Predictors of Engagement and Weight Loss in Real-World Diabetes Prevention Program (DPP)

Weight loss can significantly reduce an individual’s risk for T2D. However, it can be challenging to engage participants in the DPP long enough to lose weight. This analysis examines sociodemographic characteristics and health behaviors as predictors of participant engagement and weight loss/gain. Participants were recruited into the DPP through a referral from a provider, family/friend, or other. Classes were conducted through local ambulatory clinics and community settings in San Diego, CA. Baseline self-report surveys were administered prior to program start, and weight was assessed at every session. Participants (N=290) were mostly female (81%) with a mean age of 57 (±14), diverse [51% Hispanic, 9% Asian/Native Hawaiian or Pacific Islander (ANHPI), 4% Other], and reported household incomes <$24,000 (77%). Regression models also controlled for age, baseline BMI, education, and employment. Baseline healthful eating was a significant predictor of DPP engagement; each 1-point increase on the Towsend Food Behavior Checklist was associated with an average of 0.25 fewer sessions (p=0.016) attended (out of 34 possible sessions). Participants of Other race/ethnicity averaged significantly fewer sessions (11.5±8.5) than whites (17.40±8.6, p=0.004), Hispanics (17.36±7.7, p=0.009), and ANHPIs (16.16±8.9, p=0.01). There were significant differences in weight loss for men (-8.07±9.5) vs. women (-6.30±9.4, p=0.04) and for retirees (-6.50±7.59) vs. the employed (-8.14±10.87, p=0.023) and self-employed (-5.48 ±10.64, p=0.04), and retirees. Participants with healthier eating behaviors may not feel the need to attend as many sessions as others, although the difference in attendance is relatively small. The racial/ethnic differences in engagement should be interpreted with caution since there may be differences within the different racial/ethnic groups in this category. The weight loss differences by work status suggest more tailored approaches and strategies to lifestyle management. Disclosure M. AuYoung: None. K. Luu: None. M. Ruiz: None. C. Walker: None. A. Philis-Tsimikas: Advisory Panel; Self; AstraZeneca, Lilly Diabetes, Novo Nordisk A/S, Sanofi. Employee; Spouse/Partner; Ionis Pharmaceuticals, Inc. Research Support; Self; Dexcom, Inc., Glooko, Inc., National Institute of Diabetes and Digestive and Kidney Diseases. Stock/Shareholder; Spouse/Partner; Ionis Pharmaceuticals, Inc., Novo Nordisk Inc. A.L. Fortmann: None.