A Primer for Applying the Purnell Model: Enhancing Cultural Competence in Diabetes Prevention Programs

Black and Latino men are at increased risk for poor diabetes health outcomes but are underrepresented in lifestyle interventions for weight loss and diabetes prevention. Although relatively few men participate in the National Diabetes Prevention Program (NDPP), it remains the most widely available evidence-based approach to type 2 diabetes prevention in the United States. Thus, an NDPP tailored to Black and Latino men has the potential to address prior limitations of NDPP implementation and reduce gender, racial, and ethnic diabetes disparities. It also provides an opportunity to define a population for targeted outreach and evaluate the reach of our recruitment methods and interventions. We tailored the US Centers for Disease Control and Prevention Prevent T2 curriculum for the NDPP for Black and Latino men, called Power-Up, and will evaluate its effects in comparison to standard mixed-gender NDPP groups via virtual delivery. The primary aim of the project is to assess the effect of Power-Up versus NDPP on weight loss among men with prediabetes. The secondary aim is to compare the engagement and retention of men with prediabetes in Power-Up versus NDPP. We will also examine the reach of our recruitment methods and engagement in our screening, consenting, and assessment procedures prior to the point of randomization. We hypothesized that men randomized to Power-Up would achieve greater percent weight loss from baseline at 16 weeks (end of Core sessions) and 1 year (end of Maintenance sessions) than men randomized to standard, mixed-gender NDPP. Power-Up is also expected to have better engagement and retention. Using the electronic health record (EHR) systems of a large academic medical center and a network of small to medium independent primary care practices throughout New York City, we identified Black and Latino men who met eligibility criteria for NDPP and enrolled them in a randomized controlled trial in which they were assigned 1:1 to receive Power-Up or the standard, mixed-gender NDPP over 1 year via online videoconferencing. Coaches delivering these interventions were trained according to the standards for the NDPP. Power-Up will be delivered by men coaches. Weight will be collected with home-based electronic scales for primary outcome analyses. Engagement will be assessed by session attendance logs. We identified 11,052 men for outreach based on EHR data, successfully screened 26% of them, consented and enrolled 22% of these, and randomly assigned 48% of consented participants. Primary and secondary outcome analyses will be assessed among randomized men. This study highlights the effort required to reach and engage Black and Latino men for virtually delivered diabetes prevention programs. Forthcoming trial results for weight loss and engagement will further inform efforts to address disparities in diabetes prevention through tailored programming for Black and Latino men. ClinicalTrials.gov NCT04104243; https://clinicaltrials.gov/study/NCT04104243. DERR1-10.2196/64405.

BackgroundPrediabetes conveys an increased risk for subsequently developing type 2 diabetes (T2D). The National Diabetes Prevention Program (DPP) is a widely available intensive behavioral intervention that decreases the risk of developing T2D in adults with prediabetes. Data are needed to inform approaches to increase prediabetes awareness and National DPP participation. Few studies have explored perceptions and experiences of prediabetes diagnosis and National DPP participation, and none have focused on Hispanic adults and participation in the National DPP as implemented by a community-based organization.ObjectiveThis study aims to explore perceptions and experiences of developing prediabetes awareness and participating in the National DPP among Hispanic US adults.MethodsThe sample was recruited from participants in the National DPP as implemented in Spanish by a community-based organization in the upper Midwest. Semistructured interviews were conducted by telephone in April and May 2021. A qualitative descriptive approach was used. Data from the interviews were reviewed, coded, and integrated into themes to reflect the narratives elicited in the interviews.ResultsA total of 16 interviews were conducted. The mean age of the participants was 46 (SD 6, range 34‐55) years. Most (n=15) identified as female. The majority (n=15) reported having been born in Mexico. More than two-thirds (n=11) had a level of educational attainment of high school completion or less. Nearly half (n=7) reported not having health insurance. Qualitative description resulted in the emergence of four main themes: (1) processing the news of having prediabetes, (2) deciding on treatment for T2D primary prevention, (3) valuing language and cultural congruence in the National DPP, and (4) appreciating action-oriented knowledge gained during National DPP participation. Participants described the emotional impact of becoming aware of having prediabetes. National DPP lifestyle coaches’ outreach and recruitment efforts on a local radio program and a Facebook Live (Meta Platforms) broadcast helped raise awareness of prediabetes and influence attitudes toward participation in the National DPP. Values and cultural beliefs appeared to contribute to perceptions and experiences of participating in the National DPP. Participants were inclined to share information about the National DPP with others in their community.ConclusionsThis study presents some of the first evidence exploring perceptions and experiences of developing prediabetes awareness and participating in the National DPP among Hispanic US adults. The findings can inform approaches to increase prediabetes awareness and National DPP participation among Hispanic US adults.

Introduction: The National Diabetes Prevention Program (NDPP) is a widely-disseminated lifestyle intervention. Retention in the NDPP is problematic and leads to suboptimal weight loss, especially among racial/ethnic minority participants. We report results of implementing a novel “pre-session” protocol to support engagement among a diverse sample of NDPP participants. Methods: The NDPP was delivered in a safety net healthcare system. As of September 2016, pre-sessions were offered prior to NDPP attendance and focused on (1) education on diabetes risks, (2) motivational interviewing to participate in the NDPP, and (3) problem-solving barriers to engagement. We compared NDPP attendance and weight loss outcomes between 75 pre-session participants and a historical control group of 42 individuals who were not offered a pre-session prior to their beginning the NDPP in July 2016. This comparator group was selected to reduce potentially confounding effects of other prior modifications to NDPP dissemination over time. Results: The majority of participants in this analysis were female (78.3%), low-income (51.1%), and Hispanic (57.6%). Mean age was 46.6 (SD=12.7) with a mean baseline BMI of 35.9 (SD=5.7). There were no significant baseline differences in characteristics between NDPP participants who received a pre-session and historical controls. Pre-session participants attended 5.3 (SD=1.4) more NDPP sessions (p<.001) and stayed in the program 96.4 (SD=24.6) days longer (p<.001) than historical controls. Pre-session participants achieved 1.8% (SD=0.8) greater weight loss (p=.039) and were 2.4 times more likely to achieve ≥5% weight loss in the NDPP as historical controls; p=.044, 95% CI [1.0-5.8]. Conclusions: By improving engagement and weight loss, findings suggest pre-sessions may be a promising strategy to improve NDPP effectiveness and mitigate health disparities in program outcomes. Disclosure N. Ritchie: None. P.G. Kaufmann: None. M. Gritz: None. J.S. Holtrop: None.

BackgroundThe evidence-based National Diabetes Prevention Program (NDPP) is now widely disseminated, yet strategies to increase its effectiveness are needed, especially for underserved populations. The yearlong program promotes lifestyle changes for weight loss and can be offered in-person, online, via distance learning, or a combination of modalities. Less is known about which delivery features are optimal and may help address disparities in outcomes for subgroups. We previously demonstrated the efficacy of a stand-alone text messaging intervention based on the NDPP (SMS4PreDM) in a randomized controlled trial in a safety net health care system. Upon broader dissemination, we then showed that SMS4PreDM demonstrated high retention and modest weight loss at a relatively low cost, suggesting the potential to improve in-person NDPP delivery.ObjectiveIn this study, we aim to compare the effectiveness of in-person NDPP classes with and without supplementary SMS4PreDM on attendance and weight loss outcomes to determine whether text messaging can enhance in-person NDPP delivery for a safety net patient population.MethodsFrom 2015 to 2017, patients with diabetes risks were identified primarily from provider referrals and enrolled in NDPP classes, SMS4PreDM, or both per their preference and availability. Participants naturally formed three groups: in-person NDPP with SMS4PreDM (n=236), in-person NDPP alone (n=252), and SMS4PreDM alone (n=285). This analysis compares the first two groups to evaluate whether supplemental text messaging may improve in-person NDPP outcomes. Outcomes for SMS4PreDM-only participants were previously reported. NDPP classes followed standard delivery guidelines, including weekly-to-monthly classes over a year. SMS4PreDM delivery included messages promoting lifestyle change and modest weight loss, sent 6 days per week for 12 months. Differences in characteristics between intervention groups were assessed using chi-square and t tests. Differences in NDPP attendance and weight loss outcomes were analyzed with multivariable linear and logistic regressions.ResultsThe mean age was 50.4 years (SD 13.9). Out of a total of 488 participants, 76.2% (n=372) were female and 59.0% (n=288) were Hispanic. An additional 17.2% (n=84) were non-Hispanic white and 12.9% (n=63) were non-Hispanic black. A total of 48.4% (n=236) of participants elected to receive supplemental text message support in addition to NDPP classes. Participants who chose supplemental text message support were on average 5.7 (SD 1.2) years younger (P<.001) than the 252 participants who preferred in-person classes alone. Relatively more women and Hispanic individuals enrolled in the NDPP with supplemental text messages than in NDPP classes alone, 83.9% (n=198) vs 69.0% (n=174, P<.001) and 68.6% (n=162) vs 50.0% (n=126, P=.001), respectively. Attendance and weight loss outcomes were comparable between groups.ConclusionsDespite its appeal among priority populations, supplemental text messaging did not significantly increase attendance and weight loss for the in-person NDPP. Further research is needed to identify optimal strategies to improve the effectiveness of the NDPP.

BackgroundType 2 diabetes affects 9.4% of US adults with higher rates among racial and ethnic minorities and individuals of low socioeconomic status. The National Diabetes Prevention Program (NDPP) is an evidence-based and widely disseminated behavioral intervention to reduce diabetes incidence through modest weight loss. However, retention in the yearlong NDPP is problematic and leads to suboptimal weight loss, especially among diverse, underserved populations. Strategies to improve NDPP engagement and weight loss are needed urgently. Pilot results of the pre-NDPP, a novel enhancement to enrollment in the NDPP based on the Health Belief Model, were highly successful in a nonrandomized cohort study among 1140 racially diverse, predominately low-income participants. A total of 75 presession participants had doubled attendance and weight loss as compared with earlier participants who did not receive presessions. On the basis of these promising results, we are conducting a randomized controlled trial (RCT) to determine whether pre-NDPP reliably improves NDPP outcomes, as reported on ClinicalTrials.gov.ObjectiveThis study aims to (1) conduct an RCT comparing NDPP attendance and weight loss outcomes between participants who receive pre-NDPP versus direct enrollment into the NDPP (usual care), (2) examine potential effect mediators (perceived risk for developing diabetes and self-efficacy and readiness for weight control) and moderators (race and ethnicity; income level), and (3) evaluate implementation factors, including cost and projected return on investment.MethodsThis two-arm RCT will compare outcomes among diverse, predominately low-income participants who receive pre-NDPP versus direct enrollment into the NDPP (usual care). This is a type 1 hybrid effectiveness-implementation design to determine clinical effectiveness through an RCT, while assessing factors that may impact future pre-NDPP dissemination and implementation, including cost. Our primary research question is whether pre-NDPP improves NDPP attendance and weight loss compared with standard NDPP delivery.ResultsThis project was funded in April 2019. Recruitment is underway as of July 2019. Initial participants began the intervention in October 2019. Data analysis and results reporting are expected to be completed in 2024.ConclusionsThis RCT of pre-NDPP may lead to future dissemination of a scalable, evidence-based strategy to improve success of the NDPP, reduce disparities in NDPP effectiveness, and help prevent type 2 diabetes across the country.Trial RegistrationClinicalTrials.gov NCT04022499; https://clinicaltrials.gov/ct2/show/NCT04022499.International Registered Report Identifier (IRRID)PRR1-10.2196/15499

Introduction and Objective: Hispanic men have a relatively high prevalence of diabetes but relatively low rates of enrollment and engagement in preventive interventions like the NDPP. This qualitative study aimed to comprehensively explore influences unique to Hispanic men with low engagement in the NDPP, compared to those with high engagement, with the goal of informing strategies to improve their engagement in the program. Methods: Participants were self-identified Hispanic men, aged ≥18 years, at risk for diabetes per electronic medical records at an urban outpatient network, and invited to the NDPP. They completed individual audio-recorded interviews in English and Spanish. Using Nvivo, transcripts were analyzed deductively, informed by the Theoretical Domains Framework, to identify influences on engagement in the NDPP. Codes emerging uniquely among those with low engagement (attendance at &amp;lt;4 NDPP sessions) were identified through consensus. Results: Of 32 Hispanic men interviewed, 15 had low engagement in the NDPP. More of those with low engagement had limited English proficiency and did not complete high school. Three major themes delineated their Capacity, Motivations, and Opportunities for engaging with the NDPP. They expressed limited awareness of their prediabetes diagnosis, felt self-sufficient about enacting lifestyle change, and were skeptical about their diabetes risk and the utility of the NDPP. They also mentioned financial barriers and limited access to the program. Conclusion: Addressing the unique barriers faced by Hispanic men in engaging with the NDPP is critical to reducing diabetes-related inequities and may require tackling knowledge gaps, financial barriers, and perceptions of program relevance before, during, and after enrollment. Future research should explore how to tailor recruitment strategies and program content to Hispanic men’s specific identities, motivations, and challenges. Disclosure C.J. Gonzalez: None. C.N. Perez-Mejia: None. N. Hernandez: None. H. Flaxman: None. C. Stephenson-Hunter: None. E.N. Gil: None. T. Formagini: None. E. Chambers: None. J.S. Gonzalez: None. Funding Robert Wood Johnson Foundation (234326-01); UCSF Research in Implementation Science for Equity Subaward (R25HL126146 Subaward No 13969sc); National Heart, Lung, and Blood Institute (T32HL079891); National Institute of Diabetes and Digestive and Kidney Diseases (3R01DK121896); National Institute of Diabetes and Digestive and Kidney Diseases (3P30DK111022)

Introduction and Objective: In 2010, the Centers for Disease Control and Prevention (CDC) established the National Diabetes Prevention Program (National DPP) to address the growing rate of type 2 diabetes (T2D) in the United States and the millions of adults at high risk for the disease. The National DPP supports a structured lifestyle change program (LCP) based on the Diabetes Prevention Program (DPP) research study and subsequent translation studies. Our objective is to compare outcomes from the lifestyle intervention arm of the DPP to that of the National DPP LCP using data from CDC’s Diabetes Prevention Recognition Program. Methods: This study compares participant outcomes from the DPP (n=1,079) to two groups from the National DPP LCP: all participants (n=634,545) and those who more closely matched criteria for DPP inclusion (n=116,330). Outcomes include weight loss at ~6 months and percentage who met the 150 minutes/week of physical activity (PA) goal at ~6 months. Analysis was done using SAS 9.4. Results: Median weight loss was higher for DPP participants (7.2%) than for the two groups of LCP participants: 4.3% (all) and 4.7% (matched). Weight loss in the 5-7% range, the goal of the LCP, was the same or better for those in the LCP, 14% (all) and 16% (matched), compared to the DPP (14%). DPP participants met the PA goal of 150 weekly minutes at a rate of 74%. Among LCP participants, the percentage reporting meeting the goal during the 6-month period was 56% (all) and 62% (matched). Conclusion: The National DPP LCP is offered by various organizations in real-world settings, whereas the DPP was conducted in a controlled environment that included individualized support. Despite this, LCP participants are meeting weight loss goals at similar rates and showing increases in PA. The National DPP shows promise as a model to scale a proven lifestyle intervention from research into widespread practice, helping adults with prediabetes lower their risk for T2D. Disclosure E. Ely: None. M. Bell: None.

BackgroundThe Center for Disease Control and Prevention’s National Diabetes Prevention Program (NDPP) aims to help individuals with prediabetes avoid progression to type 2 diabetes mellitus (T2DM) through weight loss. Specifically, the NDPP teaches individuals to follow a low-fat, calorie-restricted diet and to engage in regular physical activity to achieve ≥ 5% body weight loss. Most NDPP participants, however, do not achieve this weight loss goal, and glycemic control remains largely unchanged. One promising opportunity to augment the NDPP’s weight loss and glycemic effectiveness may be to teach participants to follow a very low-carbohydrate diet (VLCD), which can directly reduce post-prandial glycemia and facilitate weight loss by reducing circulating insulin and enabling lipolysis. To date, there have been no high-quality, randomized controlled trials to test whether a VLCD can prevent progression to T2DM among individuals with prediabetes. The aim of this study is to test the effectiveness of a VLCD version the NDPP (VLC-NDPP) versus the standard NDPP. We hypothesize the VLC-NDPP will demonstrate greater improvements in weight loss and glycemic control.MethodsWe propose to conduct a 12-month, 1:1, randomized controlled trial that will assign 300 adults with overweight or obesity and prediabetes to either the NDPP or VLC-NDPP. The primary outcome will be glycemic control as measured by change in hemoglobin A1c (HbA1c) from baseline to 12 months. Secondary outcomes will include percent body weight change and changes in glycemic variability, inflammatory markers, lipids, and interim HbA1c. We will evaluate progression to T2DM and initiation of anti-hyperglycemic agents. We will conduct qualitative interviews among a purposive sample of participants to explore barriers to and facilitators of dietary adherence. The principal quantitative analysis will be intent-to-treat using hierarchical linear mixed effects models to assess differences over time.DiscussionThe NDPP is the dominant public health strategy for T2DM prevention. Changing the program’s dietary advice to include a carbohydrate-restricted eating pattern as an alternative option may enhance the program’s effectiveness. If the VLC-NDPP shows promise, this trial would be a precursor to a multi-site trial with incident T2DM as the primary outcome.Trial registrationNCT05235425. Registered February 11, 2022.

Previous interventions to lower diabetes risks among pregnant women have been largely ineffective (1–3), and the identification of effective prevention tools is needed to protect both maternal and child health (4). The National Diabetes Prevention Program (NDPP) is a widely disseminated translation of the highly successful lifestyle change intervention from the Diabetes Prevention Program research study (5,6). The NDPP promotes weight loss of ≥5% through diet and physical activity, benefiting individuals who participate regularly (6). Eighty percent of participants are women (6), but most are beyond child-bearing years (7), and those who are pregnant at enrollment are excluded (8). Increasing enrollment in the NDPP among women of childbearing age has been identified as a priority (7), yet outcomes for those who become pregnant during the year-long program are unknown. To explore whether the NDPP may support beneficial outcomes during pregnancy, we examined case studies of women who became pregnant while participating in the NDPP. We delivered the year-long NDPP intervention in a Denver, Colo., health care system to eligible adults with diabetes risks (i.e., ≥24 kg/m2 and prediabetes, history of gestational diabetes mellitus [GDM], or positive score on a diabetes risk questionnaire [8]). Participants were largely referred by their primary care providers. Trained NDPP coaches led 22–25 group sessions over 1 year following guidelines developed by the Centers for Disease Control and Prevention (9). From March 2013 to March 2018, 924 women participated. Five women who subsequently reported having become pregnant were able to continue, but were no longer prescribed the NDPP’s weight loss goal. This article describes diabetes-related outcomes in pregnancy among three women using medical records available as of May 2018. An additional case was excluded because detailed records were unavailable, and another was excluded because of the early stage of the pregnancy. …

The U.S. Centers for Disease Control and Prevention (CDC) estimates that about 1.9 million Americans develop diabetes yearly; most of them have type 2 diabetes, and almost one-third remain undiagnosed for several years (1). The Diabetes Prevention Program (DPP) provided strong evidence that lifestyle behavioral counseling interventions can prevent or delay about half of these new cases (2). Unfortunately, 15 years after the DPP, most people at high risk for developing diabetes have not been offered such an intervention (3). This gap separates millions of high-risk Americans from the most evidence-based solution currently known to prevent type 2 diabetes. In 2010, Congress authorized the CDC to launch the National Diabetes Prevention Program (National DPP), which supports organizational and workforce development, quality monitoring, and evaluation of efforts to scale up delivery of DPP-like lifestyle intervention programs nationally (4). As of April 2017, the National DPP registry listed 1,379 organizations offering DPP-like interventions across all 50 states, including 47 online-only programs and 1,332 organizations delivering face-to-face interventions (4). These numbers underscore the incredible growth in our nation’s capacity to provide DPP-like interventions. In this issue of Diabetes Care , Ely et al. (5) report findings of an evaluation of the first 14,747 adults who completed ≥1 National DPP visits through one of 220 registered organizations between February 2012 and January 2015. Strengths of this evaluation include the large sample size and inclusion of data for all National DPP participants; limitations include lack of a control group and no information about weight changes or other outcomes for participants who stopped attending the program. Still, this evaluation offers an important first glimpse of the success of National DPP’s scale-up since 2010. Over a 12-month period after their first visit, National DPP participants completed a median of 14 of 22 possible lessons and about half …

With the growing demand for lifestyle change programs that prevent or delay Type 2 diabetes onset, community organizations with broad reach should be explored for national dissemination of the National Diabetes Prevention Program (NDPP). This study evaluates the early implementation of the NDPP through Cooperative Extension in four Kentucky counties and explores the feasibility of scaling up the program to additional counties. Using a qualitative approach, semi-structured telephone interviews were conducted with 12 Family and Consumer Sciences (FCS) Agents – four who were participating in the pilot (adopters) and eight who had no experience with the NDPP (potential adopters). Five overarching themes emerged: satisfaction with and desire for the NDPP; implementation barriers (recruitment challenges and Agent comfortability issues); needed supports; roles of community partners (potential duplication of efforts); and dynamics of community relationships and trust. While there was agreement that Cooperative Extension was an appropriate platform for dissemination, notable barriers must be overcome. This study provides important information for Cooperative Extension Services across the country that are implementing or considering implementing the NDPP; specifically, that this program may need a more tailored and controlled rollout compared to traditional Extension programming.

The National Diabetes Prevention Program (NDPP) is a widely disseminated lifestyle intervention. Attendance is problematic, leading to suboptimal weight loss, especially among racial/ethnic minority participants. We conducted a novel "presession" protocol to improve engagement of diverse NDPP candidates, comparing NDPP participants who attended a presession to those who did not on attendance and weight loss outcomes. Longitudinal cohort study. A safety net health-care system. A total of 1140 patients with diabetes risks (58.9% Hispanic, 19.8% non-Hispanic black, 61.8% low income). The NDPP has been delivered in a Denver, Colorado health-care system since 2013. The program included 22 to 25 sessions over 1 year. Beginning September 2016, individuals were required to attend a presession before enrollment that focused on (1) increasing risk awareness, (2) motivational interviewing to participate in the NDPP, and (3) problem-solving around engagement barriers. Duration and intensity of NDPP attendance and weight loss. Outcomes of 75 presession participants who enrolled in the NDPP were compared to 1065 prior participants using analysis of covariance and multivariable logistic regression. Presession participants stayed in the NDPP 99.8 days longer ( P < .001) and attended 14.3% more sessions ( P < .001) on average than those without a presession. Presession participants lost 2.0% more weight ( P < .001) and were 3.5 times more likely to achieve the 5% weight loss target ( P < .001). Presessions may improve NDPP outcomes for individuals from diverse backgrounds. A full-scale trial is needed to determine whether presessions reliably improve NDPP effectiveness.

Purnell model for cultural competence has been classified as holographic complexity grand theory because it is applicable to all health professionals, has a graphic display of the model, and an extensive assessment framework based upon which the model is based. The model has been translated into Arabic, Czechoslovakian, Danish, French, German, Korean, Portuguese, Spanish, and Turkish. The model provides a comprehensive and systematic framework for learning and understanding culture and for use primarily in the clinical practice setting. The empirical framework provides a basis for health-care providers, educators, researchers, managers, and administrators in all health disciplines to provide holistic, culturally competent, therapeutic interventions; health promotion and wellness; illness, disease, and injury prevention; health maintenance and restoration; and health teaching across educational and practice settings. Reflective exercises are included for professionals to critically think about their beliefs, attitudes, and practices from a holistic perspective. An extensive assessment guide is included and can be adapted for use in the clinical setting. The twelve domains are overview/heritage, communication, family roles and organization, workforce issues, biocultural ecology, high-risk behaviors, nutrition, pregnancy, death rituals, spirituality, health-care practices, and health-care practitioners. Each population specific chapter is organized according to these 12 domains.

The Underutilization of National Diabetes Prevention Program Among Women With a History of Gestational Diabetes Mellitus: An In-Depth Focus Group Analysis

Introduction &amp; Objective: Prediabetes affects an estimated 98 million adults in the United States, yet there exists a relative underutilization of diabetes prevention programs, such as the CDC National Diabetes Prevention Program (NDPP). Given the widespread internet and social media use among US adults, effective online dissemination of information concerning the NDPP is key to heightening awareness and fostering enrollment in such programs. This study sought to assess the content of the NDPP organizations’ websites, evaluating their ability to provide pertinent information that motivates individuals to enroll and actively participate in the program. Methods: Using data from the NDPP registry and the CDC Social Vulnerability Index, we identified and systematically reviewed 368 organizations delivering in-person NDPP in socially vulnerable communities. Results: Of these, 21.7% (n=80) listed a web address for their DPP, of which only 59 were functional. Among these functional websites, 39% provided a comprehensive description of the NDPP, with 5% specifying cultural objectives. Additionally, 54% provided information on class schedules, 15% allowed online enrollment, and 39% maintained an active presence on social media platforms. Conclusion: Approximately 84% of NDPP organizations in socially vulnerable communities are without a functioning website, despite the disproportionate impact of diabetes on these populations. Only 5% of organizations with operational websites reported offering culturally and racially specific programs. These findings underscore a critical gap in the current online presence of NDPP information in socially vulnerable areas for individuals seeking diabetes prevention resources. Targeted efforts should focus on enhancing website accessibility with relevant information and social media engagement to effectively communicate the availability of the NDPP to vulnerable communities. Disclosure M. Massey: None. J. Nguyen: None. B. Ng: None.