Feasibility and Comparative Effectiveness for the Delivery of the National Diabetes Prevention Program through Cooperative Extension in Rural Communities

The U.S. Cooperative Extension Service (CE) has potential to deliver the National Diabetes Prevention Program (NDPP) to rural residents with prediabetes. However, the CE remains underutilized for the delivery of NDPP. We compared the feasibility/effectiveness of the NDPP (0-6 mos.) delivered by CE personnel to rural residents with prediabetes using Zoom (R) (CE-Zoom (R)) or by our research staff using Facebook (R) (FB). Adults (n = 31, age similar to 55 years) were enrolled (CE-Zoom (R) n = 16, FB n = 15). Attendance did not differ significantly between groups (CE Zoom (R) = 69%, FB = 83%, p = 0.15). Participant retention was similar in the CE Zoom (R) (88%) and FB groups (87%). CE-Zoom (R) and FB (R) groups provided weekly, self-monitoring data for 83% and 84% of the 24 potential weeks, respectively. Six-month weight loss was not different between groups (CE-Zoom (R) = -5.99 +/- 8.0 kg, -5.4%, FB = -1.68 +/- 3.3 kg, -1.6% p = 0.13). Participants achieving >= 5% weight loss was greater in the CE-Zoom (R) (44%) compared with the FB group (7%, p = 0.04). Participants achieving the NDPP program goal for physical activity (>= 150 min/week) did not differ (CE-Zoom (R) = 75%, FB = 67%, p = 0.91). This pilot trial demonstrated the potential feasibility and effectiveness of the NDPP delivered by CE personnel in a group remote format (Zoom (R)) to adults with prediabetes living in rural areas.