# Perceptions and Experiences of Developing Prediabetes Awareness and Participating in the National Diabetes Prevention Program Among Hispanic US Adults: Qualitative Study

## TL;DR

This study explores how Hispanic adults in the US become aware of prediabetes and participate in a diabetes prevention program, highlighting cultural and language factors.

## Contribution

The study provides new insights into prediabetes awareness and National DPP participation specifically among Hispanic adults.

## Key findings

- Participants valued culturally and linguistically congruent aspects of the National DPP.
- Local outreach efforts like radio and Facebook Live helped raise prediabetes awareness.
- Emotional responses to prediabetes diagnosis influenced participants' decisions to join the program.

## Abstract

Prediabetes 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.

This study aims to explore perceptions and experiences of developing prediabetes awareness and participating in the National DPP among Hispanic US adults.

The 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.

A 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.

This 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.