Abigail Arons, University of California, Davis, School of Medicine, San Francisco, CA, United States; Mai Baalbaki, University of California, San Francisco, School of Medicine, Berkeley, CA, United States; Nicole M. Ozuna Resendiz, University of California, San Francisco, School of Medicine, San Pablo, CA, United States; Amy Beck, University of California, San Francisco, School of Medicine, San Francisco, CA, United States
University of California, Davis, School of Medicine San Francisco, California, United States
Background: Nearly a quarter of emerging adults (ages 18-25) have prediabetes, yet lifestyle interventions in this age group face well-documented challenges with recruitment and retention. Solutions might include hosting interventions in non-traditional spaces (e.g. colleges, youth centers) and adaptation of adult programs (e.g. Diabetes Prevention Program [DPP]) to meet emerging adults' needs. However, implementation science demonstrates that organizational settings vary in their capability and preparation for hosting interventions. Objective: To explore the Acceptability, Appropriateness and Feasibility of potential organizational settings for diabetes prevention interventions tailored to emerging adults. Design/Methods: We conducted semi-structured interviews January to May 2025 with program managers and leaders from 3 organization types in 1 region: 1) DPP providers, 2) community-based organizations (CBOs) serving emerging adults, and 3) community college health or basic needs centers (CCs). The interviews addressed implementation principles in 3 domains relevant to early-stage intervention planning: Appropriateness (essential skills and functions), Acceptability (mission alignment, prioritization), and Feasibility (available resources to enable success. We determined themes using thematic analysis within these pre-specified domains, only analyzing Feasibility themes for the organization types that demonstrated both Appropriateness and Acceptability. Results: We interviewed 17 participants (5 DPP, 5 CBO, and 7 CC; Table 1). All organization types reported some Appropriateness (Table 2), with DPP having more experience with diabetes prevention content, and CBOs and CCs having greater reach and insight into youth-specific needs. DPPs reported low Acceptability, seeing emerging adults as outside their missions and low priority. In contrast CBOs and CCs saw greater alignment and priority. We next analyzed Feasibility for CBOs and CCs (Table 3), finding that while both had strong relevant partnerships and social needs supports to enable youths' engagement with interventions, CCs stood out for their access to physical spaces, relevant staff expertise, and funding streams that could support diabetes prevention activities.
Conclusion(s): Identifying organizational settings that reach emerging adults at high-risk for diabetes and have interest and capacity for intervention is an important first step to developing scalable, sustainable prevention interventions for this population. We found high acceptability and appropriateness in both CBOs and CCs, with highest feasibility in CCs.
Table 1. Interviewee characteristics
Table 2. Themes and example quotes relevant to Acceptability and Appropriateness
Table 3. Themes and example quotes relevant to feasibility
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