Investigating the Delivery of the National Diabetes Prevention Program to Latines: Coaches' Perspectives.

Abstract

Background: Latines (Latina/o/x) in the United States are disproportionately impacted by type 2 diabetes. Yet, the National Diabetes Prevention Program (National DPP), an evidence-based lifestyle intervention created by the Centers for Disease Control and Prevention, has not successfully reached and engaged Latine individuals. Implementation science frameworks stand to enhance the study of these disparate outcomes to promote equitable delivery of the National DPP.

Purpose: This project leverages the Consolidated Framework for Implementation Research (CFIR) to assess how Lifestyle Coaches of the National DPP deliver this intervention to Latines across the U.S. to understand disparate outcomes better.

Methods: A total of 28 Lifestyle Coaches completed a semi-structured interview based on the CFIR, which assessed potential barriers and facilitators that might impact the program's implementation to this specific population. A qualitative content analysis was conducted to identify patterns across coaches, including coding agreement through consensual validation and triangulation with an implementation science expert.

Results: Primarily related to the Inner Setting and Characteristics of Individuals domains of the CFIR, Lifestyle Coaches demonstrated a strong need for cultural humility training to improve their awareness of barriers; Lifestyle Coaches felt unprepared to deliver the National DPP to Latine participants. Additionally, coaches expressed contradicting beliefs regarding the National DPP's need for cultural adaptation, suggesting a need for reframing the DPP's original findings in the context of more recent effectiveness research.

Conclusions: Understanding Lifestyle Coach's experiences with and beliefs in delivering the National DPP to Latine participants improves our understanding of the disparities in implementing the National DPP.