Background: The National DPP lifestyle change program (LCP) is proven to prevent or delay type 2 diabetes among adults with prediabetes. The yearlong LCP consists of a minimum of 22 coach-led group-sessions offered at weekly and then monthly intervals. Program retention is highly correlated with desired outcomes but can be challenging to achieve.

Methods: We analyzed data from organizations that participate in CDC’s Diabetes Prevention Recognition Program. Specifically, we computed weekly retention proportions and used random effects models to account for confounding and organization-specific correlation. We limited our analyses to the 38,441 individuals who enrolled in CDC-recognized in-person LCPs from 2012-2017.

Results: Retention typically dropped 1%-2% each week, but dropped ∼5% between weeks 1-2 and between weeks 16-17, where session frequency typically transitions from weekly to monthly. Retention at 18 weeks varied by years of age (46% for 18-29, 53% for 30-44, 60% for 45-54, 67% for 55-64, 68% for 65-75), race/ethnicity (70% for non-Hispanic whites, 60% for non-Hispanic blacks, 52% for Hispanics, 51% for Other), mean physical activity minutes (13% for 0, 49% for 1-30, 72% for 30-149, 85% for ≥150), and mean weekly percentage of body weight lost (32% for ≤0, 66% for 0-0.25, 73% for 0.25-0.5, 74% for ≥0.5). Retention did not vary by sex (63% for men, 63% for women). The random effects model results were consistent with these findings.

Conclusions: Our results demonstrate the need to identify strategies to improve retention, especially among individuals who are younger or are members of racial/ethnic minority populations, and among those who report less physical activity or weight loss. Strategies that address retention after the first session and during the transition from weekly to monthly sessions, offer the biggest opportunity for impact.


S. Masalovich: None. R. Soler: None. B. Smith: None. R. Jabrah: None. E. Ely: None. M. Cannon: None.

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