Sociodemographic, Clinical, and Psychosocial Predictors of Short- and Long-term Study Retention in the Diabetes Prevention Program (DPP) Outcomes Study (DPPOS).

Authors

• Ashley H Tjaden
• Barbara H Braffett
• Nicole M Butera
• Maria Rosario Araneta
• Owen Carmichael
• Erik J Groessl
• Helen P Hazuda
• Mary A Hoskin
• Uzoma Ibebuogu
• Michelle F Magee
• Marjorie Mau
• Tamara Stich
• Diana Soliman
• Amisha Wallia
• Marinella Temprosa
• Sherita H Golden

Publication/Presentation Date

10-1-2025

Abstract

OBJECTIVE: Success of longitudinal studies depends on retention of participants. We examined characteristics as predictors of retention among participants with prediabetes and type 2 diabetes (T2D) in the Diabetes Prevention Program (DPP) and the follow-up DPP Outcomes Study.

RESEARCH DESIGN AND METHODS: A total of 3,234 adults at high risk of T2D joined the DPP (1996-1999, mean age 51 ± 10 years). They were randomized to lifestyle, metformin, or placebo intervention, and then followed through 2020. Logistic regression models estimated the association between baseline sociodemographic, clinical and psychosocial characteristics (life events, family functioning, social support), and short-term retention (∼3 years). Cox proportional hazards models, censoring at death, estimated the association between baseline and time-varying characteristics and time to dropout over the entire 20 years of follow-up.

RESULTS: Among surviving participants (n = 3,218), 93% were retained after 3 years, and 75% of those surviving remained engaged over 20 years. Younger age was associated with dropout during DPP and over 20 years of follow-up. Female sex, non-White race and ethnicity, employment, and lack of baseline depressive symptoms were associated with better long-term retention. Over time, better health state (SF-36) (hazard ratio [HR]: 0.89 per 0.1 point; 95% CI: 0.83-0.95) was associated with retention. Greater BMI (HR: 1.06 per 5 kg/m2; 95% CI: 1.00-1.12), more recent life events (HR: 1.08; 95% CI: 1.02-1.14), and depressive symptoms (HR: 1.11 per 5 points; 95% CI: 1.05-1.18) were associated with reduced retention. Among adults 45-59 years of age at baseline, development of T2D was associated with better retention (HR: 0.75; 95% CI: 0.58-0.97).

CONCLUSIONS: Twenty-year retention of a racially and geographically diverse cohort with prediabetes is possible. Retention was associated with age, psychosocial factors, T2D development, and BMI.

Volume

48

Issue

10

First Page

1685

Last Page

1694

ISSN

1935-5548

Published In/Presented At

Tjaden, A. H., Braffett, B. H., Butera, N. M., Araneta, M. R., Carmichael, O., Groessl, E. J., Hazuda, H. P., Hoskin, M. A., Ibebuogu, U., Magee, M. F., Mau, M., Stich, T., Soliman, D., Wallia, A., Temprosa, M., Golden, S. H., & Diabetes Prevention Program Research Group (2025). Sociodemographic, Clinical, and Psychosocial Predictors of Short- and Long-term Study Retention in the Diabetes Prevention Program (DPP) Outcomes Study (DPPOS). Diabetes care, 48(10), 1685–1694. https://doi.org/10.2337/dc25-0520

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

40541257

Department(s)

Administration and Leadership

Document Type

Article