InGEAR Network Funding

Identifying Effective Media and Messaging to Enroll Rural Populations in the Online LCP

The project team generated evidence-based recommendations on the lowest effective media dose, optimal marketing mix, and most effective messaging to successfully enroll rural populations in the online LCP. The project revealed that a 6-month, small quantity, paid media campaign is not effective on its own for increasing enrollment. However, the team identified several effective tactics for rural settings. The team also provided guidance on creating an effective ad, optimizing paid media efforts (both digital and traditional) to enroll rural populations, and designing messaging and frequency that showed promise.

This project was a collaboration between FHI 360 and DDT.

National DPP Employer Adoption Study

The project team conducted research to understand barriers and facilitators to employer adoption and coverage of the National DPP LCP. Team members used literature reviews as well as interviews with insurance brokers, wellness consultants, and employers. They also assessed current employer-focused materials to identify potential gaps. Through the formative research, team members determined that the main barrier was lack of knowledge about the program. The team developed, implemented, and evaluated an intervention to encourage program adoption. Tailored materials were developed to:

• Educate insurance brokers about the National DPP LCP.
• Encourage health benefits consultants to offer coverage.
• Support employer adoption of the program as a covered benefit.
• Support employer implementation of the program.

Information on program cost effectiveness was also made available for employers and insurers.

This project was a collaboration between Abt Associates and DDT.

Using Social Media Research and Analysis to Increase Engagement

Researchers used social media research and listening, internet search analytics, and website usage data to gain insight into how National DPP LCP audiences engage with key terminology related to prediabetes. Researchers also looked at how this engagement has—or has not—evolved over time. The project used advanced analytics tools and artificial intelligence technologies, such as machine learning and natural language processing, to develop insights into how the National DPP can use social media to increase recruitment, enrollment, and retention for the LCP.

A few recommendations from this project include:

• Use paid media to attract more participants instead of free media.
• Look for collaboration opportunities with companies.
• Use keywords for effective marketing, such as diabetes prevention, diabetes, prediabetes, diabetes education, prediabetic diet recommendations, and type 2 diabetes.

This project was a collaboration between Guidehouse and DDT.

Examining Lifestyle Coach and Master Trainer Characteristics Associated With Participant Engagement and Retention

The project team examined training factors associated with successful implementation and sustainability of the National DPP LCP among organizations that employ Master Trainers. Using quantitative and qualitative methods, researchers analyzed organizational, Lifestyle Coach, and Master Trainer characteristics, as well as data outcomes. The data were collected from existing records, surveys with study participants, and interviews with organization stakeholders, Master Trainer Select participants, and Lifestyle Coaches. The first manuscript was published in Implementation Science Communications.

This project was a collaboration between Emory University's Diabetes Training and Technical Assistance Center and DDT.

Testing the Effectiveness of a Text-Based Strategy to Streamline Enrollment in the National DPP

The goal of Text TODAY was to package and streamline the pathway of enrollment in the National DPP LCP by putting actionable information into the hands of the program participant. Text TODAY was promoted through geographically targeted social media, traditional media, and strategic state and local partners in selected media markets. The project prompted people to use a mobile device to text TODAY (or HOY if using Spanish), take the Prediabetes Risk Test, and take appropriate action based on their test result. People receiving a high risk score were referred to the National DPP LCP, and program staff reached out to initiate enrollment. Of the estimated 400,000 people reached by the media campaign, 180 people texted the keyword and 111 people completed the Prediabetes Risk Test. Of those 111, 33 people received a status of high risk for prediabetes and five people enrolled and attended at least one session of a National DPP LCP.

Researchers noted that the multi-step process may have led to lower-than-expected enrollment. Ideas to improve future enrollment include segmenting the potential audience, tailoring materials to each audience, and marketing the media campaign through community-based organizations in the same communities.

This project was a collaboration between the National Association of Chronic Disease Directors (NACDD) and DDT.

The Effect of Mobile 360° Videos and MAPS on Enrollment in the National DPP

The project team tested the real-world efficacy of mobile 360° videos and a motivational coaching approach known as Motivation and Problem Solving (MAPS) to increase enrollment in the National DPP LCP. The study's key outcomes were data on LCP enrollment and 4-week engagement. In addition, the team collected data on the cost effectiveness and scalability of the interventions. Researchers conducted a three-armed, randomized clinical trial comparing enrollment and 1-month engagement in the LCP among adults with prediabetes from two health care settings. People who received standard prediabetes risk notification and education were compared to participants invited to view two mobile 360° videos and participants who received up to five short MAPS coaching sessions via telephone. Results revealed no effects of risk notification, mobile 360° videos, or MAPS coaching sessions on enrollment rates in the National DPP LCP.

This project was a collaboration between the University of Utah and DDT.

Development and Evaluation of a Family Approach to the National DPP LCP

Through the Family Approach pilot study, researchers assessed whether the enrollment of mutually supportive dyads (pairs) in the National DPP LCP positively affected enrollment rates, retention rates, program satisfaction, and overall program completion. For this project, a dyad could be spouses/partners, parents and adult children, or any combination of friends/family members with close contact or some influence on food and physical activity choices. One or both members of the dyad may be eligible to participate in the National DPP LCP. Overall, retention of participants at the end of the yearlong program was 79% for those at risk of type 2 diabetes and 72% for all participants. Twenty of 34 dyads (59%) completed the program.

This project was a collaboration between FHI 360 and DDT.

Using Community Pharmacies to Expand Access to the National DPP

The project team increased the number of CDC-recognized National DPP LCP providers in rural and medically underserved communities. The team worked with independent pharmacies to train pharmacists and pharmacy technicians to identify, recruit, engage, and retain participants in the program. The goal was to address social determinants of health in rural areas (shortage of health care providers, limited access to health information, etc.) and increase access to patient education that would help pharmacy consumers reduce their risk of developing type 2 diabetes. Findings included facilitators and barriers to program implementation, such as increasing enrollment in the LCP, addressing staffing shortages, addressing cost, using the data collection system, and retaining participants during the COVID-19 public health emergency.

Best practices included using existing community partnerships (churches, health-focused organizations, and large employers such as school districts) to increase recruitment and enrollment, developing comprehensive retention plans, and using pharmacy technicians as Lifestyle Coaches.

This project was a collaboration among the National Community Pharmacists Association, OmniSys, the Association of Diabetes Care & Education Specialists, and DDT.

Engaging the Mobile Workforce in the National DPP Through Audio Content

This project aimed to help long-haul truckers overcome work-specific barriers to and reap the benefits of participating in the National DPP LCP through a podcast series. The intent was to deliver key messages of CDC's PreventT2 curriculum as a complement to the online LCP. The team used interviews, focus groups, and observations of truckers in their working environment to understand the intended audience and inform the development of the podcast series. Researchers created 22 podcast episodes to supplement the PreventT2 curriculum and tested portions of the content to ensure it resonated with the intended audience before developing the full series. Researchers used quantitative and qualitative methods to assess the comparative effectiveness of the podcasts through a demonstration project. Findings from the demonstration study suggest that the intervention was successful.

This project was a collaboration between ICF Next and DDT.