Diabetes prevention program outcomes by in-person versus distance delivery mode among ethnically diverse, primarily lower-income adults.

Objective: Physical activity and weight loss outcomes of a diabetes prevention program were compared for ethnically diverse adults, with the majority participating in public assistance programs. Outcomes were compared for those who completed the program in person versus by distance delivery. Methods: A two-group, pre-post study design compared National Diabetes Prevention Program outcomes based on in-person delivery (2018-2020 pre-COVID-19 pandemic, n = 47) and distance delivery (after March 2020, n = 31). Outcomes were measured or self-reported depending on the delivery method. Linear mixed models with a random intercept for coach and covariates were used to assess delivery mode group differences in percent weight loss and weekly physical activity minutes. Results: Completion rates were similar by in-person versus distance delivery mode (57% vs. 65%). Among those who completed the program, the mean age was 58 years, the mean baseline body mass index was 33, and 39% were Hispanic. The majority were female (87%), participating in a public assistance program (63%), and living in a micropolitan area (61%). Percent weight loss was greater in the distance delivery group (7.7%) compared to the in-person group (4.7%) in the unadjusted analysis (p = 0.009) but not when adjusted for covariates. No differences were observed in adjusted weekly physical activity minutes between the in-person (219 min) versus the distance group (148 min). Conclusions: No differences were observed by delivery mode in percent weight loss or weekly physical activity minutes, indicating that distance delivery does not compromise program effectiveness.

Feasibility of a remotely delivered program to prevent Latino adolescent obesity in the Midwestern USA.

Adolescent obesity prevention programs focusing on Latino fathers may be useful to address Latino adolescent obesity. Adolescent obesity has become an urgent issue because of the coronavirus disease 2019 pandemic, with limited ability to deliver prevention programs in-person. This study aimed to assess the feasibility of a community-based, adolescent obesity prevention program for Latino father-adolescent dyads delivered remotely, adapted from the in-person Padres Preparados, Jóvenes Saludables program. A quasi-experimental design was used to assess the feasibility of the remotely delivered program based on criteria adapted from other feasibility studies of community-based health promotion programs for Latino families. Father-adolescent dyads were recruited at two sites in a Midwestern state during 2020; mothers were also encouraged to participate. Recruitment met the feasibility criteria (65 families expressed interest between August and October) with 26 families participating in this study. The retention ratio (percentage of participants who completed a post-session survey to those who completed the baseline survey) among fathers was acceptable (77%), while a lower percentage of adolescents were retained (68%). The session attendance ratio (number of sessions attended of the eight total sessions offered) was higher among adolescents (88%) and lower among fathers (68%) compared to the criteria. Satisfaction ratings (≥88%) and completeness of data collection at both baseline and post-session survey (≥76%) were acceptable. Favorable results were obtained for parent outcomes, while adolescent outcomes were not favorably changed. This remotely delivered adolescent obesity prevention program was feasible for Latino fathers; however, additional engagement with adolescents may be needed.

Adolescent obesity became a more urgent issue because of the coronavirus disease 2019 pandemic with less physical activity under lockdown, more food insecure families and limited in-person access to programs. Our study concluded that a remotely delivered version of a community-based, adolescent obesity prevention program for Latino father­adolescent dyads (the Padres Preparados, Jóvenes Saludables program) was feasible based on participation, satisfaction and parent outcomes. Additional engagement in activities to improve adolescent health behaviors may be needed to improve the overall effectiveness of the program.