Weight Loss Disparities Among Hispanic and Underserved Participants, Colorado, 2015-2018

The National Diabetes Prevention Program (DPP) is an evidence-based strategy to prevent the development of type 2 diabetes in adults at high risk through education and behavior modifications that promote weight loss. This evaluation aimed to determine if National DPP participants' weight-related outcomes varied across demographic subgroups, including sex, age, race/ethnicity, and insurance status, after controlling for program attendance and physical activity.

Our cross-site evaluation used participant-level data from 11 organizations during July 2015 through June 2018. A modified Poisson regression model was used to examine the relationship between demographic subgroups, controlling for physical activity (minutes per week) and program attendance.

A total of 1,007 National DPP participants were included in the analyzed sample. Participants lost an average of 4% of their initial body weight, approximately 8 pounds. About one-third of participants achieved greater than 5% weight loss. In the unadjusted estimates, participants who were Hispanic, non-Hispanic Black, young, and uninsured were significantly less likely to achieve 5% or greater weight loss. Demographic differences in achieving 5% or greater weight loss, however, were not significant after adjusting for program attendance and physical activity level.

Disparities in National DPP weight-related outcomes were not observed across demographic groups after adjusting for program attendance and physical activity levels. However, non-Hispanic Black participants had lower attendance and Hispanic participants reported less physical activity than participants of other races/ethnicities. Strategies to improve National DPP participation and increase physical activity, therefore, should be prioritized among Hispanic and non-Hispanic Black participants.