Introduction
Worldwide Evidence for Type 2 Diabetes Prevention Through Lifestyle Change
Foundational Research
Translational Research
The US National DPP—a Case Study
Key Findings from In-Person National DPP Delivery in the USA
Implementation of the National DPP: New Insights
Analysis Sample
Measures and Methods
Results
Organization and participant characteristics | Total analyzed participants n = 143,489 (%) | Participants with < 9 months n = 99,046 (69%) (%) | Participants with ≥ 9 months n = 44,443 (31%) (%) | p value* |
---|---|---|---|---|
Organizations’ characteristics | < 0.001 | |||
Delivery modality | ||||
Online only | 85,362 (59.5) | 68,137 (68.8) | 17,225 (38.8) | |
Distance learning only | 471 (0.3) | 234 (0.2) | 237 (0.5) | |
Combination | 1,052 (0.7) | 519 (0.5) | 533 (1.2) | |
In-person only | 56,604 (39.5) | 30,156 (30.5) | 26,448 (59.5) | |
Participants’ average weight loss (WL) |
< 0.001
| |||
Percent WL at 12 months | ||||
5%+ | 45,068 (31.4) | 22,556 (22.8) | 22,512 (50.7) | |
< 5% | 98,421 (68.6) | 76,490 (77.2) | 21,931 (49.3) | |
Participants’ attendance and physical activity (PA) goal | ||||
Number of sessions attended |
< 0.001
| |||
17+ sessions | 56,983 (39.7) | 17,741 (17.9) | 39,242 (88.3) | |
< 17 sessions | 86,506 (60.3) | 81,305 (82.1) | 5,201 (11.7) | |
Meeting PA goal (average 150+ min/week) |
< 0.001
| |||
Met | 60,348 (45.0) | 36,503 (40.2) | 23,845 (54.9) | |
Not met | 73,837 (55.0) | 54,260 (59.8) | 19,577 (45.1) | |
Participants’ characteristics | ||||
Age (years) |
< 0.001
| |||
18–44 | 43,914 (30.6) | 36,577 (36.9) | 7,337 (16.5) | |
45–64 | 78,178 (54.5) | 51,751 (52.3) | 26,427 (59.5) | |
65+ | 21,397 (14.9) | 10,718 (10.8) | 10,679 (24.0) | |
Sex |
< 0.001
| |||
Male | 35,401 (24.7) | 25,564 (25.8) | 9,837 (22.1) | |
Female | 107,990 (75.3) | 73,437 (74.1) | 34,553 (77.8) | |
Race/ethnicity | 0.09 | |||
Hispanic | 12,898 (9.0) | 9,138 (9.2) | 3,760 (8.5) | |
Non-Hispanic Black | 17,088 (11.9) | 11,477 (11.6) | 5,611 (12.6) | |
Non-Hispanic othera | 20,846 (14.5) | 14,790 (14.9) | 6,056 (13.6) | |
Non-Hispanic White | 92,657 (64.6) | 63,641 (64.3) | 29,016 (65.3) | |
Education level | 0.06 | |||
High school or less | 3,410 (10.1) | 2,102 (9.5) | 1,308 (11.2) | |
Some college or technical school | 12,537 (37.1) | 8,598 (38.8) | 3,939 (33.8) | |
College 4 years or more | 17,878 (52.9) | 11,480 (51.8) | 6,398 (54.9) | |
Payer type |
< 0.001
| |||
Grant funding | 3,302 (7.8) | 1,363 (5.2) | 1,939 (11.9) | |
Public insurer (Medicare or Medicaid) | 208 (0.5) | 83 (0.3) | 125 (0.8) | |
Employer or private insurer | 36,985 (86.8) | 24,137 (91.7) | 12,848 (78.9) | |
Self-pay or other | 2,114 (5.0) | 748 (2.8) | 1,366 (8.4) | |
Enrollment Source |
< 0.001
| |||
Health care providersb | 2,035 (5.2) | 780 (3.1) | 1,255 (8.9) | |
Community-based organizations or community health workers | 515 (1.3) | 130 (0.5) | 385 (2.7) | |
Self or family/friends | 2,431 (6.2) | 1,382 (5.6) | 1,049 (7.4) | |
Employers or insurers | 29,272 (75.0) | 20,045 (80.5) | 9,227 (65.4) | |
Media or other | 4,757 (12.2) | 2,570 (10.3) | 2,187 (15.5) | |
Body mass index (BMI) at enrollment |
< 0.001
| |||
Overweightc | 39,226 (27.3) | 26,373 (26.6) | 12,853 (28.9) | |
Obesityd | 104,263 (72.7) | 72,673 (73.4) | 31,590 (71.1) |
Predictors | Total analyzed participants (n = 29,069) | Participants with < 9 months (n = 19,788) | Participants with 9+ months (n = 9281) |
---|---|---|---|
AOR (95% CI) | AOR (95% CI) | AOR (95% CI) | |
Organizations’ characteristic | |||
Delivery modality | |||
Online only | 0.9 (0.8–1.2) | 1.1 (0.7–1.6) | 0.9 (0.7–1.2) |
Distance learning only | – | – | – |
Combination | 1.6 (0.7–4.0) | – | 2.6 (0.9–7.5) |
In-person only (ref) | 1.00 | 1.00 | 1.00 |
Participants’ attendance and physical activity (PA) goal | |||
Number of session attendance | |||
17+ sessions |
3.2 (3.0–3.4)***
|
3.4 (3.1–3.6)***
|
2.6 (2.3–3.0)***
|
< 17 sessions (ref) | 1.00 | 1.00 | 1.00 |
Duration of participation | |||
9+ months |
1.3 (1.2–1.4)***
| – | – |
< 9 months (ref) | 1.00 | – | – |
Meeting PA goal (average + 150 min/week) | |||
Met |
1.7 (1.6–1.8)***
|
1.7 (1.6–1.9)***
|
1.7 (1.5–1.8)***
|
Not met (ref) | 1.00 | 1.00 | 1.00 |
Participants’ characteristics | |||
Age (years) | |||
18–44 (ref) | 1.00 | 1.00 | 1.00 |
45–64 |
3.2 (3.0–3.4)**
| 1.2 (1.0–1.3) | 1.0 (0.9–1.1) |
65+ |
1.6 (1.5–1.8)***
|
1.7 (1.5–2.0)***
|
1.4 (1.2–1.6)***
|
Sex | |||
Male (ref) | 1.00 | 1.00 | 1.00 |
Female |
0.8 (0.7–0.8)***
|
0.7 (0.6–0.7)***
| 0.9 (0.8–1.0) |
Race/ethnicity | |||
Hispanic | 0.9 (0.8–1.0) | 0.9 (0.8–1.0) |
0.8 (0.7–0.9)*
|
Non-Hispanic Black |
0.8 (0.7–0.9)*
| 0.9 (0.7–1.0) |
0.8 (0.7–0.9)*
|
Non-Hispanic othera | 0.9 (0.8–1.0) | 0.9 (0.8–1.0) | 0.9 (0.8–1.1) |
Non-Hispanic White (ref) | 1.00 | 1.00 | 1.00 |
Education level | |||
High school or less (ref) | 1.00 | 1.00 | 1.00 |
Some college or technical school | 0.9 (0.8–1.0) | 0.9 (0.8–1.0) | 1.0 (0.8–1.1) |
College 4 years or more | 0.9 (0.8–1.0) |
0.8 (0.7–0.9)***
| 1.0 (0.9–1.1) |
Payer type | |||
Grant funding (ref) | 1.00 | 1.00 | 1.00 |
Public insurer (Medicare or Medicaid) | 1.1 (0.7–1.7) | 1.4 (0.5–3.9) | 0.9 (0.5–1.5) |
Employer or private insurer | 1.2 (1.0–1.5) | 1.5 (1.0–2.0) | 1.0 (0.7–1.3) |
Self-pay or other | 1.4 (1.0–1.8) |
2.3 (1.5–3.7)*
| 1.0 (0.7–1.4) |
Enrollment source | |||
Health care providersb (ref) | 1.00 | 1.00 | 1.00 |
Community-based organizations or community health workers | 0.7 (0.4–1.1) | 0.1 (0.1–1.1) | 0.8 (0.5–1.3) |
Self or family/friends | 0.9 (0.7–1.2) | 1.0 (0.7–1.6) | 0.8 (0.6–1.1) |
Employers or insurers | 0.8 (0.6–1.0) | 0.9 (0.6–1.3) | 0.8 (0.6–1.0) |
Media or other | 0.9 (0.7–1.1) | 0.9 (0.6–1.4) | 0.8 (0.6–1.1) |
Body mass index (BMI) at enrollment | |||
Overweightc |
1.1 (1.1–1.2)**
| 1.1 (0.9–1.1) |
1.2 (1.1–1.3)***
|
Obesityd (ref) | 1.00 | 1.00 | 1.00 |