The study examined the impact of the Diabetes Prevention and Management program on dietary tracking, changes in dietary behavior, glycosylated hemoglobin (HbA1c) and weight loss over six months among rural adults with type 2 diabetes and prediabetes. The program was a health coach (HC)-led, community-based lifestyle intervention.

The study used an explanatory sequential quantitative and qualitative design to gain insight on participant’s dietary behavior and macronutrient consumption as well as experience with food tracking. Five of the 22 educational sessions focused on dietary education. Participants were taught strategies for healthy eating and dietary modification. Trained HCs delivered the sessions and provided weekly feedback to food journals.

Obese adults with type 2 diabetes or prediabetes (n=94) participated in the program and fifty-six (66%) completed dietary tracking (optional) for six months. Twenty-two participated in three focus groups.

Fifty-nine percent consistently completed food journals. At 6 months, average diet self-efficacy and dietary intake improved, and average weight loss was 4.58 ± 9.14lbs. Factors associated with weight loss included attendance, consistent dietary tracking, higher HbA1c, diabetes status, and calorie intake (Adjusted R2 = 43.5%; F=.003). Focus group participants reported the program improved eating habits. Consistency of dietary tracking was cumbersome yet was beneficial for making better choices and key to being honest.

Participants who consistently tracked their diet improved dietary self-efficacy and intake over six months. This model has the potential to be reproduced in other rural regions of the United States.