Abstract P350: Modifiable Features of a Group Weight Loss Program: The Patient Perspective

Introduction: The Group Lifestyle Balance™ (GLB) program is an adaptation of the landmark Diabetes Prevention Program (DPP) group lifestyle intervention that is approved by the Centers for Disease Control and Prevention as a model curriculum for diabetes (T2D) prevention. While participation in the program has been associated with clinically significant weight loss and decreases in other risk factors for T2D and cardiovascular disease in community settings, participant retention and sustained engagement throughout the 12-month program have been major challenges. Little is known about participant preference for key customizable structural aspects of program delivery that are known to influence program acceptability. Hypothesis: We hypothesized that there are features of GLB that can be customized by the delivery system to enhance recruitment and retention. Methods: We conducted a discrete choice experiment at Sutter Health, a large integrated healthcare system in northern California. We invited 122,744 patients who met DPP eligibility criteria and had elevated BMI (>25), to complete an online survey. The questions were constructed to address four aspects of the structure of the program: delivery mode (in-person vs online); timing of sessions (day and time of day); facilitator (lifestyle coach vs. lifestyle coach with extra formal training); session format (group vs group plus 1:1). Three cohorts answered four different questions - each with 2 choices to determine optimal design of the program. We also asked participants to rate qualities of the facilitator and the group according to importance. Results: Surveys were completed by 6,923 (5.6%) of those invited. Two-thirds of respondents reported they would rather meet online with live video than in-person (64.2%, 1556 of 2425) and preferred the program be set in the health system (68.6%, 1664 of 2425). Most preferred the addition of private sessions (72.8%, 3273 of 4498), and a lifestyle coach with formal clinical training (80.9%, 1962 of 2425). A plurality of respondents rated facilitator personal experience with weight management as important/very important (45.2%, 3132 of 6923) and the majority also reported importance of teaching experience, and professional training (50.0%, 3456; 71.2%, 4932; both of 6923, respectively). One-quarter reported that it was important/very important for the other participants to be of similar age and sensitive to cultural differences (25.4%, 1759; 23.7%, 1639; both of 6923, respectively). Conclusions: This study identified patient preferences for several modifiable features of GLB (delivery mode, timing, session format) and several group factors. Understanding and optimizing these factors to meet the needs of participant subpopulations may be an important mechanism for improving intervention uptake and retention. Multivariable analysis is forthcoming to determine preferences for subgroups.