Are Diabetes Prevention Programs Reaching Those Most at Risk? A Scoping Review

Objectives: Previous reviews have highlighted the efficacy of lifestyle diabetes prevention programs (DPPs) in decreasing type 2 diabetes (T2D) risk, but the participating populations were predominantly white. This is concerning as ethnically diverse populations are disproportionately affected by T2D. The objective of this scoping review was to: 1) summarize existing tailored DPPs and 2) provide recommendations for future program implementation to improve access and reach for diverse populations.

Methods: This work represents a subanalysis of a larger scoping review synthesizing DPPs. Several databases were searched for studies relating to T2D risk and lifestyle programs. Study characteristics were systematically extracted using the Template for Intervention Description and Replication checklist.

Results: Of 25,110 screened publications, 351 (220 programs) were included in the larger review. Only 29% (64 programs) of the 220 programs were identified as specifically serving ethnically diverse populations and were included in this subanalysis. An updated search was run that identified an additional 10 publications (10 programs). Over a third (35%) of programs reported strategies used to tailor their intervention to the target population; of those that reported, 62% tailored the content of the intervention to be culturally appropriate and relevant as well as accommodate the geographic and cultural context.

Conclusions: Based on recruitment, tailoring, and provision strategies used in DPPs targeting specific underresourced populations, this review provides recommendations on how future program developers can increase access and reach, improving individual- and population-level health outcomes via T2D reduction in those at highest risk.