YMCA Delivery of the National Diabetes Prevention Program: National Trends and Case Study Insights

YMCAs were instrumental in establishing the National Diabetes Prevention Program (NDPP), including a Medicare-covered model of the lifestyle intervention in 2018. Despite this key milestone for sustainability and strong clinical outcomes, reach has been extremely limited. Greater uptake is key to reducing diabetes prevalence and requires more NDPP suppliers. In a mixed-methods evaluation, we found the rate of sustained YMCA adoption declined 63.7% nationally, from 193 NDPP suppliers in 2018 to 70 in 2024. In surveys of YMCAs that had largely sustained delivery ( n = 26), leadership support was cited as a strength, while inadequate resources were a primary challenge. Three in-depth case reports identified strategies for sustainability in resource-limited settings: diversifying funding, identifying cost efficiencies, leveraging incentives to engage participants, and partnering with peer organizations and leadership to address barriers. Findings may inform practice and policy efforts to stabilize NDPP delivery in community settings and support its intended public health impact.