518-P: “What Can I Eat?” Healthy Choices for American Indians and Alaska Natives with T2D: Facilitators’ and Participants’ Voices from a Virtual Diabetes Nutrition Education Program

“What Can I Eat? (WCIE) Healthy Choices for American Indians and Alaska Natives (AI/AN) with T2D is a 5-lesson diabetes nutrition education program culturally adapted for AI/ANs with T2D. Registered dietitian nutritionists (RDNs) taught classes synchronously via Zoom at 5 reservation-based or urban inter-tribal sites nationwide throughout 2021. Each class included a didactic session, interactive learning activities, physical activity, a mindful eating activity, and goal setting. Participants were recruited through diabetes registries at each collaborating site. Participants were randomized to either the immediate or wait list control group. Virtual classes were taught weekly for 4 weeks (classes 1-4) with a 5^th class 3 months after class 1. Participants and facilitating RDNs completed short answer feedback surveys after each class. A sample of participants (n=24) and all RDN/site coordinators (n=10) engaged in virtual focus groups after completing WCIE to understand their experiences of the program. Focus groups were audio recorded, transcribed, and analyzed using qualitative thematic analysis, as were the short answer post-class feedback surveys from participants (n=186) and RDNs (n=58) . Key themes emerged: 1) class satisfaction largely focused on peer-to-peer interaction, camaraderie, and broader support (e.g., tribe) ; 2) pros, cons, and tips to improve virtual classes; 3) preference for AI/AN RDN educator; 4) recommendations to improve recruitment and retention. These findings will guide program modifications prior to piloting in-person and peer-educator-led WCIE classes.