Specific Aim 2 – Secondary outcomes:
weight loss, T2DM
REGRESSION
Hypotheses: The intervention will result in: 1) a greater proportion of participants achieving ≥ 5% weight loss at 24 months, 2) increased uptake of lifestyle change and/or metformin at 6 months, 3) better patient-reported outcomes (physical activity, eating patterns, patient activation, health-related quality of life), 4) annual follow-up screening for progression to T2DM.We will use the same analytic plan as described above for the primary outcome to compare intervention and usual care in terms of the rates of ≥5% weight loss at 24 months, uptake of lifestyle change and/or metformin use at 6 months, and rates of screening for T2DM. Linear regression will be used to examine patient-reported outcomes at 6, 12, and 24 months, and we will be able to measure whether patients attended a minimum of 9 of 16 weekly lifestyle change sessions even if there was a delay in enrollment. Annual follow-up screening for progression to T2DM will include any ADA-recommended screening test for the detection of T2DM, including measuring fasting plasma glucose or HbA