Differences in Weight Loss by Race and Ethnicity in the PRIDE Trial: a Qualitative Analysis of Participant Perspectives

J Gen Intern Med. 2022 Apr 25:1-8. doi: 10.1007/s11606-022-07521-5. On-line forward of print.

ABSTRACT

BACKGROUND: Many Diabetes Prevention Program (DPP) translation efforts have been much less efficient for underresourced populations. Within the cluster-randomized Prediabetes Knowledgeable Resolution and Schooling (PRIDE) trial, which evaluated a shared decision-making (SDM) intervention for diabetes prevention, Hispanic and non-Hispanic Black individuals misplaced much less weight than non-Hispanic White individuals at 12-month follow-up.

OBJECTIVE: To discover views about weight reduction from PRIDE individuals of various racial and ethnic teams.

PARTICIPANTS: Pattern of individuals with prediabetes who had been randomized to the PRIDE intervention arm (n=24).

APPROACH: We carried out semi-structured interviews inside three teams stratified by DPP participation and % weight reduction at 12 months: (DPP+/WL+, enrolled in DPP and misplaced >5% weight; DPP+/WL-, enrolled in DPP and misplaced <3% weight; DPP-/WL-, didn’t enroll in DPP and misplaced <3% weight). Every group was additional subdivided on race and ethnicity (non-Hispanic Black (NHB), non-Hispanic White (NHW), Hispanic). Interviews had been carried out on Zoom and transcripts had been coded and analyzed with Dedoose.

KEY RESULTS: In comparison with NHW individuals, Hispanic and NHB individuals extra usually endorsed weight reduction boundaries of restricted time to make life-style modifications as a consequence of lengthy work and commute hours, inconvenient DPP class places and choices, and restricted disposable revenue for additional weight reduction actions. Conversely, facilitators of weight reduction no matter race and ethnicity included retirement or having versatile work schedules; having the ability to establish handy DPP lessons; having a powerful, optimistic assist system; and buying supplementary assets to assist life-style change (e.g., gymnasium memberships, one-on-one exercise lessons).

CONCLUSIONS: We discovered that NHB and Hispanic SDM individuals report sure boundaries to weight reduction extra generally than NHW individuals, significantly boundaries associated to restricted disposable revenue and/or time constraints. Our findings recommend that elevated life-style change assist and versatile program supply choices could also be wanted to make sure fairness in DPP attain, participant engagement, and outcomes.

PMID:35469358 | PMC:PMC9037581 | DOI:10.1007/s11606-022-07521-5