(PS1-90) Lifestyle Coach Perceptions of Barriers and Facilitators to Participation Among Black and Latinx National Diabetes Prevention Program Participants

Despite the disproportionate impact of type 2 diabetes on racial/ethnic groups that have been marginalized, existing lifestyle interventions to prevent diabetes  have not effectively engaged and retained these populations. To effectively meet the needs of these groups, a better understanding of barriers and facilitators to lifestyle interventions to prevent type 2 diabetes is needed. The U.S. Department of Health and Human Services’ social determinants of health (SDOH; e.g., economic stability) framework was utilized to examine barriers and facilitators to participation and lifestyle change in the National Diabetes Prevention Program (National DPP) from the perspective of Lifestyle Coaches delivering the intervention to participants from Black and Latinx communities. Using an online survey, Lifestyle Coaches reported on barriers to participation and lifestyle change observed among participants and strategies to facilitate engagement and retention in the National DPP. We qualitatively coded and summarized the responses of coaches who served majority Black (n = 26) or majority Latinx (n = 21) participants. The two groups of Lifestyle Coaches shared five of the seven most commonly endorsed barriers: lack of time off work, low motivation, cost/access to healthy food, conflicts with work schedule, and lack of confidence in ability to make healthy lifestyle change. Both groups shared the same four most endorsed strategies to bolster success: offering makeup sessions, sending reminders before an upcoming class, offering “session 0” or “pre-session” before the National DPP starts, and offering smaller incentives for participating (e.g., cookbooks, scales). Results illustrate the impact that SDOH have on individuals’ ability to engage in diabetes prevention, suggesting a tailored approach may be necessary to effectively reach Black and Latinx participants. This presentation will highlight the importance of incorporating broader social and environmental factors in behavioral health intervention design and implementation.