Reach of a Fully Digital Diabetes Prevention Program in Health Professional Shortage Areas

Abstract

The National Diabetes Prevention Program (NDPP) offers lifestyle change education to adults at risk for diabetes across the United States, but its reach is curbed due, in part, to limitations of traditional in-person programs. Diabetes Prevention Programs (DPPs) that are fully digital may increase reach by overcoming these barriers. The aim of this research was to examine the reach of Lark's DPP, a fully digital artificial-intelligence-powered DPP. This study assessed geographic features and demographic characteristics of a sample of Lark DPP commercial health plan members with complete data (N = 16,327) and compared several demographic features with a large composite sample of members from DPPs across the nation (NDPP; N = 143,489) and a National Health Interview Survey (NHIS) sample of prediabetic adults in the United States (NHIS; N = 2118). Examination of the Lark DPP sample revealed that 24.4% of members lived in rural areas, 30.8% lived in whole county health professional shortage areas, and only 7.6% of members lived in a zip code with an in-person DPP. When comparing the Lark sample with the NDPP and NHIS samples, Lark DPP enrollees tended to be younger and have a higher body mass index (BMI) (p's < 0.001). Lark provides convenient access to a DPP for individuals living in hard-to-reach areas who may face barriers to participating in in-person or telephonic DPPs or who prefer a digital program. Compared with the NDPP sample, Lark is also reaching younger and higher BMI users, who are traditionally difficult to enroll and have a high need for intervention.

Keywords: artificial intelligence; diabetes prevention program; digital health; prediabetes; rural health.

FIG. 1.

Lark members by HHS region. HHS, Health and Human Services.

FIG. 2.

Lark members by HPSA designation, rurality, and DPP access type. DPP, Diabetes Prevention Program; HPSA, health professional shortage area.

FIG. 3.

Proportion of individuals in each BMI category for NHIS, NDPP, and lark samples. BMI, body mass index; NDPP, National Diabetes Prevention Program; NHIS, National Health Interview Survey.