Diabetes prevention program outcomes by in-person versus distance delivery mode among ethnically diverse, primarily lower-income adults.

Objective: Physical activity and weight loss outcomes of a diabetes prevention program were compared for ethnically diverse adults, with the majority participating in public assistance programs. Outcomes were compared for those who completed the program in person versus by distance delivery. Methods: A two-group, pre-post study design compared National Diabetes Prevention Program outcomes based on in-person delivery (2018-2020 pre-COVID-19 pandemic, n = 47) and distance delivery (after March 2020, n = 31). Outcomes were measured or self-reported depending on the delivery method. Linear mixed models with a random intercept for coach and covariates were used to assess delivery mode group differences in percent weight loss and weekly physical activity minutes. Results: Completion rates were similar by in-person versus distance delivery mode (57% vs. 65%). Among those who completed the program, the mean age was 58 years, the mean baseline body mass index was 33, and 39% were Hispanic. The majority were female (87%), participating in a public assistance program (63%), and living in a micropolitan area (61%). Percent weight loss was greater in the distance delivery group (7.7%) compared to the in-person group (4.7%) in the unadjusted analysis (p = 0.009) but not when adjusted for covariates. No differences were observed in adjusted weekly physical activity minutes between the in-person (219 min) versus the distance group (148 min). Conclusions: No differences were observed by delivery mode in percent weight loss or weekly physical activity minutes, indicating that distance delivery does not compromise program effectiveness.