Cooperative Extension Delivery of the National Diabetes Prevention Program: Outcomes by Age Group and Delivery Modality

Objective: To examine differences in attendance, weight loss, and physical activity across age groups and delivery modalities in the National Diabetes Prevention Program lifestyle change program (LCP) delivered by Cooperative Extension. Methods: We conducted a retrospective analysis of de-identified program data collected from January 2018 through August 2022. Of 189 enrolled participants, 139 attended at least eight sessions and were included in the outcome analyses. Outcomes at 6 and 12 months were compared by age group (<60 vs. ≥60 years) and delivery modality (in-person vs. synchronous distance learning). Results: Fifty-three percent of participants were aged ≥60 years, and 51% participated through distance learning. At 6 months, participants aged ≥60 years attended more sessions than younger participants (p < 0.001). Among participants aged ≥60 years, those in distance learning attended more sessions than those attending in person at 6 months (17.11 vs. 14.82; p < 0.001) and 12 months (21.28 vs. 17.69; p < 0.001) and achieved greater weight loss at 6 months (4.61% vs. 2.07%; p = 0.02). Overall, 35% achieved at least 5% weight loss, and 62% averaged at least 150 min of physical activity per week by program completion. Conclusions and Implications: Selected outcomes differed by age group and delivery modality. Among adults aged ≥60 years, synchronous distance learning was associated with higher attendance and greater short-term weight loss and may help expand access to evidence-based diabetes prevention. These findings should be interpreted cautiously because delivery modality was not randomly assigned and outcome measurement differed by modality.