media metrics show > 2 million people were reached (increase of 794% from baseline) and > 17,000 people (increase of 86% from baseline) with prediabetes enrolled in programs. Facilitators included partnerships, technical assistance to build capacity, and development of referral policies. Barriers included lack of referral processes, unclear communication among partners, and language barriers in some populations. As grantees worked to increase awareness of prediabetes and extend the reach of the National DPP, they created a network of partners, engaged community stakeholders, and developed activities to sustain the programs by leveraging existing resources.