There is a crucial need for successful strategies for DPP enrollment and implementation in safety net populations which are disproportionally affected by diabetes. We examine enrollment outcomes in a DPP referral program in the San Francisco Health Network, a safety net serving over 140,000 patients. Overweight patients with prediabetes are referred via an electronic consultation system from 20 community primary care and weight management clinics. Eligible Spanish- or English-speaking patients are contacted by a patient navigator, screened for eligibility, given a readiness assessment and if appropriate, invited to participate in either a digital or in-person DPP. Patients interested in an in-person program but not ready for the full DPP are offered the 6-week Diabetes Empowerment Education Program (DEEP). From August 2017 to November 2018, 305 patient referrals were evaluated: 44 (14.4%) did not qualify after chart review (e.g., they already had diabetes, were not prediabetic, or were out of network), 124 (40.7%) were unable to be reached (13 did not have a working phone, 23 had no voicemail, 88 did not return calls) and 137 (44.9%) patients were reached. Of those 137, 26 (19.0%) were unaware that their provider had referred them or were not interested while 111 (81.0%) were interested. Ten of those patients were not ready for the full DPP and chose DEEP. The remaining 101 patients completed the intake process, passed a readiness assessment and chose to enroll in a DPP: 25 (24.8%) chose a digital DPP and 76 (75.2%) an in-person DPP with a nonsignificant trend towards a preference for a digital DPP by younger patients. Thus, of 305 initial referrals less than half (36.4%) were successfully enrolled. The primary challenge was difficulty reaching and engaging patients. Potential strategies to improve patient yield include better education of referring providers on initial readiness assessments, DPP eligibility, and the importance of a good contact number. Measuring weight loss outcomes in these patients will be crucial.


S. Kim: None. A.H. Tang: None. C. Kuo: None. R.S. Garcia: None. S. Kim: None. E. Murphy: None.

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