Shared Decision-Making Participants Highlight Time and Financial Barriers to Weight Loss

Dr. Divya C Ragate, Medical Director, Consultant Adult and Pediatric Endocrinologist Avantis Super Speciality Clinic, Bengaluru
Senior Specialist, Department of Endocrinology, Aster CMI Hospital, Hebbal, Bengaluru

Among participants in a shared decision-making diabetes prevention intervention, Hispanic and non-Hispanic Black adults more commonly reported time and financial barriers to weight loss than non-Hispanic White adults.

A study from the Prediabetes Informed Decision and Education (PRIDE) trial explored why weight loss outcomes differed among people with prediabetes from different racial and ethnic groups. Previous diabetes prevention efforts have often been less successful among underresourced populations, underscoring the need to better understand the factors that influence participation and weight loss.

The study aimed to examine participants’ views and experiences related to weight loss after taking part in a shared decision-making intervention for diabetes prevention. Researchers conducted semi-structured interviews with 24 participants who had been assigned to the PRIDE intervention arm. Participants were grouped based on whether they enrolled in a Diabetes Prevention Program (DPP) and the amount of weight they lost over 12 months.

The groups also included Hispanic, non-Hispanic Black, and non-Hispanic White participants. Interviews were conducted online, and the responses were analyzed to identify common themes. Compared with non-Hispanic White participants, Hispanic and non-Hispanic Black participants more frequently described barriers such as long work and commuting hours, inconvenient DPP class schedules or locations, and limited financial resources for additional weight loss activities.

Across all groups, factors that supported weight loss included flexible schedules, access to convenient DPP classes, strong social support, and the ability to use extra resources such as fitness programs. The findings suggest that more flexible program delivery and additional support may help improve participation and weight loss outcomes across diverse populations.

(Reference: Saju R, Castellon-Lopez Y, Turk N, Moin T, Mangione CM, Norris KC, Vu A, Maranon R, Fu J, Cheng F, Duru OK. Differences in weight loss by race and ethnicity in the PRIDE trial: a qualitative analysis of participant perspectives. Journal of General Internal Medicine. 2022 Apr 25;37(14):3715..)