A Qualitative Study Exploring Diabetes Prevention Intervention Needs and Ideas Among Young Adults at High Risk for Diabetes.

OBJECTIVE

To explore perspectives of young adults with prediabetes and high burden of social needs about their intervention needs and ideas for solutions to enable behavior change.

DESIGN

Qualitative study with semistructured interviews.

SETTING

One safety-net hospital and 1 academic medical center in a US city.

PARTICIPANTS

Twenty-four publicly-insured adults aged 18-26 years with prediabetes (63% female, 71% Latino/a/x, 29% Black, 61% food insecure, and 39% any college; mean age 22.6 years).

PHENOMENON OF INTEREST AND VARIABLES: Internal and external factors affecting dietary and exercise behaviors, within the Capability-Opportunity-Motivation-Behavior framework.

ANALYSIS: Data were analyzed using a general inductive approach followed by directed content analysis within the Capability-Opportunity-Motivation-Behavior framework.

RESULTS

Participants reported few intervention needs regarding Capability, with sophisticated nutrition knowledge and an accurate understanding of prediabetes. Major Opportunity needs emerged, including the high cost of food not offset by the food safety net, internalized effects of immersion in unhealthy environments, and low control over time. Motivation varied: most desired to avoid diabetes, but interviewees had mixed perceptions of their risk and self-efficacy. Interviewees shared 23 Intervention Ideas to address identified needs.

CONCLUSIONS

Our findings can inform youth-centered multimodal diabetes prevention interventions for young adults at high risk of diabetes that leverage existing knowledge, address Opportunity barriers, and differentiate among subgroups with varying motivation.