Individualization through “toolbox”
DPP participants encountered a variety of barriers to adherence over the course of the trial. Lifestyle coaches were encouraged to work with each participant individually to identify the specific barriers and possible solutions to these barriers. To help participants achieve and maintain the lifestyle goals, a “toolbox” of strategies that could be used with individual participants was developed. The toolbox was arranged in a hierarchy from less expensive to more expensive approaches (in terms of staff time as well as money) and contained problem-solving strategies and reinforcements for use with individual participants.