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. 2023 Dec;30(6):904-913.
doi: 10.1007/s12529-022-10146-x. Epub 2023 Jan 11.

Attendance, Weight Loss, and Participation in a Behavioural Diabetes Prevention Programme

Stavros Poupakis  1 , Maria Kolotourou  2 , Harry J MacMillan  2 , Paul M Chadwick  3
Affiliations

Attendance, Weight Loss, and Participation in a Behavioural Diabetes Prevention Programme

Stavros Poupakis et al. Int J Behav Med. 2023 Dec.

Abstract

Background: Weight loss in diabetes prevention programmes has been shown to be associated with participants' age, socio-economic status, and ethnicity. However, little is known about how these differences relate to attendance and whether such differences can be mediated by other potentially modifiable factors. Differential effectiveness across these factors may exacerbate health inequalities.

Method: Prospective analysis of participant data collected by one provider of the standardised national NHS diabetes prevention programme in England. Mediation analysis was performed via a structural equation model to examine whether the number of attended sessions mediated the associations of age, socio-economic status, and ethnicity with follow-up weight. The group-level factor of number of attended sessions was examined using multiple linear regression as a benchmark; multilevel linear regression using three levels (venue, coach, and group); and fixed effects regression to account for venue-specific and coach-specific characteristics.

Results: The associations of age, socio-economic status, and ethnicity with follow-up weight were all mediated by the number of attended sessions. Group size was associated with attendance in an inverted 'U' shape, and the number of days between referral and group start was negatively associated with attendance. Time of day, day of the week, and the number of past groups led by the coach were not associated with attendance.

Conclusion: Most of the differences in weight loss initially attributed to socio-demographic factors are mediated by the attendance of the diabetes prevention programme. Therefore, targeted efforts to improve uptake and adherence to such programmes may help alleviate inequalities.

Keywords: Behavioural change; Diabetes prevention programme; Health inequalities; Weight loss.

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Figures

Fig. 1
Fig. 1
Mediation analysis graph and equations for estimated models
Fig. 2
Fig. 2
Flowchart of participants
Fig. 3
Fig. 3
Weight loss predictions based on interactions of sessions attended with age, socio-economic status, and ethnicity
See this image and copyright information in PMC

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