563-P: The Relationship between Educational Attainment and Attrition Rates among Participants in the National Diabetes Prevention Program

Research shows that education plays a critical role in participants’ commitment to public health programs. While participants’ age and race/ethnicity have been shown to be associated with attrition in the National Diabetes Prevention Program (National DPP), the effect of education remains uncertain. Using data from the CDC Diabetes Prevention Recognition Program, we examined the relationship between educational attainment and attrition rates. We included the study population who enrolled from March 2018 through February 2019 and had the opportunity to attend for at least one year. Cumulative attrition rates were calculated by delivery mode: in-person, online, distance-learning, and combination. Education was categorized as follows: <high school (HS), HS graduate, 1-3 years college, and college graduate. We used cross-tabulation method with chi-square tests in our analyses. The study population (N=313,150) was 74.8% female and 65.5% white, with a mean age of 49.1 years (SD: 12.5) and mean BMI of 35.0 kg/m² (SD: 7.1). Participants with lower educational attainment had significantly higher cumulative attrition rates compared to those with higher educational attainment among programs delivered in-person (through Session 5: 20.4% in <high school (HS) group vs. 12.5% in HS graduate group vs. 9.3% in 1-3 years college group vs. 8.4% in college graduate group, p<0.05) and distance-learning programs; by contrast, differences were not significant in online and combination programs. This pattern continued through Session 16, when similar attrition rates emerged from all education groups. These findings highlight the need for new strategies to better engage participants in the National DPP, especially those with lower educational attainment.