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The authors have no competing interests to declare.
JD was the chief investigator of the GGT DPP and was responsible for its design and for obtaining funding. JD and PR were responsible for the research question for this study. CW and AH were responsible for acquisition of data and interpretation of data. CW primarily undertook the analysis. CW wrote the first draft of this manuscript. CW and AH were responsible for its revisions, with JD and PR contributing to specific sections of the manuscript. All authors read and approved the final version of the manuscript.
The Greater Green Triangle diabetes prevention program was conducted in primary health care setting of Victoria and South Australia in 2004–2006. This program demonstrated significant reductions in diabetes risk factors which were largely sustained at 18 month follow-up. The theoretical model utilised in this program achieved its outcomes through improvements in coping self-efficacy and planning. Previous evaluations have concentrated on the behavioural components of the intervention. Other variables external to the main research design may have contributed to the success factors but have yet to be identified. The objective of this evaluation was to identify the extent to which participants in a diabetes prevention program sustained lifestyle changes several years after completing the program and to identify contextual factors that contributed to sustaining changes.
A qualitative evaluation was conducted. Five focus groups were held with people who had completed a diabetes prevention program, several years later to assess the degree to which they had sustained program strategies and to identify contributing factors.
Participants value the recruitment strategy. Involvement in their own risk assessment was a strong motivator. Learning new skills gave participants a sense of empowerment. Receiving regular pathology reports was a means of self-assessment and a motivator to continue. Strong family and community support contributed to personal motivation and sustained practice.
Family and local community supports constitute the contextual variables reported to contribute to sustained motivation after the program was completed. Behaviour modification programs can incorporate strategies to ensure these factors are recognised and if necessary, strengthened at the local level.