Leveraging Technology and Theory to Change Health Behaviors, Close Gaps in Health-Related Social Needs, and Increase Enrollment in the National Diabetes Prevention Program
IMPLEMENTATION EVALUATION — Volume 22 — March 13, 2025
PEER REVIEWED
The figure depicts a series of 3 cycles of assessment and feedback that can repeat up to 6 times for each participant to achieve the 4 objectives of bRIght communities: 1) increase readiness to engage in key diabetes prevention behaviors; 2) increase engagement with community resources to address unmet social needs; 3) increase awareness of prediabetes risk; and 4) increase readiness to engage in the National DPP and enrollment in the National DPP. The mechanisms of bRIght communities are to build rapport and provide evidence-based individualized feedback to increase readiness and confidence by assessing and providing immediate personalized feedback on readiness and self-efficacy for fruit and vegetable consumption and physical activity, as well as administering the Prediabetes Risk Screen Test. Barriers are reduced by assessing unmet social needs and providing zip code–matched or regional resources to address them. Participants receive ongoing personalized behavior change “nudges” to activate use of behavior change strategies via tailored text messages, and behavioral economics–informed weekly drawings to drive sustained engagement.
Figure 1.
Range of objectives and strategies of bRIght communities.
A consort chart shows that 565 community members were screened for eligibility for the bRIght communities study. The flow chart reflects that 57 community members screened out for being younger than 18 years (n = 2); having been diagnosed with diabetes (n = 32); being pregnant or being unsure if they were pregnant (n = 8); or choosing not to provide informed consent to take part in the study (n = 15). An additional 76 community members did not complete baseline enrollment (n = 60) or withdrew (n = 16). A total of 432 community members enrolled. Thirty-five participants had a nonworking telephone number during the 6-month intervention period and therefore were not eligible to complete the follow-up survey. Two-hundred seventy-three of the remaining participants completed the 6-month follow-up survey, resulting in a retention rate of 68.7%.
Figure 2.
Eligibility and participation of bRIght communities participants.
This bar chart reflects how the proportion of unmet health-related social needs decreased from the first to the final session for participants in the bRIght communities program. The proportion of participants who experienced food insecurity dropped from 54.9% to 23.2%. The proportion of participants who endorsed transportation concerns decreased from 19.4% to 8.3%. At the final session, 9.4% of participants reported concerns about neighborhood safety as compared to 20.5% at the first session. The proportion of participants endorsing concerns about childcare declined from 24.4% to 20.5%.
Figure 3.
Comparison of proportion of bRIght communities participants reporting health-related social needs from first to last session.