Delivering the National Diabetes Prevention Program: Assessment of Enrollment in In-Person and Virtual Organizations

Abstract

The aim of the US Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program (National DPP) is to make an evidence-based lifestyle change program widely available to the more than 88 million American adults at risk for developing type 2 diabetes. The National DPP allows for program delivery using four delivery modes: in person, online, distance learning, and combination. The objective of this study was to analyze cumulative enrollment in the National DPP by delivery mode. We included all participants who enrolled in CDC-recognized organizations delivering the lifestyle change program between January 1, 2012, and December 31, 2019, and whose data were submitted to CDC’s Diabetes Prevention Recognition Program. During this time, the number of participants who enrolled was 455,954. Enrollment, by delivery mode, was 166,691 for in-person; 269,004 for online; 4,786 for distance-learning; and 15,473 for combination. In-person organizations enrolled the lowest proportion of men (19.4%) and the highest proportions of non-Hispanic Black/African American (16.1%) and older (65+ years) participants (28.2%). Online organizations enrolled the highest proportions of men (27.1%), younger (18-44 years) participants (41.5%), and non-Hispanic White participants (70.3%). Distance-learning organizations enrolled the lowest proportion of Hispanic/Latino participants (9.0%). Combination organizations enrolled the highest proportions of Hispanic/Latino participants (37.3%) and participants who had obesity (84.1%). Most in-person participants enrolled in organizations classified as community-centered entities (41.4%) or medical providers (31.2%). Online and distance-learning participants were primarily enrolled (93.3% and 70.2%, respectively) in organizations classified as for-profit businesses or insurers. Participants in combination programs were enrolled almost exclusively in organizations classified as medical providers (89%). The National DPP has reached nearly half a million participants since its inception in 2012, but continued expansion is critical to stem the tide of type 2 diabetes among the many Americans at high risk.

It’s Always the Same Map: Advancing Diabetes Prevention in Underresourced Counties During COVID-19

“…In both rural and urban communities, individuals at highest risk of type 2 diabetes—men, Medicare beneficiaries, Latinos, African Americans, and individuals from other racial and ethnic groups— were under-enrolling in CDC-recognized lifestyle change programs. 4 For some, it was a basic access issue—the closest program was hours away— whereas for others, it was a more complicated interplay between social determinants of health challenges, cultural disconnection, lack of awareness, and cost that kept them from enrolling in a National DPP lifestyle change program.…”

“…With every variant, there was another spike of cases and more exponential graphs as we observed this novel coronavirus spreading rapidly within our own neighborhoods, cities, counties, and states. 4 For some, it was a basic access issue-the closest program was hours awaywhereas for others, it was a more complicated interplay between social determinants of health challenges, cultural disconnection, lack of awareness, and cost that kept them from enrolling in a National DPP lifestyle change program.…”

Weight loss and modeled cost savings in a digital diabetes prevention program

“…10 Increasing enrollment in the DPP is an ongoing challenge, but digital health offerings improve the availability of accessible programs by meeting participants when and where they need assistance. [11][12][13] Digital solutions can also improve the personalization of coaching interactions through the large volume of data they collect from members and the frequent feedback delivery and reminders made possible via automation. 14 Participation in a digital DPP can improve both individual health through disease prevention and save the healthcare system substantial medical costs by reducing the incidence of T2D and its associated complications.…”

“…Research has shown that individuals at high risk for diabetes who are not enrolled in a lifestyle modification program like the National Diabetes Prevention Program (DPP) gain ∼0.42 kg per year 10 . Increasing enrollment in the DPP is an ongoing challenge, but digital health offerings improve the availability of accessible programs by meeting participants when and where they need assistance 11–13 . Digital solutions can also improve the personalization of coaching interactions through the large volume of data they collect from members and the frequent feedback delivery and reminders made possible via automation 14 …”

Implementation of Session Zero as a Recruitment Strategy in the National Diabetes Prevention Program’s Lifestyle Change Program

“…The CDC has made great strides in scaling and sustaining the National DPP. 7 However, expanding enrollment in the lifestyle change program remains a priority. 8 Offering a “session zero” is one promising strategy to increase engagement in the National DPP lifestyle change program and other chronic disease programs.…”