Innovation in Community-Based Health Promotion Programming: Reimagining the Greater Boston YMCA Diabetes Prevention Program

Abstract

Type 2 diabetes – the seventh leading cause of death in the United States – is a chronic condition that is generally preventable. In 2014, the YMCA of Greater Boston (Boston YMCA) launched a modified version of the evidenced-based National Diabetes Prevention Program to support individuals with prediabetes in addressing modifiable risk factors for diabetes and potential complications. Now at the five-year mark, the Boston YMCA management team aims to redesign its Diabetes Prevention Program to expand its footprint in the local health promotion landscape and increase the likelihood of positive, sustainable lifestyle change for participants. Potential long-term objectives for the Boston YMCA Diabetes Prevention Program (YDPP) are (1) to move toward parity in program offerings by launching, tracking, and maintaining high-quality YDPPs at each branch and (2) to develop and implement community-clinical linkages to streamline participant recruitment and provider-patient communication. This DELTA (Doctoral Engagement in Leadership and Translation for Action) project examined the diabetes prevention services and supports landscape to map key internal and external stakeholders and identify potential YDPP collaborators. Key themes from qualitative interviews with Boston YMCA executive and branch leadership highlighted neighborhood-level factors that impact enrollment in lifestyle modification programming and opportunities to streamline internal policies and procedures to improve recruitment, lifestyle coach training, participant retention, and data reporting for YDPP. From YDPP participant surveys and Boston YMCA staff focus groups emerged viable, actionable recommendations for YDPP redesign and relaunch. Looking forward, the Boston YMCA may consider implementing a supplemental, wrap-around health and wellness program – the Year of You™ – to demonstrate improved participant outcomes under a holistic care model that accounts for the social and economic drivers of health inequities.