Understanding Latino Individual and Family Perspectives in a National Diabetes Prevention Program.

Importance: Latino/a adults in the US are at higher risk for developing type 2 diabetes and are less likely to achieve goals in the National Diabetes Prevention Program (NDPP) than non-Latino/a White adults. Little is known about the barriers and facilitators to diabetes prevention behaviors among Latino/a adults. Objective: To describe the perspectives of Latino/a NDPP participants regarding barriers and facilitators to diabetes prevention behaviors. Design, Setting, and Participants: This qualitative study using semistructured phone interviews with Spanish-speaking Latino/a adults who participated in a community-based NDPP in an urban and suburban area of Colorado was conducted from June 2022 to August 2023. Main Outcome and Measures: The primary outcome was themes and subthemes reflecting individual and family support perspectives. Interviews were audio-recorded and transcribed. An inductive thematic analysis was conducted. Results: In total, 22 Spanish-speaking Latino/a participants, including 17 women (77%) and 5 men (22%) with a mean (SD) age of 44 (8) years, were interviewed. The interviews revealed 5 themes with respective subthemes. The first theme and subthemes described the perceived impact of culture and self-perception (frustration and presence of self-critical beliefs, perceived traditional gender roles, and internalized cultural biases of health behaviors) on diabetes prevention behaviors. The next 2 themes described family as reciprocal catalysts for diabetes prevention action (perceived family exercise engagement, dietary education influencing family eating habits, and collective emotional impact and accountability) and having a culturally and linguistically aligned program to support participants (perceived support and motivation from community health workers, culturally and linguistically concordant information as essential, and perceived peer support through shared experiences). The last 2 themes described reflection on personal motivation for behavior change (family diabetes lived experience awareness and motivation, desire to model lifestyle behaviors, and perceived mental health and spiritual appreciation) and desired program components for family inclusion (perceived role of knowledge for family participation, structured family-friendly wellness activities, and preventing diabetes among children). Conclusions and Relevance: In this qualitative study of Spanish-speaking Latino/a adults, participating in a diabetes prevention program, gender roles and internalized cultural biases were perceived as barriers to engaging in diabetes prevention behaviors, while family support and culturally aligned programming served as key facilitators. These findings may be used to improve diabetes prevention programs in Latino communities.