Neighborhood Vulnerability and Participation of Men in a Virtual Diabetes Prevention Program in New York City

Introduction and Objective: Research on participation in the National Diabetes Prevention Program (DPP) primarily focuses on individual level factors such as demographics and health beliefs, while largely overlooking the impact of neighborhood context. We aim to examine neighborhood vulnerability as a factor influencing the likelihood of participation in a DPP intervention for men. Methods: The Area Deprivation Index (ADI) State Ranking is a validated census tract-based neighborhood level score reflecting a neighborhood’s socioeconomic disadvantage relative to others in the state. The men included in this study were recruited as part of the Power-Up virtual DPP trial for men, identified based on National DPP eligibility from the electronic health records of a large academic medical center and a network of small-to-medium independent primary care practices throughout New York City. Power-Up was a 12-month DPP weight loss trial delivered online between Oct 2021 - Aug 2024. Participation in Power-Up was defined by: enrollment - agreeing to participate in the trial, and engagement - attending 4+ DPP sessions vs. 0-3 DPP sessions. The association between ADI and both enrollment and engagement was examined using logistic regression, adjusting for age. Results: Of the 601 men consented to participate in Power-Up, 572 were eligible for this study based on a complete residential address. Eligible participants had a median age of 50 years (SD: 9 years) and median ADI of 5 (SD: 1 rank), ranging from 1 (least disadvantaged) to 9 (most disadvantaged). Of 295 enrolled men, 109 attended 4+ sessions. In the adjusted analysis, there were higher odds of enrollment (OR=1.14, 95% CI: 1.05-1.25), but not engagement (OR=1.02, 95% CI: 0.92-1.14), with increasing ADI. Conclusion: These findings suggest that while neighborhood disadvantage is associated with enrollment, other factors may be important for sustaining long term engagement. Disclosure: K. Diaz: None. J.S. Gonzalez: None. E. Chambers: None. Funding: National Institutes of Health (R01-DK121896)