Engaging Hispanic Men in the National Diabetes Prevention Program (NDPP)—A Comparative Qualitative Study Examining Influences on Low Engagement

Introduction and Objective: Hispanic men have a relatively high prevalence of diabetes but relatively low rates of enrollment and engagement in preventive interventions like the NDPP. This qualitative study aimed to comprehensively explore influences unique to Hispanic men with low engagement in the NDPP, compared to those with high engagement, with the goal of informing strategies to improve their engagement in the program. Methods: Participants were self-identified Hispanic men, aged ≥18 years, at risk for diabetes per electronic medical records at an urban outpatient network, and invited to the NDPP. They completed individual audio-recorded interviews in English and Spanish. Using Nvivo, transcripts were analyzed deductively, informed by the Theoretical Domains Framework, to identify influences on engagement in the NDPP. Codes emerging uniquely among those with low engagement (attendance at <4 NDPP sessions) were identified through consensus. Results: Of 32 Hispanic men interviewed, 15 had low engagement in the NDPP. More of those with low engagement had limited English proficiency and did not complete high school. Three major themes delineated their Capacity, Motivations, and Opportunities for engaging with the NDPP. They expressed limited awareness of their prediabetes diagnosis, felt self-sufficient about enacting lifestyle change, and were skeptical about their diabetes risk and the utility of the NDPP. They also mentioned financial barriers and limited access to the program. Conclusion: Addressing the unique barriers faced by Hispanic men in engaging with the NDPP is critical to reducing diabetes-related inequities and may require tackling knowledge gaps, financial barriers, and perceptions of program relevance before, during, and after enrollment. Future research should explore how to tailor recruitment strategies and program content to Hispanic men’s specific identities, motivations, and challenges. Disclosure: C.J. Gonzalez: None. C.N. Perez-Mejia: None. N. Hernandez: None. H. Flaxman: None. C. Stephenson-Hunter: None. E.N. Gil: None. T. Formagini: None. E. Chambers: None. J.S. Gonzalez: None. Funding: Robert Wood Johnson Foundation (234326-01); UCSF Research in Implementation Science for Equity Subaward (R25HL126146 Subaward No 13969sc); National Heart, Lung, and Blood Institute (T32HL079891); National Institute of Diabetes and Digestive and Kidney Diseases (3R01DK121896); National Institute of Diabetes and Digestive and Kidney Diseases (3P30DK111022)