Start-Up and Implementation Costs for a Community-Based Culturally Tailored Diabetes Prevention Program

The Diabetes Prevention Program (DPP) is a Center for Disease Control and Prevention (CDC) endorsed lifestyle intervention aimed at preventing Type-2 Diabetes Mellitus. Despite demonstrated effectiveness, DPP implementation remains limited outside clinical settings, often due to funding challenges, difficulties obtaining CDC recognition and limited reimbursement, especially for programs serving minority populations. This analysis estimated start-up and protocol costs of a culturally-tailored DPP and a standard CDC protocol, using Activity-Based Costing methodology. Both the standard CDC DPP and a culturally-tailored DPP protocol were developed by defining all program components, activities, personnel involved and time associated with all activities. Start-up costs were estimated utilizing data on standard start-up activities from two sites prior to launching the tailored DPP. Protocol and start-up costs were calculated by multiplying the wage for varying personnel by the time allocated to each defined start-up and protocol activity, costs are presented in 2025 USD. National average wage data were extracted from the Bureau of Labor Statistics O*Net database. Start-up costs totaled $87,886, with a cost per planned participant of $1,465. Implementing the standard CDC DPP protocol cost $10,573 in total, or $705 per participant. The culturally tailored protocol cost $23,849, or $1,590 per participant. This analysis is one of the first to estimate of start-up costs of a tailored DPP, and compare implementation costs for the culturally-tailored DPP with a standard CDC protocol. Understanding these costs is essential for organizations planning to implement DPP, especially in community settings. The findings offer insight into the necessary investments for a sustainable and culturally-tailored DPP.