Abstract
Individuals in low socioeconomic status (SES) areas are disproportionately affected by diabetes and have poor lifestyle change outcomes. Organizations delivering the CDC National DPP lifestyle change program receive pending, preliminary, or full recognition status based on specific program criteria and outcomes. Full recognition is critical for organizations to sustain the program and receive reimbursements to cover costs, but organizations in low SES areas may face barriers to receiving it. A multinomial logit model was used to examine the association between the CDC social vulnerability index (SVI) and in-person full recognition organizations at the county level, adjusting for confounders (n=843). Using the National DPP registry, Census data, SVI, and CDC Diabetes Surveillance System, a three-level categorical dependent variable was created: counties without full recognition organizations, counties with at least one non-full recognition organization, and counties with all organizations with full recognition (reference group). The CDC created a four-level categorical SVI (Low, Low-Medium, Medium-High, High) using 16 Census variables to rank counties by social vulnerability: SES, Household Composition and Disability (e.g., age), Minority Status and Language, and Housing Type and Transportation (e.g., vehicle). Of the studied counties, 38.4% had no organizations with full recognition, 22.6% had at least one organization without full recognition, and 39.0% had all organizations with full recognition. Counties with higher SVI were more likely to be in counties without full recognition organizations (High vs. Low; OR=2.71, P <0.001). Counties with high SVI lack fully recognized programs, indicating barriers for organizations in high SVI areas to attain full recognition. This study highlighted the need to develop strategies to ensure organizations in high SVI areas can reach full recognition status to better serve at-risk populations. Disclosure T.Formagini: None. A.Rezwan: None. D.Rodriguez: None. B.Ng: None.
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