Retention among participants in the National Diabetes Prevention Program Lifestyle Change Program, 2012–2017
Open accessAbstract
OBJECTIVE: To assess retention in the National Diabetes Prevention Program (DPP) lifestyle change program, which seeks to prevent type 2 diabetes in adults at high risk. RESEARCH DESIGN AND METHODS: We analyzed retention among 41,203 individuals who enrolled in Centers for Disease Control and Prevention (CDC)-recognized in-person lifestyle change programs at organizations that submitted data to CDC’s Diabetes Prevention Recognition Program during January 2012–February 2017. RESULTS: Weekly attrition rates were typically <1–2% but were between 3.5% and 5% at week 2 and at weeks 17 and 18, where session frequency typically transitions from weekly to monthly. The percentage of participants retained through 18 weeks varied by age (45.9% for 18–29 year olds, 53.4% for 30–44 year olds, 60.2% for 45–54 year olds, 66.7% for 55–64 year olds, and 67.6% for ≥65 year olds), race/ethnicity (70.5% for non-Hispanic whites, 60.5% for non-Hispanic blacks, 52.6% for Hispanics, and 50.6% for other), mean weekly percentage of body weight lost (41.0% for ≤0% lost, 66.2% for >0% to <0.25% lost, 72.9% for 0.25% to <0.5% lost, and 73.9% for ≥0.5% lost), and mean weekly physical activity minutes (12.8% for 0 min, 56.1% for >0 to <60 min, 74.8% for 60 to <150 min, and 82.8% for ≥150 min) but not by sex (63.0% for men and 63.1% for women). CONCLUSIONS: Our results demonstrate the need to identify strategies to improve retention, especially among individuals who are younger or are members of racial/ethnic minority populations and among those who report less physical activity or less early weight loss. Strategies that address retention after the first session and during the transition from weekly to monthly sessions offer the greatest opportunity for impact.
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Retention in this therapy was high, exceeding persistence among available lifestyle programs and many pharmaceutical therapies.
“Retention in this therapy was high, exceeding persistence among available lifestyle programs [24,25] and many pharmaceutical therapies [26].”
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- Authors
- Cannon, M. J., Masalovich, S., Ng, B. P., Soler, R. E., Jabrah, R., Ely, E. K., & Smith, B. D.
- Affiliations
- Centers for Disease Control and Prevention (US)
- CyberData Technologies, Inc., Herndon, VA
- University of Central Florida (US)
- Boston Consulting Group (United States) (US)
- Corresponding author
- Cannon, Michael J.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2020-07-02
- Volume
- 43
- Issue
- 9
- Pages
- 2042-2049
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC11000538
- OpenAlex
- W3038332575
- Cited by
- 150
- References
- 38
- Citations by year
- 2026: 21 · 2025: 33 · 2024: 29 · 2023: 24 · 2022: 22 · 2021: 14 · 2020: 7
- FWCI
- 12.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Centers for Disease Control and Prevention
- 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 › Medicine › Physiology › Physical Activity and Health
- Keywords
- participant retention, National Diabetes Prevention Program, lifestyle modification program, type 2 diabetes prevention, attrition rates, racial and ethnic minorities, young adults, weight loss, physical activity
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Centers for Disease Control and Prevention, U.S., Diabetes Mellitus, Type 2, Ethnicity, Female, Humans, Life Style, Male, Middle Aged, Minority Groups, Patient Participation, Primary Prevention, United States, Weight Loss, Exercise, Risk Reduction Behavior, Young Adult
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