scholarly journals An active strategy to identify individuals eligible for type 2 diabetes prevention by lifestyle intervention in Dutch primary care: the APHRODITE study

2010 ◽  
Vol 27 (3) ◽  
pp. 312-319 ◽  
Author(s):  
P. Vermunt ◽  
I. Milder ◽  
F. Wielaard ◽  
J. van Oers ◽  
G. Westert
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Lifestyle Intervention ◽  
Diabetes Prevention ◽  
Active Strategy ◽  
Type 2 Diabetes Prevention

scholarly journals Implementation of a lifestyle intervention for type 2 diabetes prevention in Dutch primary care: opportunities for intervention delivery

2012 ◽  
Vol 13 (1) ◽  
Author(s):  
Paulina WA Vermunt ◽  
Ivon EJ Milder ◽  
Frits Wielaard ◽  
Caroline A Baan ◽  
Jos DM Schelfhout ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Lifestyle Intervention ◽  
Diabetes Prevention ◽  
Intervention Delivery ◽  
Type 2 Diabetes Prevention

scholarly journals Behavior change in a lifestyle intervention for type 2 diabetes prevention in Dutch primary care: opportunities for intervention content

2013 ◽  
Vol 14 (1) ◽  
Author(s):  
Paulina WA Vermunt ◽  
Ivon EJ Milder ◽  
Frits Wielaard ◽  
Caroline A Baan ◽  
Jos DM Schelfhout ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Behavior Change ◽  
Lifestyle Intervention ◽  
Diabetes Prevention ◽  
Type 2 Diabetes Prevention ◽  
Intervention Content

scholarly journals Effectiveness of two procedures for deploying a facilitated collaborative modeling implementation strategy—the PVS-PREDIAPS strategy—to optimize type 2 diabetes prevention in primary care: the PREDIAPS cluster randomized hybrid type II implementation trial

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Alvaro Sanchez ◽  
◽  
Susana Pablo ◽  
Arturo Garcia-Alvarez ◽  
Silvia Dominguez ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Diabetes Prevention ◽  
Implementation Strategy ◽  
Type Ii ◽  
Collaborative Process ◽  
Type 2 Diabetes Prevention ◽  
Cluster Randomized ◽  
Implementation Trial

Abstract Background The most efficient procedures to engage and guide healthcare professionals in collaborative processes that seek to optimize practice are unknown. The PREDIAPS project aims to assess the effectiveness and feasibility of different procedures to perform a facilitated interprofessional collaborative process to optimize type 2 diabetes prevention in routine primary care. Methods A type II hybrid cluster randomized implementation trial was conducted in nine primary care centers of the Basque Health Service. All centers received training on effective healthy lifestyle promotion. Headed by a local leader and an external facilitator, centers conducted a collaborative structured process—the PVS-PREDIAPS implementation strategy—to adapt the intervention and its implementation to their specific context. The centers were randomly allocated to one of two groups: one group applied the implementation strategy globally, promoting the cooperation of all health professionals from the beginning, and the other performed it sequentially, centered first on nurses, who later sought the pragmatic cooperation of physicians. The following patients were eligible for inclusion: all those aged ≥ 30 years old with at least one known cardiovascular risk factor and an impaired fasting glucose level (≥ 110-125 mg/dl) but without diabetes who attended centers during the study period. The main outcome measures concerned changes in type 2 diabetes prevention practice indicators after 12 months. Results After 12 months, 3273 eligible patients at risk of type 2 diabetes had attended their family physician at least once, and of these, 490 (15%) have been addressed by assessing their healthy lifestyles in both comparison groups. The proportion of at-risk patients receiving a personalized prescription of lifestyle change was slightly higher (8.6%; range 13.5-5.9% vs 6.8%; range 7.2-5.8%) and 2.3 times more likely (95% CI for adjusted hazard ratio, 1.38-3.94) in the sequential than in the global centers, after 8 months of the intervention program implementation period. The probability of meeting the recommended levels of physical activity and fruit and vegetable intake were four- and threefold higher after the prescription of lifestyle change than only assessment and provision of advice. The procedure of engagement in and execution of the implementation strategy does not modify the effect of prescribing healthy habits (p interaction component of intervention by group, p > 0.05). Discussion Our results show that the PVS-PREDIAPS implementation strategy manages to integrate interventions with proven efficacy in the prevention of type 2 diabetes in clinical practice in primary care. Further, they suggest that implementation outcomes were somewhat better with a sequential facilitated collaborative process focused on enhancing the autonomy and responsibility of nurses who subsequently seek a pragmatic cooperation of GPs. Trial registration Clinicaltrials.gov identifier: NCT03254979. Registered 16 August 2017—retrospectively registered.

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