Racial Disparities in Diabetes Prevention Program Participation Among Asian American Communities

Abstract

Background: Despite being one of the fastest-growing racial groups in the United States, Asian Americans face disproportionately low participation in Diabetes Prevention Programs (DPPs), despite having a higher risk of developing type 2 diabetes at lower body mass index (BMI) thresholds. Participation remains under 12% among eligible Asian Americans compared to 23% among non-Asians. These disparities are exacerbated by intersecting barriers, including cultural stigma, language inaccessibility, structural rigidity of DPP models, and the “model minority” myth, which contributes to systematic underinvestment in outreach and tailored interventions for Asian communities.

Materials and Methods: This mixed-methods study integrates a comprehensive literature review with primary data collection. Quantitative data were collected via community surveys targeting 200 Asian American participants, while qualitative data came from two focus groups and key informant interviews. The study employs the Socio-Ecological Model (SEM) as a theoretical framework to examine individual, interpersonal, organizational, community, and policy-level barriers. Project deliverables include a multilingual, culturally tailored DPP toolkit, a community outreach guide, a training module for healthcare professionals, and a policy brief informed by successful legislative models such as California’s SB97.

Results: Findings revealed significant barriers to DPP participation: 62% of Asian Americans face language obstacles, and 74% disengage from culturally non-adapted content. Only 18% of DPPs in the U.S. offer substantial cultural modifications. Structural constraints, such as scheduling conflicts and lack of accessible locations, disproportionately impact immigrant communities. However, programs integrating cultural sensitivity, language adaptation, and flexible delivery methods showed marked improvements in retention (up to 92%) and enrollment (up to 137%). Disaggregated data analysis also revealed subgroup differences, with U.S.-born Asians participating at rates 40% higher than foreign-born peers.

Conclusion: To close the gap in DPP participation among Asian Americans, public health strategies must move beyond uniform interventions and adopt culturally, linguistically, and structurally tailored approaches. This study demonstrates that addressing stigma, improving access, and recognizing subgroup diversity through community-rooted, policy-supported initiatives can significantly enhance DPP engagement and reduce type 2 diabetes risk. These findings inform future national frameworks aimed at equity in diabetes prevention for racially diverse populations.