Enhancing the Diabetes Prevention Program to Promote Weight Loss Among Non-Responders in a Community Based Lifestyle Intervention

T2D is a persistent public health and clinical crisis, with 12.4% of the US adult population affected. Disparities also persist, with Non-Hispanic Blacks adults almost twice as likely than non-Hispanic Whites to have a T2D diagnosis, 50% higher morbidity and mortality and are at substantially higher risk of diabetes-related complications. Obesity is the number one and most preventable T2D risk factor; 87% of US adults are overweight or obese and Blacks carry a disproportionate burden of obesity with 47% of adult Blacks being obese compared to 37.9% of Whites. The Diabetes Prevention program demonstrated that weight loss as small as 5% is clinically meaningful, yet 40-60% of intervention participants do not achieve the weight loss goal. A critical barrier to obesity treatment is that the current delivery model is group-based, during group-based interventions, individual participant response is not assessed until the end of the intervention; therefore, potential nonresponders are not identified and provided with enhanced treatment. Evidence suggests that a weight loss of