Outcome dissimilarities in age group and delivery modality studied in the prediabetes Lifestyle Change Program conducted by Virginia Cooperative Extension

Abstract BACKGROUND : The National Diabetes Prevention Program established by the Centers for Disease Control and Prevention promotes the implementation of an evidence-based lifestyle change program (LCP) to prevent or delay the onset of diabetes. The LCP is a 12-month program with 26 lessons covering topics on healthy diets, increasing physical activity, managing stress, and coping with triggers, among others. It includes weekly goal-setting, food and physical activity tracking, and group support. The program goals are 5-7% sustained weight loss and 150 minutes of physical activity weekly. Little is known about the real-world effectiveness of the LCP in different age groups, particularly in older adults. OBJECTIVES : The aim of this study was to evaluate the effects of age on LCP outcomes conducted by Virginia Cooperative Extension between 2018–2022 with the following objectives: (a) Evaluate the effects of age on LCP outcomes in different age groups. (b) Evaluate how LCP delivery methods (in-person and distance learning) influence program outcomes. PARTICIPANTS : 189 participants enrolled in the LCP, 139 (73%) completed eight or more sessions, and 56% were above 60 years of age. Among the enrolled population, 51% of participants enrolled in the distance learning LCP program, while 49% preferred in-person. METHODS : To assess the differences in LCP outcomes between different age groups and delivery modalities, we performed t-tests followed up by post-hoc tests. RESULTS : At six months, participants 60 years and older had significantly higher attendance compared to participants under 60 years old (17 vs. 15, p<0.001). When considering the program delivery methods, participants 60 years and older had significantly higher attendance in distance learning programs by the end of six (15 vs. 17, p<0.001) and 12 months (18 vs. 21, p<0.001). Also, this age group who attended the distance learning programs had significantly higher weight loss compared to those who attended the in-person program at the end of the six months (4.61% vs. 2.07, p=0.02). Meanwhile, 86 persons (62%) had at least an average of 150 minutes of physical activity per week by the end of the program. Among them, the majority were 60 and older (67%) and enrolled in in-person programs (64%). CONCLUSION : The results showed that older participants were more successful than their younger counterparts in meeting LCP goals. These findings suggest that targeting different age groups and intervention delivery methods can improve program outcomes.