(1057) Barriers and Facilitators to Translating the Diabetes Prevention Program in Rural Church Settings: Perspectives of Church Leaders and Lifestyle Coaches

Objectives: Diabetes is the seventh leading cause of death in the United States, affecting over 30 million adults. The Centers for Disease Control and Prevention’s Diabetes Prevention Program (DPP) is an effective lifestyle intervention to reduce or prevent type 2 diabetes. Several studies have translated the DPP into “real-world” settings. However, limited knowledge exists about the factors that influence the translation of DPP into rural communities.

The objective of this study was to gain an in-depth understanding of barriers and facilitators to translating the DPP in rural settings via faith-based organizations and provide recommendations for improvement.

Methods: This study utilized a cross-sectional study design. Purposive sampling was used to recruit 30 participants, comprising 15 church leaders and 15 lifestyle coaches affiliated with churches implementing the DPP in rural areas. Currently, semi-structured interviews are being conducted to investigate participants’ beliefs and experiences related to translating the DPP in rural church settings. Interview questions are guided by the Consolidated Framework for Implementation Research (CFIR). Thematic analysis is being used to identify key themes, including barriers and facilitators, related to DPP translation. These emergent themes will be further organized and classified according to CFIR constructs. The study’s rigor is ensured by following Lincoln and Guba’s (1985) four trustworthiness criteria: credibility, transferability, dependability, and confirmability. An iterative consensus process is being adopted to maintain consistency and achieve inter-coder agreement. COREQ guidelines will be used to report study findings.

Results: Nine interviews are complete, with data collection ongoing until data saturation is reached. Several facilitators emerged from the initial data analysis, including a supportive church leadership structure, organizational compatibility, financial assistance, community interest in adopting healthier lifestyles, participant incentives, participants' openness to sharing their weekly dietary/physical activity goals and achievements, and biweekly support calls/meetings with the research team. Key barriers identified included limited time for recruiting participants, transportation issues, and work-related commitments. Additional barriers elicited by interviewees included the perception held by some DPP participants that the program offered a quick-fix solution to their health issues. Concerns were raised about people’s expectations for quick results, which could potentially result in attrition or reduced commitment to the DPP's longer-term preventive efforts.

Conclusions: Preliminary findings identified key factors that may impact the translation of DPP in rural communities. These initial findings underscore the need for tailored strategies that leverage facilitators while proactively addressing barriers to improve future program planning/development and ensure the successful translation of DPP in rural settings. As the study progresses and the remaining interviews are completed, a comprehensive understanding of the challenges and opportunities in translating the DPP within rural communities is anticipated. This understanding may contribute to informing program planning and development aimed at enhancing DPP outcomes in rural communities.