Translation and Impact of the National Diabetes Prevention Program in Two Rural Settings: Participant Outcomes, Individual Experiences, and Recommendations
Bibliographic record
Abstract
Background/Objectives: The National Diabetes Prevention Program (National DPP) assists individuals with lifestyle change for type 2 diabetes risk reduction through education, skills, and support. To further understand program effectiveness, implementation research needs to consider influences on retention, effectiveness, and sustainability of the program in rural settings. The purpose of this study was to understand National DPP implementation in two rural workplace settings as well as the factors that influence program participation and outcomes. Methods: Individuals who met criteria for being at risk for developing type 2 diabetes participated in two National DPPs. The first program (Technology-Augmented DPP) occurred in 2016 with the goal of understanding the role of psychosocial factors in relation to National DPP outcomes, and quantitative data were obtained from 47 participants. Variables of interest included the Lifestyle-Health-Related Self-Concept questionnaire (HRSC), weight, and physical activity. The second program (Hybrid-Format DPP) occurred in 2022 with the goal of understanding individual participant experiences within the program by conducting a reflexive thematic analysis on data obtained during a semi-structured group interview with 3 participants. Results: In the Technology-Augmented DPP, Lifestyle-HRSC dimensions of nutrition, social support, avoiding diabetes, and problem solving were associated with weight, steps per day, and activity minutes. In the Hybrid-Format DPP, the generated themes included Frequency Matters, Rules of Engagement, Promoting Self-Efficacy, and Bridging the Intention-Behavior Gap. Conclusions: Based on this study, a focus on understanding and responding to context-specific and participant-focused National DPP implementation is the essential next step in National DPP research. Prevention programs and policies individualized to people and communities will improve participation and outcomes. The National DPP should consider how to evolve to the changing needs of at-risk individuals in rural and underserved areas.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".