An Evaluation of the Reach and Effectiveness of a Diabetes Prevention Behaviour Change Program Situated in a Community Site

More than 350 million people are living with prediabetes. Preventing type 2 diabetes (T2D) progression can reduce morbidity, mortality and health-care costs. Interventions can support people with diet and physical activity behaviour changes; however, many interventions are university-based, posing barriers (e.g. accessibility, limited reach and maintenance), which highlight the need for community intervention. Limited research has comprehensively evaluated programs in community contexts. The purpose of this study was to pragmatically examine the reach and effectiveness of a diabetes prevention behaviour change program in the community using the RE-AIM framework. Demographic and outcome data were collected through telephone screening and survey data, and analyzed using descriptive and multivariate analyses. Over 2 years, 9,954 individuals were identified by a medical laboratory as living with prediabetes. Information letters were sent by the laboratory to individuals upon physician approval (N=2,241, 22.5%) as a main form of recruitment. From this, 271 individuals and an additional 160 individuals via other recruitment methods contacted the research team (N=431). Two hundred thirteen adults with prediabetes were enrolled (87.4% Caucasian, 69.7% female; 95% program completion). Analyses of 6-month follow-up data revealed significant maintenance of reductions in weight and waist circumference and improvements in physical function, self-reported physical activity and all-food frequency items except fruit intake (N=121, d=0.21 to 0.68, p <0.05 to 0.001). The program demonstrated diabetes risk-reducing benefits for enrolled individuals. Future work is needed to increase physician referral and participant response rates and to explore program expansion through digitization to reach more individuals at risk of developing T2D. (c) 2020 Canadian Diabetes Association.