Service user experiences of a nationally implemented diabetes prevention programme in England: a qualitative interview study

INTRODUCTION: Type 2 diabetes (T2D) is a chronic condition linked to obesity that affects millions of people within England. Behaviour change interventions implemented worldwide targeting weight loss have been effective in preventing T2D. In response to this, the NHS Diabetes Prevention Programme (NHS-DPP) was introduced in 2016, and was the first initiative in England to implement a diabetes prevention programme at scale. The current study investigates service users' experiences of attending in-person sessions of the NHS-DPP when the programme was first rolled out.

METHODS: Semi-structured interviews were conducted with service users ( n  = 20) after they completed the programme. Interviews were transcribed verbatim and analysed using a framework approach to thematic analysis.

RESULTS: Three themes were produced. Mindset Shift: whilst the participants did not always maintain their behaviour changes, they experienced a change in mindset towards T2D and their current behaviours. Content tailoring: the participants described how the lack of content tailoring towards culture and the starting weight of participants within the programme negatively impacted their experiences. Social experiences: participants reported that the programme's group format and wider social support from their friends and family were important for engaging with and maintaining behaviour change.

DISCUSSION: The current study identifies how diabetes prevention programmes can promote behaviour changes and mindset shifts to support diabetes prevention. However, greater content tailoring, particularly concerning culturally informed food preferences and encouraging social support for participants, may improve the long-term effectiveness and engagement of diabetes prevention programmes.