An Examination of Gender Differences in the National Diabetes Prevention Program's Lifestyle Change Program.

PURPOSE: The purpose of the study was to examine how gender was related to enrollment and number of sessions attended in the National Diabetes Prevention Program's Lifestyle Change Program (DPP LCP). METHODS: To better understand program uptake, a population of those who would be eligible for the LCP was compared to those who enrolled. Estimates of those eligible were computed using data from the National Health and Nutrition Examination Survey, whereas enrollment and sessions attended were computed using data from the Centers for Disease Control and Prevention's Diabetes Prevention Recognition Program. RESULTS: Results revealed that although similar numbers of males and females were eligible for the program, only 39 321 males versus 121 007 females had enrolled in the National DPP LCP by the end of 2017 (odds ratio = 3.20; 95% CI, 3.17-3.24). The gender differences persisted even when stratifying by age or race/ethnicity. In contrast, no significant gender differences were found between the average number of sessions attended for males (14.0) and females (13.8). DISCUSSION: Results of the study can help inform efforts to market and tailor programs to appeal more directly to men and other groups that are underrepresented in the National DPP LCP.

Retention Among Participants in the National Diabetes Prevention Program Lifestyle Change Program, 2012-2017.

OBJECTIVE: To assess retention in the National Diabetes Prevention Program (DPP) lifestyle change program, which seeks to prevent type 2 diabetes in adults at high risk. RESEARCH DESIGN AND METHODS: We analyzed retention among 41,203 individuals who enrolled in Centers for Disease Control and Prevention (CDC)-recognized in-person lifestyle change programs at organizations that submitted data to CDC's Diabetes Prevention Recognition Program during January 2012-February 2017. RESULTS: Weekly attrition rates were typically <1-2% but were between 3.5% and 5% at week 2 and at weeks 17 and 18, where session frequency typically transitions from weekly to monthly. The percentage of participants retained through 18 weeks varied by age (45.9% for 18-29 year olds, 53.4% for 30-44 year olds, 60.2% for 45-54 year olds, 66.7% for 55-64 year olds, and 67.6% for ≥65 year olds), race/ethnicity (70.5% for non-Hispanic whites, 60.5% for non-Hispanic blacks, 52.6% for Hispanics, and 50.6% for other), mean weekly percentage of body weight lost (41.0% for ≤0% lost, 66.2% for >0% to <0.25% lost, 72.9% for 0.25% to <0.5% lost, and 73.9% for ≥0.5% lost), and mean weekly physical activity minutes (12.8% for 0 min, 56.1% for >0 to <60 min, 74.8% for 60 to <150 min, and 82.8% for ≥150 min) but not by sex (63.0% for men and 63.1% for women). CONCLUSIONS: Our results demonstrate the need to identify strategies to improve retention, especially among individuals who are younger or are members of racial/ethnic minority populations and among those who report less physical activity or less early weight loss. Strategies that address retention after the first session and during the transition from weekly to monthly sessions offer the greatest opportunity for impact.

Association between C-reactive protein and depression: modulated by gender and mediated by body weight.

Literature on the relationship between depression and C-reactive protein (CRP), a biomarker of systematic inflammation, remains inconsistent. Insufficient adjustment for confounders and effect modifiers might be one explanation. We used the data of 6396 men and 6610 women aged 18 or older, who completed a depression screening and had blood collected as a part of the National Health and Nutrition Examination Survey, 2005-2010. Depression was measured using the 9-item depression scale of the Patient Health Questionnaire (PHQ-9). The odds ratios (ORs) of depression were 1.00 (reference), 1.89 (95% CI=0.77-4.67) and 3.41(1.25-9.25) respectively for men with low, intermediate and upper quartile of CRP. Adjustment for covariates, mainly body mass index, diminished the association among women, from 1.65(1.00-2.74) to 1.08(0.57-2.03) for intermediate, from 2.44 (1.43-4.16) to 1.05 (0.56-1.98) for upper quartile of CRP. Adjustment for the history of major medical illnesses changed ORs neither among men nor among women. The study concluded that CRP remained significantly associated with depression in a dose-response fashion among men but women after being adjusted for body weight. Abnormal body weight, both under and overweight, explained a substantial part of the relationship between CRP and depression among women.