What does this research mean for the field?

Sustaining the National Diabetes Prevention Program requires a combination of multiple financing strategies, grant funding, and cost-control measures, as current reimbursement rates are insufficient to cover delivery costs. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To identify strategies that organizations use to sustain the delivery of the National Diabetes Prevention Program over time.

June 7, 2026

1072-OR: How Organizations Sustain the National Diabetes Prevention Program: A Qualitative Study

Key Points

To identify strategies that organizations use to sustain the delivery of the National Diabetes Prevention Program over time.
Conducted qualitative interviews with 21 coordinators from various organizations that sustained NDPP delivery for five or more years.
Sampled organizations across all US regions and types to capture a broad perspective.
Analyzed data thematically to uncover successful financial sustainability strategies.
Organizations had averaged 8.5 years of NDPP delivery, with strategies including grants, billing third-party payers, and self-pay.
Only one organization was fully sustainable through billing alone, indicating reliance on multiple funding sources.
Cost-control strategies involved low-cost recruitment, virtual delivery, and minimizing administrative overhead.

Abstract

Introduction and Objective: The National Diabetes Prevention Program (NDPP) is an evidence-based lifestyle intervention that reduces the risk of type 2 diabetes. Over 3,000 organizations have adopted the NDPP, but over half have since discontinued services, often due to challenges with financial sustainability. To address problematic de-adoption of the NDPP, we examined organizations that have sustained program delivery over time to identify strategies that may be adopted by other programs. Methods: In this qualitative study, we interviewed 21 coordinators from organizations that had sustained NDPP delivery for five or more years and planned to continue delivery. Organizations were sampled to include all US regions and organization types. Interviews focused on implementation practices related to operations and financing. Data were analyzed thematically to identify successful strategies for financial sustainability. Results: Interviewees represented a range of settings: community-based organizations (n=9), healthcare organizations (n=8), local health departments (n=2), and universities (n=2). Organizations had delivered the NDPP for 8.5 years (SD=2.7) on average. Most relied on multiple financing strategies, including grant and institutional funding, billing third-party payers, self-pay options, and charitable donations. Only one organization described a program that was fully sustainable through billing alone. Cost-control strategies focused on low-cost recruitment channels, minimum group sizes, virtual delivery, reducing administrative overhead, and using volunteer and part-time coaches. Conclusion: Organizations can sustain NDPP delivery through multiple strategies for program financing and cost control. Despite expanding payer coverage, grant funding and in-kind support remain critical, highlighting the gap between reimbursement rates and delivery costs. These strategies may help other organizations strengthen and sustain access to the NDPP while reimbursement models continue to evolve. Disclosure N. Ritchie: None. M. Turk: None. Funding NIH (R15HL163736)

Mark Helpful

Bookmark

Relay