Older Adult Perspectives on Barriers and Facilitators to Participating in the Medicare Diabetes Prevention Program

Introduction and Objective: An estimated 27 million older adults have prediabetes; yet, from 2018-2024, only 9,015 Medicare beneficiaries participated in the Medicare Diabetes Prevention Program (MDPP), a fully covered benefit. Factors affecting the use of the MDPP among older adults with prediabetes have not been well-documented. The purpose of this qualitative study was to uncover barriers and facilitators to MDPP participation from the perspectives of older adults who have and have not joined the program. Methods: Two groups of adults age 65+ were recruited—current or former MDPP participants and those who were eligible for the MDPP but had not yet participated. Using a semi-structured interview guide informed by the Consolidated Framework for Implementation Research, we conducted 45-60-minute individual interviews until data saturation occurred. Interviews were conducted in-person or via Zoom, transcribed, coded, and analyzed using thematic analysis. Results: Fourteen MDPP participants and 12 non-participants aged 71.4 ± 4.9 years completed interviews (N=26). Facilitator themes included: 1) Social connection provides motivation and accountability for attendance; 2) Encouragement from healthcare providers helps older adults understand the value of the MDPP; and 3) Convenience for attending group sessions is essential. Barrier themes included: 1) Individuals are unaware of the MDPP and that there is no cost to participate; 2) Low motivation for lifestyle changes and limited understanding of their importance impede interest in participation; and 3) Online sessions are a challenge for those who are uncomfortable using technology. Participants recommended expanding MDPP awareness through endorsements from healthcare providers and strategic advertising via existing Medicare outreach materials. Conclusion: Results highlight several targets for facilitating wider MDPP participation among the millions of older adults at risk for diabetes. Disclosure: M. Turk: None. A. Firemark: None. N. Ritchie: None. Funding: National Institutes of Health (R15HL163736)