PT  - JOURNAL ARTICLE
AU  - Chatzi, Georgia
AU  - Whittaker, William
AU  - Chandola, Tarani
AU  - Mason, Thomas
AU  - Soiland-Reyes, Claudia
AU  - Sutton, Matt
AU  - Bower, Peter
TI  - Could diabetes prevention programmes result in the widening of sociodemographic inequalities in type 2 diabetes? Comparison of survey and administrative data for England
AID  - 10.1136/jech-2022-219654
DP  - 2023 Sep 01
TA  - Journal of Epidemiology and Community Health
PG  - 565--570
VI  - 77
IP  - 9
4099  - http://jech.bmj.com/content/77/9/565.short
4100  - http://jech.bmj.com/content/77/9/565.full
SO  - J Epidemiol Community Health2023 Sep 01; 77
AB  - Background The NHS Diabetes Prevention Programme (DPP) in England is a behavioural intervention for preventing type 2 diabetes mellitus (T2DM) among people with non-diabetic hyperglycaemia (NDH). How this programme affects inequalities by age, sex, limiting illnesses or disability, ethnicity or deprivation is not known.Methods We used multinomial and binary logistic regression models to compare whether the population with NDH at different stages of the programme are representative of the population with NDH: stages include (1) prevalence of NDH (using survey data from UK Household Longitudinal Study (n=794) and Health Survey for England (n=1383)); (2) identification in primary care and offer of programme (using administrative data from the National Diabetes Audit (n=1 267 350)) and (3) programme participation (using programme provider records (n=98 024)).Results Predicted probabilities drawn from the regressions with demographics as each outcome and dataset identifier as predictors showed that younger adults (aged under 40) (4% of the population with NDH (95% CI 2.4% to 6.5%)) and older adults (aged 80 and above) (12% (95% CI 9.5% to 14.2%)) were slightly under-represented among programme participants (2% (95% CI 1.8% to 2.2%) and 8% (95% CI 7.8% to 8.2%) of programme participants, respectively). People living in deprived areas were under-represented in eight sessions (14% (95% CI 13.7% to 14.4%) vs 20% (95% CI 16.4% to 23.6%) in the general population). Ethnic minorities were over-represented among offers (35% (95% CI 35.1% to 35.6%) vs 13% (95% CI 9.1% to 16.4%) in general population), though the proportion dropped at the programme completion stage (19% (95% CI 18.5% to 19.5%)).Conclusion The DPP has the potential to reduce ethnic inequalities, but may widen socioeconomic, age and limiting illness or disability-related inequalities in T2DM. While ethnic minority groups are over-represented at the identification and offer stages, efforts are required to support completion of the programme. Programme providers should target under-represented groups to ensure equitable access and narrow inequalities in T2DM.Data are available in a public, open access repository. Data may be obtained from a third party and are not publicly available. UKHLS and HSE data used in this paper are available to researchers via the UK Data Service https://ukdataservice.ac.uk. National Diabetes Audit data was obtained via an application to NHS Digital, which required approval by their Independent Group Advising on the Release of Data (IGARD). https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-audit. Minimum Data Set was made available to the authors by NHS England under a data processing agreement, and the authors are not permitted to share them beyond the study team.