464-P: Does the Referral Source Influence Retention in Community Diabetes Prevention Programs

Abstract

The Montana Diabetes Prevention Program (DPP), with over 20 community sites, has tracked participants in a statewide registry since the inception of the program in 2008. Montana’s DPP sites conduct the standard lifestyle intervention in the fall and the spring of each year, recruiting group participants who have been referred from the surrounding community. Because retention in the program is key for success, we used data from the registry to ascertain if the referral source influenced the hazard of dropout among DPP participants. From the 2015 fall cohort through the fall cohort of 2019, 3,030 participants were eligible for analyses and referral information was available for 75.2% (2,280). The three primary referral methods were: physician referral (n=914), referral by a former DPP participant (n=422), and referral by a friend or family member (n=393). We conducted a survival analysis using the last DPP session attended as a measure for dropout. Backwards selection was used to identify significant covariates for inclusion in the adjusted model. A significant difference in time to dropout by type of referral was observed (p=0.0045). When compared to participants referred by a friend or family member and after adjusting for age, income, and distance traveled, the hazard of dropout was 17.4% higher for participants who were referred by a physician (HR: 1.174, 95% CI: 1.014, 1.395, p=0.0321) and 26.5% higher for participants who were referred by a former DPP participant (HR: 1.265, 95% CI: 1.057, 1.513, p=0.0103). These findings suggest that enlisting support from friends and family members may be helpful in retaining participants referred by physicians or former DPP participants. Disclosure H. Koeppen: None. S. Tysk: None. M. House: None. J. Fernandes: None. T. S. Harwell: None. S. D. Helgerson: None. D. M. Gohdes: None. Funding Centers for Disease Control and Prevention (NU58DP006517)