Reach and Effectiveness of the National Diabetes Prevention Program for Young Women

Abstract

Reducing obesity and diabetes risks among women of child-bearing age is urgently needed to halt the transgenerational cycle of disease. Interventions among pregnant women have largely been ineffective and may be initiated too late to improve maternal and child health. The National Diabetes Prevention Program is a widely disseminated lifestyle intervention that may help mitigate risks before pregnancy. However, the program has targeted relatively older adults, and effectiveness among women of child-bearing age remains largely unknown. The National Diabetes Prevention Program was delivered in an urban safety net hospital. Reach and effectiveness were evaluated among 4,866 eligible women who were invited to participate in the program. The authors compared enrollment, attendance, and weight loss for women aged 18-39 years as compared to women aged ≥40 years. Data were collected between 2013 and 2016. Analyses were conducted in 2017. Women of child-bearing age were nearly half as likely to enroll than older women in adjusted models (OR=0.58, 95% CI=0.49, 0.69). Subsequently, younger enrollees were less likely to attend ≥1 session(s) than older women (OR=0.77, 95% CI=0.61, 0.99). There was no significant age group difference in program completion rates or weight-loss outcomes. Both groups lost an average of 3% body weight. Women of child-bearing age were less likely than older women to engage in the National Diabetes Prevention Program; however, they were equally likely to benefit from weight loss when they attended. Further efforts are needed to improve engagement of women of child-bearing age.