Document Type

Masters Project

Abstract

Type 2 diabetes is a significant and growing public health concern, disproportionately affecting American Indian and Alaska Native populations. The Diabetes Prevention Program (DPP) has demonstrated effectiveness in reducing diabetes risk through lifestyle modification. However, implementation in rural and geographically isolated regions presents unique challenges. The COVID-19 pandemic further disrupted in-person delivery models, creating the need for rapid transformation to virtual formats.

This graduate project evaluated the implementation of a virtually delivered Prevent T2 at Chief Andrew Isaac Health Center program in the Tana Chiefs Conference region. This program was adapted for distance delivery using Zoom and supported by collaboration with information technology and communication departments. Program evaluation was guided by the RE-AIM framework and included three data sources: participant surveys, employee interview, and a lifestyle coach self-assessment.

Results indicated high participant satisfaction, strong engagement, and attendance rates ranging from 91% to 100%. Participants achieved clinically significant weight loss, with average reductions of 12.8% and 9.7% across two cohorts, exceeding program goals. Key factors supporting success included consistent communication, culturally relevant materials, and flexible program delivery. Identified barriers included technology access, challenges with self- monitoring behaviors, limited access to healthy foods, and constraints on physical activity in rural environments.

These findings demonstrate that virtual DPP delivery is a feasible and effective approach for diabetes prevention in both rural and urban Alaska. This model expands access to underserved populations and provides a sustainable program for overcoming geographic barriers. Future efforts should focus on enhancing digital engagement strategies, improving access to supportive technologies, and strengthening community partnerships to address social determinants of health and optimize program outcomes.

Publication Date

5-1-2026

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