1546-P: Machismo and Loneliness Associated with Lower Engagement in the National Diabetes Prevention Program: A Secondary Analysis of the Power-Up Study

Introduction and Objective: The National Diabetes Prevention Program (NDPP) effectively prevents diabetes, but Hispanic and non-Hispanic Black (NHB) men demonstrate lower engagement in this lifestyle intervention. We assessed the association of sociocultural factors with NDPP engagement among Hispanic and NHB men. Methods: This is a secondary analysis of self-identifying Hispanic and NHB men enrolled in the Power-Up study, a randomized control trial of an NDPP tailored for men. NDPP-eligible men participated in remote NDPPs in English or Spanish. Baseline surveys included sociocultural measures of social connectedness (Duke Social Support Index; UCLA Loneliness Scale), nativity (in US for >10 years), and cultural masculinity ideals (Machismo; Caballerismo). Primary outcome was the number of NDPP sessions attended. Separate multivariable regression models evaluated associations between each exposure and the outcome, adjusting for demographic factors and randomization group. Results: Among 301 men participating in Power-Up, mean age was 52.1 years (SD 12.5). A majority were Hispanic (50.2%), attended at least some college (54.2%), and had a yearly income >$30,000 (50.2%). On average, participants attended 5.42 sessions (SD 7.53); 47.2% of men attended no sessions. In linear regression models, Machismo (B= -1.21 95% CI [-2.20,-0.22], p=0.017) and Loneliness (B= -2.32 95% CI[-4.14,-0.49] p=0.013) were inversely associated with NDPP engagement, including in adjusted models. Nativity, caballerismo, and social support were not significantly associated with NDPP engagement. Conclusion: Among men in Power-Up, a 1-point increase in a 5-point machismo scale or in a 3-point loneliness scale related to attending approximately 1 and 2 fewer NDPP sessions, respectively. NDPP session attendance is associated with reaching the program's 5% weight loss goal-future interventions might tailor the NDPP to address these sociocultural factors, potentially improving its effectiveness for Hispanic and NHB men. Disclosure C.J. Gonzalez: None. C. Schechter: None. E. Gil: None. E. Chambers: None. J.S. Gonzalez: None. Funding RWJF (234326), NIH (K23DK139410)