723-P: "One Size Does Not Fit All” among Church-Based Black Adult Diabetes Prevention Program Participants

Black adults bear disproportionate obesity and Type 2 Diabetes.Group-based translation of the Diabetes Prevention Program is the gold standard with Black participants in these interventions having the lowest weight loss. Weight loss in the early intervention weeks predicts post-treatment outcomes. One limitation of these group-based interventions is that all receive the same treatment without personalized attention to those needing more support. We examined the weight loss effects of adding telephone motivational-interviewing (MI) sessions for Nonresponders (4-wk loss ≤ 1%) to their DPP intervention. Through a cluster randomized community based participatory design among Black churches, 216 participants received 18 group-based classes over 24 weeks delivered by trained Community Health Workers. Nonresponders in both intervention and control groups were identified with those in the intervention group receiving an additional weekly telephone MI session by CHWs to develop personalized strategies to overcome barriers to weight loss. Participants were 55 years (SD=11) with mean weight 234lbs (SD=53). Repeated measures mixed modeling evaluated the percent weight change from baseline to weeks 12 and 24, including class attendance as covariate, with separate models for Responders and Nonresponders. Significant effects in the Responder model (n=154) were time and classes attended (p<u><</u>.001 for both). Among Nonresponders (n=62), significant effects were treatment group and classes attended (p .020 and.035, respectively). Nonresponders in the personalized telephone MI group achieved 2.7% weight loss compared to controls (0.3%). These results suggest that identifying potential Nonresponders early and adding personalized attention may enhance the effectiveness of group-based DPP programs.