Abstract P1143: Not So Invincible: Young Adults with Prediabetes Report Fear of Future Diabetes Motivates Behavior Change

Introduction: Young adulthood is an unmet opportunity for cardiovascular prevention. While prediabetes is often assessed in young adult primary care visits, the “young invincibles” assumption presumes youth are unmotivated by long term health. No qualitative study has garnered young adults’ perspectives on what prediabetes means to them. Methods: Semi-structured interviews in English and Spanish with outpatients ages 18-26 with prediabetes (HgbA1c or chart diagnosis) January to September 2024, at one safety net hospital and one academic medical center. We excluded patients with diabetes, or who were unaware of their diabetes risk. Interviewees were asked about diabetes risk perceptions and experiences discussing prediabetes with providers. We used thematic analysis to determine themes. Results: We interviewed 24 participants (63% female, 71% Latino/a/x, 29% Black, 61% food insecure, 39% any college). Several key themes emerged (Table 1). Participants understood prediabetes accurately and had mixed perceptions of whether diabetes was avoidable for themselves. Learning of prediabetes had a strong emotional impact, often grounded in family experiences with diabetes. Fear of diabetes prompted behavior changes, which youth largely made on their own, with short duration. Youth preferred honest, encouraging communication from providers. Conclusions Fear of future diabetes motivates behavior change for young adults. Health care providers’ conversations with young adults about prediabetes have lasting emotional impact. Providers should use honest, clear language that emphasizes the possibility of change. Strengthening connections to supportive programs could continue momentum after these conversations to facilitate lasting behavior change.