RESUMEN
Early onset diabetes has adverse transgenerational effects, yet in-person National Diabetes Prevention Programs (NDPPs) have low reach among adults of peak reproductive age. We examined participation and weight loss with online NDPPs for younger versus older adults. Solera Health, Inc., collected data from 12,966 adults who enrolled in a yearlong online NDPP from 2015 to 2018. We used general linear models and logistic regression to assess differences between younger and older adults (<45 vs. ≥45 years) in session initiation (logging in), session completion (activities approximating intensity of in-person classes), and weight loss, overall and according to engagement thresholds. Almost all (N = 12,497, 96%) individuals who enrolled initiated ≥1 session(s), but fewer (N = 2,408, 19%) completed ≥4 sessions over ≥9 months, achieving 4.5% weight loss on average. Among all enrollees with ≥2 weights (N = 10,161), younger men and women lost less weight (1.8% and 1.7%, respectively) than older men (3.3%) and women (2.7%; all p < .05). Among all enrollees who completed ≥4 sessions over ≥9 months, weight loss did not differ between older men (4.3%), older women (4.0%), and younger men (3.5%), but younger women achieved less weight loss (3.0%) than older adults (all p < .001). Online programming supports NDPP reach and weight loss, although younger adults completed fewer sessions and young women achieved less weight loss than older adults. Efforts to increase ongoing engagement among younger adults are needed to prevent early onset of diabetes and adverse transgenerational effects.