The Reach of an Urban Hospital System-Based Diabetes Prevention Program: Patient Engagement and Weight Loss Characteristics
Open accessAbstract
Purpose: The purpose of this study was to identify patient and program delivery characteristics associated with engagement and weight loss in a Diabetes Prevention Program (DPP) implemented in an urban hospital system. Methods: Patient and program delivery data were collected between July 2015 and December 2017. DPP eligibility was determined based on age, body mass index (BMI), and hemoglobin A1C data via the electronic health record. Engagement was measured at 3 levels: ≤3 sessions, 4 to 8 sessions, and ≥9 sessions. Weight was measured at each DPP session. Results: Among the eligible patients (N = 31 524), referrals and engagement were lower in men than women, in Spanish speakers than English speakers, in younger (18-34 years) and middle-aged (35-54 years) than older adults, and in patients receiving Medicaid than other patients. Referral and engagement were higher in patients with higher BMIs and those prescribed ≥5 medications. Current smokers were less frequently engaged. Prior health care provider contact was associated with higher engagement. Overall, 28% of DPP participants achieved ≥5% weight loss; younger and middle-aged patients and those who gained weight in the prior 2 years were less likely to lose weight. Conclusion: This assessment identified characteristics of patients with lower levels of referral and engagement. The DPP staff may need to increase outreach to address barriers to referral and during all points of engagement among men, younger patients, and Spanish speakers. Future research is needed to increase understanding with regard to why referrals and engagement are lower among these groups.
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High initial no-shows among enrollees overall are 25-60%, and appear higher for racial/ethnic minority, low-income, and younger participants.
“Another challenge is high initial “no shows” among enrollees overall (25–60%),21–23 which appear higher yet for racial/ethnic minority, low-income, and younger participants.”
From <p>Current Perspectives on the Impact of the National Diabetes Prevention Program: Building on Successes and Overcoming Challenges</p> (2020) · cites this paper as [23]
The Results (Characteristics Associated With Engagement; page unavailable) report 247 patients placed in a class who never attended and 747 who started—about 25% of those placed did not attend. The paper also reports lower engagement among younger patients and Medicaid patients, but it does not establish a 25–60% overall initial no-show range or show that initial no-show rates were higher for all three named demographic groups. (LLM, conf=0.78)
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Cites
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011 · cited 2× · see citing works
“DPP is an evidence-based lifestyle program that, in clinical trials, reduced the incidence of diabetes among high-risk individuals by 58%.(5,6) DPP focuses on encouraging participants to improve their diet, increase physical activity, and lose weight.”
BackgroundPrevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012
Menke, A., Casagrande, S., Geiss, L., & Cowie, C. C. (2015) · JAMA · doi:10.1001/jama.2015.10029 · Cited by 2,362 · see citing works
The Diabetes Prevention Program (DPP)
The Diabetes Prevention Program (DPP) Research Group (2002) · Diabetes Care · doi:10.2337/diacare.25.12.2165 · Cited by 1,938 · see citing works
Diabetes 2030: Insights from Yesterday, Today, and Future Trends
Rowley, W. R., Bezold, C., Arikan, Y., Byrne, E. N., & Krohe, S. (2016) · Population Health Management · doi:10.1089/pop.2015.0181 · Cited by 662 · see citing works
<i>Standards of Medical Care in Diabetes—2019</i> Abridged for Primary Care Providers
American Diabetes Association (2019) · Clinical Diabetes · doi:10.2337/cd18-0105 · Cited by 539 · see citing works
One-year weight losses in the Look AHEAD study: factors associated with success
Wadden, T. A., West, D. S., Neiberg, R. H., Wing, R. R., Ryan, D. H., Johnson, K. C., Foreyt, J. P., Hill, J. O., Trence, D. L., Vitolins, M. Z., et al. (2009) · Obesity · doi:10.1038/oby.2008.637 · Cited by 525 · see citing works
Ely, E. K., Gruss, S. M., Luman, E. T., Gregg, E. W., Ali, M. K., Nhim, K., Rolka, D. B., & Albright, A. L. (2017) · Diabetes Care · doi:10.2337/dc16-2099 · Cited by 386 · see citing works
Rose, S. A., Poynter, P. S., Anderson, J. W., Noar, S. M., & Conigliaro, J. C. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.24 · Cited by 220 · see citing works
Family Physicians' Practices and Attitudes Regarding Care of Extremely Obese Patients
Ferrante, J. M., Piasecki, A. K., Ohman‐Strickland, P., & Crabtree, B. F. (2009) · Obesity · doi:10.1038/oby.2009.62 · Cited by 204 · see citing works
Translating the Diabetes Prevention Program to Primary Care
Whittemore, R., Melkus, G. D., Wagner, J. A., Dziura, J. D., Northrup, V. S., & Grey, M. J. (2008) · Nursing Research · doi:10.1097/nnr.0b013e31818fcef3 · Cited by 182 · see citing works
A systematic review of the translational research on the Diabetes Prevention Program
Whittemore, R. (2011) · Translational Behavioral Medicine · doi:10.1007/s13142-011-0062-y · Cited by 173 · see citing works
Bellin, E. Y., Fletcher, D. D., Geberer, N., Islam, S., & Srivastava, N. (2010) · Academic Medicine · doi:10.1097/acm.0b013e3181df0f3b · Cited by 117 · see citing works
The National Diabetes Prevention Program
Robitscher, J. W. (2020) · Cited by 110 · see citing works
Tabak, R. G., Sinclair, K. A., Baumann, A. A., Racette, S. B., Sebert Kuhlmann, A., Johnson-Jennings, M. D., & Brownson, R. C. (2015) · Translational Behavioral Medicine · doi:10.1007/s13142-015-0341-0 · Cited by 110 · see citing works
Prevalence and Correlates of Diabetes Prevention Program Referral and Participation
Venkataramani, M., Pollack, C. E., Yeh, H.-C., & Maruthur, N. M. (2019) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.10.005 · Cited by 82 · see citing works
A narrative systematic review of factors affecting diabetes prevention in primary care settings
Messina, J., Campbell, S., Morris, R., Eyles, E., & Sanders, C. (2017) · PLoS ONE · doi:10.1371/journal.pone.0177699 · Cited by 79 · see citing works
Primary Care Providers’ Prediabetes Screening, Testing, and Referral Behaviors
Nhim, K., Khan, T., Gruss, S. M., Wozniak, G., Kirley, K., Schumacher, P., Luman, E. T., & Albright, A. (2018) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.04.017 · Cited by 54 · see citing works
Ritchie, N. D., Christoe-Frazier, L., McFann, K. K., Havranek, E. P., & Pereira, R. I. (2018) · American Journal of Health Promotion · doi:10.1177/0890117117698623 · Cited by 53 · see citing works
The Special Diabetes Program for Indians Diabetes Prevention Demonstration Project, Jiang, L., Manson, S. M., Dill, E. J., Beals, J., Johnson, A., Huang, H., Acton, K. J., & Roubideaux, Y. D. (2014) · Prevention Science · doi:10.1007/s11121-013-0451-1 · Cited by 40 · see citing works
Chambers, E. C., Wylie‐Rosett, J., Blank, A. E., Ouziel, J., Hollingsworth, N., Riley, R. W., & Selwyn, P. A. (2015) · Preventing Chronic Disease · doi:10.5888/pcd12.150294 · Cited by 39 · see citing works
Self-citationRehm, C. D., Marquez, M. E., Spurrell-Huss, E., Hollingsworth, N., & Parsons, A. S. (2017) · Population Health Management · doi:10.1089/pop.2016.0109 · Cited by 35 · see citing works
Self-citationMehta, S., Mocarski, M., Wisniewski, T., Gillespie, K. B., Narayan, K. M. V., & Lang, K. M. (2017) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2017-000406 · Cited by 34 · see citing works
Reach and Effectiveness of the National Diabetes Prevention Program for Young Women
Ritchie, N. D., Sauder, K. A., & Fabbri, S. (2017) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2017.06.013 · Cited by 34 · see citing works
Gary‐Webb, T. L., Walker, E. A., Realmuto, L., Kamler, A., Lukin, J., Tyson, W., Carrasquillo, O., & Weiss, L. (2018) · American Journal of Men s Health · doi:10.1177/1557988318758788 · Cited by 33 · see citing works
Horowitz, C. R., Eckhardt, S. E., Talavera, S., Goytia, C. N., & Lorig, K. R. (2011) · Translational Behavioral Medicine · doi:10.1007/s13142-011-0067-6 · Cited by 32 · see citing works
Longitudinal Relationship between Elapsed Time in the Action Stages of Change and Weight Loss
Logue, E. E., Jarjoura, D. G., Sutton, K., Smucker, W. D., Baughman, K. R., & Capers, C. F. (2004) · Obesity Research · doi:10.1038/oby.2004.187 · Cited by 30 · see citing works
Availability of the National Diabetes Prevention Program in United States Counties, March 2017
Jayapaul-Philip, B., Dai, S., Kirtland, K., Haslam, A., & Nhim, K. (2018) · Preventing Chronic Disease · doi:10.5888/pcd15.180063 · Cited by 30 · see citing works
Walker, E. A., Weiss, L., Gary‐Webb, T. L., Realmuto, L., Kamler, A., Ravenell, J. E., Tejeda, C., Lukin, J., & Schechter, C. B. (2018) · American Journal of Men s Health · doi:10.1177/1557988318758787 · Cited by 26 · see citing works
Jiang, L., Huang, H., Johnson, A., Dill, E. J., Beals, J., Manson, S. M., Roubideaux, Y. D., & the Special Diabetes Program for Indians Diabetes Prevention Demonstration Project (2015) · Diabetes Care · doi:10.2337/dc15-0394 · Cited by 25 · see citing works
(2018) · PubMed · Cited by 24 · see citing works
Self-citationBuilding Toward a Population-Based Approach to Diabetes Screening and Prevention for US Adults
Bowen, M. E., Schmittdiel, J. A., Kullgren, J. T., Ackermann, R. T., & O’Brien, M. J. (2018) · Current Diabetes Reports · doi:10.1007/s11892-018-1090-5 · Cited by 23 · see citing works
Realmuto, L., Kamler, A., Weiss, L., Gary‐Webb, T. L., Hodge, M. E., Pagán, J. A., & Walker, E. A. (2018) · American Journal of Men s Health · doi:10.1177/1557988318758786 · Cited by 21 · see citing works
Chambers, E. C., Rehm, C. D., Correra, J., Garcia, L. E., Marquez, M. E., Wylie‐Rosett, J., & Parsons, A. S. (2017) · Preventing Chronic Disease · doi:10.5888/pcd14.160486 · Cited by 16 · see citing works
Self-citationRitchie, N. D., Kaufmann, P., & Sauder, K. A. (2017) · Diabetes Care · doi:10.2337/dc17-1242 · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Ritchie, N. D., Baucom, K. J., & Sauder, K. A. (2020) · Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy · doi:10.2147/dmso.s218334 · Cited by 70 · see citing works
Herman, W. H., Joiner, K. L., Hurst, T. E., & McEwen, L. N. (2021) · Diabetes Care · doi:10.2337/dc20-3112 · Cited by 10 · see citing works
Clinic- and Community-Based National Diabetes Prevention Programs in Los Angeles
DeFosset, A. R., Sivashanmugam, M., Mosst, J., & Kuo, T. (2021) · Health Education & Behavior · doi:10.1177/10901981211016759 · Cited by 10 · see citing works
Stephenson-Hunter, C., Pacheco, G., Kim, R. S., Gao, Q., Hosgood, H. D., & Chambers, E. C. (2023) · Preventing Chronic Disease · doi:10.5888/pcd20.230072 · Cited by 6 · see citing works
Self-citationMcMullen, B., Duncanson, K., Collins, C. E., & MacDonald‐Wicks, L. K. (2024) · Diabetic Medicine · doi:10.1111/dme.15323 · Cited by 5 · see citing works
Adapting the Diabetes Prevention Program for Older Adults: Descriptive Study
Beasley, J. M., Johnston, E. A., Costea, D., Sevick, M. A., Rogers, E., Jay, M. R., Zhong, J., & Chodosh, J. (2023) · JMIR Formative Research · doi:10.2196/45004 · Cited by 6 · see citing works
Algorithm for diabetic retinal image analysis based on deep learning
Deng, L., Liu, S.-S., Cheng, Y., Zhao, G., & Xu, J. (2023) · Multimedia Tools and Applications · doi:10.1007/s11042-023-15503-w · Cited by 3 · see citing works
Kong, A., Smart, M. H., Asada, Y., Limpoco, L. D., Tang, C., Lin, J., & Layden, B. T. (2025) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2025.103090 · Cited by 2 · see citing works
Thomas, T., Finertie, H., Sanchez, P. E., Rodríguez, L. A., & Schmittdiel, J. A. (2024) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2024.102850 · Cited by 1 · see citing works
Scherr, K. A., Turner, C. D., Wolf, S., Barden, A., Richardson, C. J., Kullgren, J. T., Piatt, G., McEvilly-Rosenbach, C., Sensing, E., Henderson, J., et al. (2025) · The Annals of Family Medicine · doi:10.1370/afm.240337 · Cited by 2 · see citing works
Saiki, K., Lim, E., Nett, B., Ogawa, G., Ching, L. K., Kawasaki, R. M., Barreto, N. A., Inoue, K., Irvin, L., Kaupiko, K. R., et al. (2026) · doi:10.2196/preprints.90880
Barriers and assets in diabetes prevention: A community-based assessment in a Latino population
Cruz, M., Raine, L. M., Ortiz, L., & Alemi, Q. (2026) · Social Work in Health Care · doi:10.1080/00981389.2026.2648201
Saiki, K., Lim, E., Nett, B., Ogawa, G., Ching, L. K., Kawasaki, R. M., Barreto, N. A., Inoue, K., Irvin, L., Kaupiko, K. R., et al. (2026) · JMIR Public Health and Surveillance · doi:10.2196/90880
Geographic Analysis of Access to the National Diabetes Prevention Program in New York State
Vrany, E. A., Chiuzan, C. C., Oh, E. J., Ephraim, P. L., Austin, R., Brissette, I. F., Millstein, S. L., & Fitzpatrick, S. L. (2026) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2026.103500
- Authors
- Chambers, E. C., Gonzalez, J. S., Marquez, M. E., Parsons, A., & Rehm, C. D.
- Affiliations
- Albert Einstein College of Medicine (US)
- Montefiore Health System (US)
- Corresponding author
- Chambers, Earle C.
- Venue
- The Diabetes Educator
- Publisher
- SAGE Publications
- Published
- 2019-10-14
- Volume
- 45
- Issue
- 6
- Pages
- 616-628
- ISSN
- 0145-7217 (ISSN-L)
- 1554-6063
- PMC
- PMC7328524
- OpenAlex
- W2981219898
- Cited by
- 14
- References
- 34
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 2 · 2023: 3 · 2021: 2 · 2020: 1
- FWCI
- 0.61
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Science of Diabetes Self-Management and Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K01HL125466, P30 DK020541, P30 DK111022, R01 DK104845, R03 HL140265, R18 DK098742)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- Diabetes Prevention Program, prediabetes, patient engagement, weight loss, referral barriers, Medicaid, Spanish speakers, sex differences, age differences, smoking, medication burden
- MeSH terms
- Adolescent, Adult, Diabetes Mellitus, Type 2, Female, Health Promotion, Glycated Hemoglobin, Hospitals, Urban, Humans, Male, Middle Aged, Patient Participation, Referral and Consultation, Program Evaluation, Weight Loss, Body Mass Index, Young Adult
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