Preferences for receiving diabetes prevention support and factors influencing healthy eating and physical activity and among patients with prediabetes in Chicago, Illinois.

Objective: Lifestyle interventions that promote healthful eating and physical activity are recommended for individuals with prediabetes. However, individuals with low-income and racial and ethnic minority groups tend to be underserved by these programs. Therefore, this study aimed to examine patient preferences for delivery of diabetes prevention support and factors influencing healthful eating and physical activity in this sample of patients. Methods: Data from this qualitative study were collected from January 2023 through May 2023. Semi-structured interviews were conducted with 35 patients with prediabetes (hemoglobin A1c: 5.7 to 6.4 %) detected from screening in an urban emergency department in Chicago, Illinois. The emergency department primarily serves a racially and ethnically diverse patient population, especially individuals with low income. Themes were generated using both inductive and deductive methods. Initial codes were guided by the Capability, Opportunity, and Motivation Model for Behavior Change and Theoretical Domains Framework. Results: Most patients (85.7 %) were interested in diabetes prevention support and preferred text-based delivery with some interaction. Patients were aware (84 %) that diabetes could be delayed or even prevented but had limited knowledge of prediabetes and its management. Overall, patients were highly motivated to engage in lifestyle change; however, individuals that experienced food insecurity or lived in unsupportive environments encountered unique barriers. Conclusion: These findings highlight areas where diabetes prevention support (e.g., programs, services) can align their implementation with patient preferences and address basic needs. Taking such action might enhance uptake and engagement among groups at higher risk of diabetes who may not usually receive such support.