[Lifestyle] Women more likely to enroll in national DPP lifestyle change program

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Women are three times more likely than men to enroll in the national Diabetes Prevention Program, although once enrolled, men and women attend the same number of sessions, according to study data published in The Diabetes Educator.

“Although similar numbers of males and females were eligible for the national Diabetes Prevention Program (DPP) lifestyle change program, nearly three times as many females, compared with males, had enrolled in the lifestyle change program by the end of 2017,” Bryce D. Smith, PhD, MSSW, branch chief for translation, health education and evaluation in the division of diabetes translation at the CDC, told Healio. “One interesting finding was that, while enrollment differences between males and females persisted across ethnicity and age groups, once in the program, males and females attended about the same number of sessions.”

Smith and colleagues compiled data on the number of people eligible to be participants in the lifestyle change program and compared it with the program’s cumulative enrollment. Program eligibility was estimated using National Health and Nutrition Examination Survey data from 2011 to 2014. Adults aged 18 years or older who had a history of prediabetes or gestational diabetes, were not pregnant, and had overweight or obesity were deemed eligible. Program enrollment was calculated using data from the CDC’s Diabetes Prevention Recognition Program on participants enrolled in the lifestyle change program from February 2012 to December 2017. The data included demographic information as well as height, weight and physical activity minutes during the week preceding a session.

Slightly more men were eligible to participate in the program compared with women (32,043,820 vs. 30,861,053); however, there were more women enrolled than men (121,007 vs. 39,321). Women were about three times more likely to enroll than men (OR = 3.2; 95% CI, 3.17-3.24). The difference was unchanged after adjusting for age and ethnicity.

Although there was a large difference in enrollment by sex, researchers found no significant difference in the number of sessions men and women attended through 44 weeks. The researchers wrote that several barriers may be keeping men from enrolling in the program, including the nature of their interaction with the health care system and their perceptions of health care.

“The clinical findings from this study suggest that lifestyle change programs may benefit from tailoring enrollment and recruitment efforts to male-centered audiences when attempting to enroll more men into their programs,” Smith said.

When broken down by age, adults aged 45 to 64 years were more likely to enroll than those aged 18 to 44 years (OR = 1.46; 95% CI, 1.44-1.47), whereas those aged 65 to 75 years were less likely to enroll (OR = 0.88; 95% CI, 0.87-0.89), according to study data. Ethnicity was categorized as non-Hispanic white, non-Hispanic Black, Hispanic and other. Compared with white adults, the “other” group had the highest likelihood for enrollment (OR = 2.88; 95% CI, 2.84-2.92), whereas Hispanic adults were the least likely to participate (OR = 0.62; 95% CI, 0.61-0.63).