Date of Award


Document Type



College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Gayle Robinson


Jeanne Lowe


Introduction: This qualitative research study examined barriers to enrollment in YMCA of Greater Seattle’s Diabetes Prevention Program (DPP) and how to improve the enrollment and referral process. Methodology: This was a quality improvement project that used qualitative methods in the research design. Semi-structured interviews and open-ended questionnaires were used to explore barriers in enrollment and to improve the referral and enrollment process from the perspective of participants with prediabetes referred to the DPP, YMCA staff who facilitate the DPP, and primary care providers who referred participant to the DPP. Results: A total of 10 interviews were conducted with the participants between the ages of 32-78 (P1-P10) who declined enrollment to the DPP. The cohort of participants were African heritage (n=6) , Asian (n=1) and White (n=3). There were a total of 8 women and two men. Five main themes resulted from the thematic analysis: 1) cost, 2) gap in communication, 3) time constraint, 4) adequate knowledge, and 5) program format. Three YMCA staff and one provider expressed similar barriers based on their perspectives. In addition, the referral process can be improved through a more thorough explanation of the DPP to eligible participants and reducing or covering the DPP cost. Conclusion: Better referral management, shared decision-making, and financial assistance seem to be the underpinning elements for the success of the participants’ enrollment into the DPP.

Included in

Nursing Commons