BACKGROUND: In NYS an estimated 4.5 million adults have prediabetes. People with prediabetes have an increased risk of type 2 diabetes. An effective method for preventing diabetes is lifestyle change (LSC) through the year-long National Diabetes Prevention Program (NDPP). However, there are significant barriers to attending and completing the NDPP LSC program, especially among disparate populations. Understanding these barriers, and the factors that facilitate NDPP attendance and completion, can encourage LSC to prevent diabetes.
METHODS: The New York State Department of Health (NYSDOH) collaborated with four Local IMPACT (CDC 1422) sub-awarded communities to conduct 14 focus groups to identify barriers and facilitators to participation in, and completion of NDPP LSC program from the perspective of potential and past participants. The groups were held in four NY regions outside New York City and included 160 respondents. Data were analyzed and reported on in each region. Reports were then used as data sources to identify and code common themes.
RESULTS: Barriers to enrolling include concerns about commitment to the program, inconvenience and cost, family and individual constraints and responsibilities, social discomfort, and the lack of understanding about or information on the program. Barriers to completing the program consist of the class content, format, expectations and cost, inconvenient class time and location, and feeling out of place in class based on gender differences. Facilitators to enrolling in the program include referrals from a medical provider, being motivated by health issues, family and friends, program’s low or no cost, effective marketing, and program qualities such as the role of the coach, new ways to make changes and the known success of the program. In terms of completing the program, facilitators consist of the social reinforcement, seeing and feeling the impact of the program, and the program qualities such as focusing on active lifestyle rather than weight loss.
CONCLUSIONS: Conducting focus groups was an effective method for identifying barriers and facilitators to enrolling and participating in the NDPP LSC program. Based on the information captured, NYSDOH developed actionable recommendations and shared those recommendations with community partners. Additionally, the community partners’ role in the process which included facilitating focus groups, collecting data and reporting on it, also reinforced their understanding of issues. Consequentially, community partners have been utilizing the findings and recommendations in an effort to enhance the successful implementation of the NDPP LSC program in NYS.