Purpose The purpose of this study was to understand barriers and facilitators to engagement in a diabetes prevention program for young women at an urban safety-net health care system. Methods Individual semistructured interviews (N = 29) explored motivations, challenges, and successes regarding participation and suggestions for improvement among women aged 18 to 39 years who enrolled in the National Diabetes Prevention Program in the past 2 years. Participants were classified as nonattendees (n = 10), early-withdrawers (n = 9), or completers (n = 10). Interview transcriptions were analyzed using a grounded hermeneutic editing approach. Results Qualitative analysis revealed 4 main themes (enrollment, attendance, experience, and suggestions) with multiple subthemes. Most women were motivated to enroll for health and family concerns. Early-withdrawers and nonattendees reported confusion about the program’s aim and relevancy, logistical barriers, and lack of connection with fellow participants/coaches. Highly engaged women noted persistent motivation, perceived weight loss, and supportive program relationships. Conclusions Multiple barriers/facilitators for young women appear addressable in future adaptations. Additional research is needed to confirm these findings in other settings and explore implementation and effectiveness of adaptations, with a goal of reducing risks prior to conception.

中文翻译：

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育龄妇女参与国家糖尿病预防计划的障碍和促进因素：一项定性研究

目的 本研究的目的是了解在城市安全网卫生保健系统中参与针对年轻女性的糖尿病预防计划的障碍和促进因素。方法 个人半结构式访谈 (N = 29) 探讨了过去 2 年参加国家糖尿病预防计划的 18 至 39 岁女性参与的动机、挑战和成功以及改进建议。参与者被分类为未参加者 (n = 10)、提前退出者 (n = 9) 或完成者 (n = 10)。访谈记录使用扎根的解释学编辑方法进行分析。结果 定性分析揭示了 4 个主要主题（入学、出勤、经验和建议）和多个子主题。大多数妇女都因健康和家庭问题而被鼓励参加。提前退出者和未参加者报告说对该计划的目标和相关性、后勤障碍以及与其他参与者/教练缺乏联系感到困惑。高度敬业的女性注意到持续的动力、感知到的体重减轻和支持性的计划关系。结论 在未来的适应中，年轻女性的多重障碍/促进因素似乎可以解决。需要额外的研究来证实其他环境中的这些发现，并探索适应的实施和有效性，目的是在受孕前降低风险。结论 在未来的适应中，年轻女性的多重障碍/促进因素似乎可以解决。需要额外的研究来证实其他环境中的这些发现，并探索适应的实施和有效性，目的是在受孕前降低风险。结论 在未来的适应中，年轻女性的多重障碍/促进因素似乎可以解决。需要额外的研究来证实其他环境中的这些发现，并探索适应的实施和有效性，目的是在受孕前降低风险。