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Since the Diabetes Prevention Program Research Group (2002) concluded that type 2 diabetes [T2D] can be prevented or delayed in pre-diabetic individuals, translation of the study’s intensive lifestyle intervention has been a research priority. Translational research conducted with the high-risk Hispanic population is in its infancy. In general, the needs of this population for the development and refinement of interventions to prevent T2D have been neglected. This qualitative study explored intervention components and the perceived facilitators and barriers to making and sustaining dietary and physical activity behavior changes within the context of a lifestyle intervention program designed for a high-risk Hispanic population. This study also explored the impact of the lifestyle intervention program and individual behavior change on the lives of participants. Three focus group interviews and one individual interview were conducted with 17 uninsured, predominantly Spanish-speaking individuals who completed a lifestyle program offered by a free urban community health clinic in the northeast region of the U.S. A moderator’s guide with semistructured interview questions was used. Interviews were translated and transcribed verbatim. Data analysis was conducted using an inductive data-driven approach. Krueger and Casey’s (2000) criteria for coding and Sandelowski’s (1995) suggestions for qualitative data analysis provided guidance for analysis. Participants described the program they attended as (1) a novel learning experience that provided practical and detailed information, (2) a supportive environment that was motivating and encouraging and (3) a catalyst for changing dietary and physical activity behaviors. Participants voiced the desire to both maintain changes and have access to more program sessions with opportunities for physical activity. Participants described rapidly adopting multiple dietary and physical activity behaviors by linking health behavior to health outcomes and self-regulating through cognitive processes. Three facilitators of dietary and physical activity behaviors were identified: (1) physical and emotional benefits, (2) social support and (3) persistence. Barriers identified were physical sensations, social and emotional aspects of everyday life and unawareness of healthy food options. Program impact included a preference for life after making behavior changes, an increased consciousness that helped sustain behaviors and the desire to continue forward. Participants also recognized the effect their individual changes had on others. In summary, this study found that education, in-person support and program duration were important components of a lifestyle intervention program for a high-risk Hispanic population. Further research is needed to explore tailoring of evidence-based lifestyle interventions and issues related to the sustainability of programs aimed at reducing T2D in high-risk populations.

Understanding the Barrier and Facilitators of Lifestyle Intervention Programs for Preventing Diabetes in High Risk Hispanic Adults