Document Type

Thesis

Date of Degree Completion

Spring 2021

Degree Name

Master of Public Health (MPH)

Department

Health Sciences

Committee Chair

Jill Hoxmeier

Second Committee Member

Amie Wojtyna

Third Committee Member

Casey Mace Firebaugh

Abstract

Approximately 34.2 million U.S. adults were diagnosed with type 2 diabetes in 2018 and diabetes prevalence is projected to reach 60.6 million by 2060. A predicted 88 million adults have prediabetes, but only 15.3% have been diagnosed by a medical provider. Approximately 15-30% of the population with prediabetes will develop diabetes within 5 years without lifestyle modification to decrease risk. Reduced incidence of diabetes is an urgent priority for Healthy People 2030 and increased participation in lifestyle change programs is a primary objective. The Diabetes Prevention Program promotes behavior modification to prevent or delay diabetes. Despite evidence to support effective intervention, many individuals with prediabetes do not engage in behavior modification to lower their risk; therefore, it is critical to understand the factors that influence individual motivation to engage in risk reduction behaviors. A prediabetes diagnosis based on a clinical blood test or self-risk assessment is required for enrollment in the program and thus, the purpose of this study is to examine whether participants who completed the program have different outcomes based on their mode of diagnosis of prediabetes.

This research used archival data from participants (N =793) in Diabetes Prevention Programming, 46.7% (n = 370) reported clinical testing and 53.3% (n = 423) completed a self-test for program enrollment. A quantitative non-experimental cross-sectional design was conducted to explore the association between mode of diagnosis—clinical blood test or self-risk assessment on outcomes of attendance, physical activity, and weight loss in a diabetes prevention program. Results for the measures of attendance, physical activity, and measures of goal completion outcomes indicate significant results that reject the null hypothesis that there is no difference in outcomes between the two sample groups. The study measures for percentage of weight loss were not significant and failed to reject the null hypothesis. Increased understanding of the mechanisms by which diagnosis method may impact outcomes could be used to inform screening procedures and policies as well as communication strategies for participation. The results may influence physician attitudes regarding patient self-assessment and provide new opportunity to analyze outcomes of diabetes prevention programming on population health.

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