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

Abstract

ObjectivePrevious reviews have highlighted the efficacy of lifestyle diabetes prevention programs (DPPs) in decreasing type 2 diabetes (T2D) risk; however, the participating population is 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. MethodsThis work represents a sub-analysis 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. ResultsOf 25,110 screened publications, 351 (220 programs) were included in the larger review. Only 29% (64 programs) of these 220 were identified as specifically serving ethnically diverse populations and were included in this sub-analysis. An updated search was run which 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 geographical and cultural context. ConclusionBased on recruitment, tailoring, and provision strategies utilized in DPPs targeting specific under-resourced 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.