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Abstract

Diabetes prevention programs (DPPs) focused on changes in diet and physical activity behaviours have been successful in reducing the risk of prediabetes progressing to type 2 diabetes (T2D). Small Steps for Big Changes (SSBC) is a brief community-based DPP that has been effective at empowering individuals with prediabetes to reduce their risk of developing T2D through behavioural modification. SSBC is now being delivered in ten urban community cities across Canada. New strategies must be integrated to support adoption and implementation. Virtual Communities of Practice (VCoPs) have been used in other health contexts to support program adoption and implementation. By leveraging virtual networks, VCoPs enable members to collaborate and share knowledge regardless of geographical location. However, little is known about the use of a VCoP when scaling up a DPP. This thesis evaluates the early development of the SSBC Network, a VCoP designed to support SSBC implementors (YMCA site leads). The first objective was to explore value creation for SSBC Network members through narrative interviews. Narrative interviews were conducted virtually with SSBC Network members, and thematic narrative analysis of 3 interviews revealed a spectrum of engagement. Some participants reported limited use but recognized the VCoP’s value, while others described more active participation and identified it as a valuable space to learn about program updates. The second objective was to examine changes in network size and structure using Social Network Analysis (SNA) within the first six months post-launch. Across six months, the number of members increased from 10 to 18, with the monthly density increasing from month 1 (5%) to its highest in month 4 (14%). Descriptive trends in closeness and degree centrality indicated fluctuating levels of connectivity and information flow. In addition, the number of isolated subgroups (components) decreased, reflecting a shift towards a more integrated network structure over time.. Findings suggest the SSBC Network is developing greater cohesion over time, with evidence of both structural growth and perceived value creation. These insights will inform future SSBC Network adaptations and may guide similar strategies in scaling community-based programs nationally.