The City of New York employs over 380,000 people and is the largest employer in New York City (NYC). In 2015, the City's newly-created workplace wellness initiative, WorkWell NYC, began a pilot implementation of the National Diabetes Prevention Program (NDPP). NDPP is a Centers for Disease Control and Prevention (CDC)-recognized program that aims to prevent or delay the onset of type 2 diabetes. The NDPP is a yearlong, evidence-based program that helps participants at risk of diabetes to eat a healthier diet, increase physical activities, set goals, and manage stress. One of the goals of the NDPP for the participant is to lose 5 to 7% of their initial body weight through moderate changes in both diet and physical activity. Initially offered in-person at two NYC government agencies, the NDPP was later expanded, and an online version was offered in 2017. The New York Academy of Medicine (NYAM) partnered with WorkWell NYC (a program within New York City's Office of Labor Relations) to evaluate the effectiveness and participant experiences of the two versions. While effectiveness of the NDPP has been evaluated by many, this research contributes to the literature in its focus on worksite implementation and implementation using two modalities. The evaluation team used a mixed-methods approach that involved 190 participants from seven NYC agencies (129 from the in-person program and 61 from the online program). Participants were asked about their health-related behaviors, challenges, and self-reported health at baseline and after 16 sessions. Weight, attendance, and minutes of physical activity were collected at each session. NYAM also conducted focus groups and interviewed participants after completion of 16 sessions. At the 16th session, the in-person group had an average weight loss of 10.1 pounds (4.9% of initial body weight), compared to the average weight loss of 6.3 pounds (3.7% of initial body weight) among the online group. The weight loss results were greater than the NDPP average but fell short of CDC's 5% goal. There were improvements in self-reported health, dietary behavior, and physical activity in both groups, but these findings were only statistically significant among the in-person group. While both the in-person and online participants had high levels of engagement and good adherence to the program, in-person participants had higher levels of satisfaction with the program and the lifestyle coach. Both groups noted that offering the NDPP at their workplace made it easier for them to participate. Reducing the burden of type 2 diabetes through lifestyle intervention is an important strategy to build a healthy workforce. Providing such evidence-based programs in the workplace allows greater participation and engagement. Ongoing monitoring and evaluation can provide important information for quality assurance and improvement for both in-person and online diabetes prevention programs.
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