1504-P: PRECEDE: Using an Implementation Framework to Codesign a Peer-Support Enhanced Diabetes Prevention Program

Introduction and Objective: The Diabetes Prevention Program (DPP), a community-based program that promotes risk reduction through weight loss, has shown limited success in socioeconomically and culturally diverse populations. Peer support is a well-received, yet underutilized, form of social support linked to improvements in diabetes self-management and weight loss. The objective of this study was to co-develop implementation strategies to address barriers and facilitators to implementing the DPP enhanced with two forms of peer support (dyadic and a community-led group) in churches in medically underserved areas. Methods: We conducted semi-structured interviews and focus groups with community members and then created an eight member community advisory board (CAB). This study was guided by PHASE 1 and 2 (identify desired outcomes and behavior change), Phase 3 (identify and categorize barriers and facilitators as predisposing, enabling, and reinforcing factors), and Phase 4 (identify implementation strategies) of the PRECEDE-PROCEED implementation framework. Directed content analysis was used to analyze interview transcripts. Results: Interviewees and the CAB identified desired outcomes (e.g, healthier families and communities, improved diabetes knowledge) and strategies to address predisposing factors (e.g., perceived value of community led weight loss groups, church values, familial influence; Example strategy - invite participants’ family members to a class); enabling factors (timing of peer support components, dyad matching, dyad communication; Example strategy - teach participants effective dyadic communication techniques), and reinforcing factors (peer accountability, pastoral support, dyad competition; Example strategy - weekly giveaways to dyads with the best attendance, outcomes, knowledge retention) that may affect program implementation. Conclusion: This academic-community partnership led to the co-development of potentially feasible implementation strategies for a peer support enhanced DPP. Disclosure C. Conley: None. F.L. Liao: None. T. Kosturanova: None. A. Mays: None. G. Piatt: None. Funding American Diabetes Association (CTDR-20); University of Michigan, Michigan Institute for Clinical and Health Research (5-UM-TR-004404-02)