Prevalence and Correlates of Diabetes Prevention Program Referral and Participation

As the burden of type 2 diabetes rises, there is increasing focus on improving the reach of evidence-based lifestyle interventions. Using nationally representative data, this study identifies how frequently at-risk adults are being referred to and participating in diabetes prevention programming, and explores correlates of referral, participation, and interest.

Data from the 2016 National Health Interview Survey, a cross-sectional survey of U.S. households, were analyzed in 2017. The study population consisted of adults (aged ≥18 years) without a self-reported diabetes diagnosis, who were likely eligible for diabetes prevention programming based on (1) self-reported diagnosis of prediabetes or gestational diabetes, and (2) meeting BMI criteria. Prevalence of self-reported referral and participation was determined, and sociodemographic correlates of referral, participation, and interest were characterized through multivariable logistic regression analyses.

The study population consisted of 2,341 adults. The majority were female (63%), white (74.6%), non-Hispanic (83.4%), and aged ≥45 years (68.2%). A total of 4.2% reported ever being referred to a 12-month prevention program and only 2.4% reported ever participating. In multivariable logistic regression, race was correlated with referral (black and Asian adults more likely to report referral) and age was positively correlated with participation. More than 25% of adults who were never referred or participated reported an interest in engaging in programming.

Although more than one quarter of adults likely eligible for diabetes prevention programming express interest in participating, few are being referred and fewer still have participated. This underscores the need for efforts to enhance program referral and access.