Racial and Ethnic Disparities in Diabetes Prevention Outcomes: Insights from the Prediabetes Informed Decisions and Education Study

Background: To achieve health equity, interventions should yield similar effectiveness across all patient subgroups. However, the adoption of diabetes prevention strategies and successful weight loss in “real-world” Diabetes Prevention Program (DPP) translational studies have varied by race and ethn...

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Main Authors: Yelba Castellon-Lopez, O. Kenrik Duru, Norman Turk, Gerardo Moreno, Keith C. Norris, Amanda Vu, Rintu P. Saju, Chi-Hong Tseng, Kia Skrine-Jeffers, Carol M. Mangione, Dominick Frosch, Tannaz Moin
Format: Article
Language:English
Published: Mary Ann Liebert 2024-12-01
Series:Health Equity
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Online Access:https://www.liebertpub.com/doi/10.1089/heq.2023.0186
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author Yelba Castellon-Lopez
O. Kenrik Duru
Norman Turk
Gerardo Moreno
Keith C. Norris
Amanda Vu
Rintu P. Saju
Chi-Hong Tseng
Kia Skrine-Jeffers
Carol M. Mangione
Dominick Frosch
Tannaz Moin
author_facet Yelba Castellon-Lopez
O. Kenrik Duru
Norman Turk
Gerardo Moreno
Keith C. Norris
Amanda Vu
Rintu P. Saju
Chi-Hong Tseng
Kia Skrine-Jeffers
Carol M. Mangione
Dominick Frosch
Tannaz Moin
author_sort Yelba Castellon-Lopez
collection DOAJ
description Background: To achieve health equity, interventions should yield similar effectiveness across all patient subgroups. However, the adoption of diabetes prevention strategies and successful weight loss in “real-world” Diabetes Prevention Program (DPP) translational studies have varied by race and ethnicity. We examined racial and ethnic differences in diabetes prevention outcomes among study participants from the Prediabetes Informed Decisions and Education (PRIDE) Study. Methods: In a retrospective analysis of data from the PRIDE cluster randomized trial across a large health system, we examined (1) percent weight change and (2) uptake of DPP and/or metformin among overweight/obese participants with prediabetes 12 months after participating in a pharmacist-led shared decision-making (SDM) intervention. We stratified the outcomes by race and ethnicity using a generalized linear mixed-effects model. Results: The study participants (n = 515) had an average age of 56 years (standard deviation [SD] = 11.0), hemoglobin A1c of 6.0% (SD = 0.20), and body mass index of 30.3 (SD = 5.2). Black/African American and Latino study participants lost significantly less weight at the 12-month follow-up compared with White/Caucasian participants (−1.0% and −1.2%, respectively, vs. −3.3%, p < 0.01 for both comparisons). There was no significant difference in the adoption of diabetes prevention strategies between racial and ethnic groups after completing an educational SDM intervention. Conclusion: To better promote health equity, future studies should investigate the potential causal factors for these differences in weight loss, such as variations in socioeconomic status, physical activity, cultural influences, and neighborhood characteristics.
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spelling doaj-art-9b31a553d91c4712807b8b75e5d93b052025-08-20T03:49:37ZengMary Ann LiebertHealth Equity2473-12422024-12-018165966610.1089/heq.2023.0186Racial and Ethnic Disparities in Diabetes Prevention Outcomes: Insights from the Prediabetes Informed Decisions and Education StudyYelba Castellon-Lopez0O. Kenrik Duru1Norman Turk2Gerardo Moreno3Keith C. Norris4Amanda Vu5Rintu P. Saju6Chi-Hong Tseng7Kia Skrine-Jeffers8Carol M. Mangione9Dominick Frosch10Tannaz Moin11Department of Biomedical Sciences, Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California, USA.David Geffen School of Medicine, University of California, Los Angeles, California, USA.Department of Medicine, Division of General Internal Medicine-Health Services Research, University of California, Los Angeles, California, USA.Department of Biomedical Sciences, Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California, USA.David Geffen School of Medicine, University of California, Los Angeles, California, USA.Department of Medicine, Division of General Internal Medicine-Health Services Research, University of California, Los Angeles, California, USA.David Geffen School of Medicine, University of California, Los Angeles, California, USA.Department of Medicine, Division of General Internal Medicine-Health Services Research, University of California, Los Angeles, California, USA.UCLA School of Nursing, Los Angeles, California, USA.David Geffen School of Medicine, University of California, Los Angeles, California, USA.Patient Centered Outcomes Research Institute, Washington, DC, USA.David Geffen School of Medicine, University of California, Los Angeles, California, USA.Background: To achieve health equity, interventions should yield similar effectiveness across all patient subgroups. However, the adoption of diabetes prevention strategies and successful weight loss in “real-world” Diabetes Prevention Program (DPP) translational studies have varied by race and ethnicity. We examined racial and ethnic differences in diabetes prevention outcomes among study participants from the Prediabetes Informed Decisions and Education (PRIDE) Study. Methods: In a retrospective analysis of data from the PRIDE cluster randomized trial across a large health system, we examined (1) percent weight change and (2) uptake of DPP and/or metformin among overweight/obese participants with prediabetes 12 months after participating in a pharmacist-led shared decision-making (SDM) intervention. We stratified the outcomes by race and ethnicity using a generalized linear mixed-effects model. Results: The study participants (n = 515) had an average age of 56 years (standard deviation [SD] = 11.0), hemoglobin A1c of 6.0% (SD = 0.20), and body mass index of 30.3 (SD = 5.2). Black/African American and Latino study participants lost significantly less weight at the 12-month follow-up compared with White/Caucasian participants (−1.0% and −1.2%, respectively, vs. −3.3%, p < 0.01 for both comparisons). There was no significant difference in the adoption of diabetes prevention strategies between racial and ethnic groups after completing an educational SDM intervention. Conclusion: To better promote health equity, future studies should investigate the potential causal factors for these differences in weight loss, such as variations in socioeconomic status, physical activity, cultural influences, and neighborhood characteristics.https://www.liebertpub.com/doi/10.1089/heq.2023.0186shared decision makingdiabetes preventionracial and ethnic disparitiesevidence-based interventionsweight loss
spellingShingle Yelba Castellon-Lopez
O. Kenrik Duru
Norman Turk
Gerardo Moreno
Keith C. Norris
Amanda Vu
Rintu P. Saju
Chi-Hong Tseng
Kia Skrine-Jeffers
Carol M. Mangione
Dominick Frosch
Tannaz Moin
Racial and Ethnic Disparities in Diabetes Prevention Outcomes: Insights from the Prediabetes Informed Decisions and Education Study
Health Equity
shared decision making
diabetes prevention
racial and ethnic disparities
evidence-based interventions
weight loss
title Racial and Ethnic Disparities in Diabetes Prevention Outcomes: Insights from the Prediabetes Informed Decisions and Education Study
title_full Racial and Ethnic Disparities in Diabetes Prevention Outcomes: Insights from the Prediabetes Informed Decisions and Education Study
title_fullStr Racial and Ethnic Disparities in Diabetes Prevention Outcomes: Insights from the Prediabetes Informed Decisions and Education Study
title_full_unstemmed Racial and Ethnic Disparities in Diabetes Prevention Outcomes: Insights from the Prediabetes Informed Decisions and Education Study
title_short Racial and Ethnic Disparities in Diabetes Prevention Outcomes: Insights from the Prediabetes Informed Decisions and Education Study
title_sort racial and ethnic disparities in diabetes prevention outcomes insights from the prediabetes informed decisions and education study
topic shared decision making
diabetes prevention
racial and ethnic disparities
evidence-based interventions
weight loss
url https://www.liebertpub.com/doi/10.1089/heq.2023.0186
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