scholarly journals Scaling Up Diabetes Prevention Programs in North Carolina: Perceptions of Demand From Potential Program Recipients and Providers

2018 ◽  
Vol 45 (1) ◽  
pp. 116-124 ◽  
Author(s):  
Tainayah Thomas ◽  
Carmen D. Samuel-Hodge ◽  
Deborah S. Porterfield ◽  
Maria L. Alva ◽  
Jennifer Leeman
Keyword(s):  
North Carolina ◽  
Qualitative Study ◽  
Diabetes Prevention ◽  
Scale Up ◽  
Diabetes Prevention Program ◽  
Transportation Cost ◽  
Prevention Programs ◽  
Scaling Up ◽  
Community Settings ◽  
Staff Support

Purpose The purpose of this study was to assess factors that influence demand for the Diabetes Prevention Program (DPP) from the perspectives of potential program participants and providers. Methods A qualitative study guided by a conceptual framework was conducted with potential DPP participants and potential DPP providers. Five focus groups with potential participants (n = 37) and key informant interviews with potential providers (n = 14) were conducted in community settings across North Carolina. Results Although providers considered prediabetes to be an important health problem, potential DPP participants expressed less urgency related to a diagnosis of prediabetes. Potential participants felt that they were more likely to adopt diabetes prevention programs if affordable and convenient. For potential program providers, funding, collaboration, and staff support were key considerations for DPP adoption. Providers were supportive of DPP features; however, there was concern from both stakeholders on retention in a 16-week program. Both groups cited transportation, cost, and health insurance reimbursement as existing barriers to the uptake of these programs. Conclusion This qualitative study highlights important considerations for scaling up diabetes prevention programs in community settings, including what constraints agencies face in adopting programs, the perceived demand and programmatic needs for these services by customers, and the need for improving patient education on prediabetes. This implementation science study allows us to increase the potential to scale up and sustain diabetes prevention programs that fit available resources and customer needs.

scholarly journals A Qualitative Study on the Perspectives of Latinas Enrolled in a Diabetes Prevention Program: Is the Cost of Prevention Too High?

2020 ◽  
Vol 11 ◽  
pp. 215013272094542
Author(s):  
Maud Joachim-Célestin ◽  
Thelma Gamboa-Maldonado ◽  
Hildemar Dos Santos ◽  
Susanne B. Montgomery
Keyword(s):  
Qualitative Study ◽  
Low Income ◽  
Behavior Modification ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Prevention Programs ◽  
Theory Approach ◽  
Preventive Behaviors ◽  
Culturally Adapted

Introduction: Latinas are among the groups most affected by diabetes health disparities, yet they often benefit less from diabetes interventions even when these are culturally adapted. The purpose of this qualitative study was to explore readiness of Latinas enrolled in a diabetes prevention program to adopt recommended preventive behaviors, and to identify factors associated with the adoption and maintenance of these recommended lifestyle changes. Insights gained will be used to inform future efforts at reducing diabetes disparities and the burden of chronic diseases among Latinas. Methods: Nine focus group discussions (FGDs) and 3 key informant interviews (KIIs) were conducted after the completion of a culturally adapted diabetes prevention program led by Latino community health workers. A grounded theory approach by Charmaz informed by the transtheoretical model guided the questions. Discussions and interviews were audio-taped with participants’ permission, transcribed, coded, and themed. Results: Forty low-income Latinas contributed to FGDs and KIIs. Baseline readiness to engage in new behaviors varied. Negative personal and family health events and physician referral impacted most readiness to enroll and to adopt preventive behaviors. Built environment, financial constraints, and threat of social alienation constituted major barriers to behavior adoption and maintenance, while physician involvement, awareness of diabetes complications, and social support partially mitigated these impediments. Conclusions: Our results suggest that timing of enrollment, physician-patient dynamics, and the emotional personal/family cost of behavior modification should all be considered when planning diabetes prevention programs for low-income Latinas. Besides appropriately timing referrals to accessible culturally informed prevention programs, health educators and health care providers should be aware of the potentially negative impact of behavior modification on family dynamics and be prepared to address resulting repercussions. Future research on Latinas should also include and report data on physician involvement, family context, and social determinants of health for more consistent program comparisons.

scholarly journals Diabetes Prevention in Adolescents: Co-design Study Using Human-Centered Design Methodologies

10.2196/18245 ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. e18245
Author(s):  
Julie M Pike ◽  
Courtney M Moore ◽  
Lisa G Yazel ◽  
Dustin O Lynch ◽  
Kathryn M Haberlin-Pittz ◽  
...  
Keyword(s):  
Diabetes Prevention ◽  
Design Research ◽  
Diabetes Prevention Program ◽  
Prevention Programs ◽  
Lifestyle Changes ◽  
Health Concern ◽  
Human Centered Design ◽  
Design Methodologies ◽  
Hands On Learning ◽  
Program Characteristics

Background The rise in pediatric obesity and its accompanying condition, type 2 diabetes (T2D), is a serious public health concern. T2D in adolescents is associated with poor health outcomes and decreased life expectancy. Effective diabetes prevention strategies for high-risk adolescents and their families are urgently needed. Objective The aim of this study was to co-design a diabetes prevention program for adolescents by using human-centered design methodologies. Methods We partnered with at-risk adolescents, parents, and professionals with expertise in diabetes prevention or those working with adolescents to conduct a series of human-centered design research sessions to co-design a diabetes prevention intervention for youth and their families. In order to do so, we needed to (1) better understand environmental factors that inhibit/promote recommended lifestyle changes to decrease T2D risk, (2) elucidate desired program characteristics, and (3) explore improved activation in diabetes prevention programs. Results Financial resources, limited access to healthy foods, safe places for physical activity, and competing priorities pose barriers to adopting lifestyle changes. Adolescents and their parents desire interactive, hands-on learning experiences that incorporate a sense of fun, play, and community in diabetes prevention programs. Conclusions The findings of this study highlight important insights of 3 specific stakeholder groups regarding diabetes prevention and lifestyle changes. The findings of this study demonstrate that, with appropriate methods and facilitation, adolescents, parents, and professionals can be empowered to co-design diabetes prevention programs.

scholarly journals Women Veterans’ Experience With a Web-Based Diabetes Prevention Program: A Qualitative Study to Inform Future Practice

2015 ◽  
Vol 17 (5) ◽  
pp. e127 ◽  
Author(s):  
Tannaz Moin ◽  
Kristyn Ertl ◽  
Jessica Schneider ◽  
Elena Vasti ◽  
Fatima Makki ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Women Veterans ◽  
Diabetes Prevention Program ◽  
Web Based ◽  
Future Practice

scholarly journals A Feasibility Study of Supply and Demand for Diabetes Prevention Programs in North Carolina

2017 ◽  
Vol 14 ◽  
Author(s):  
Maria L. Alva ◽  
Carmen D. Samuel-Hodge ◽  
Deborah Porterfield ◽  
Tainayah Thomas ◽  
Jennifer Leeman
Keyword(s):  
North Carolina ◽  
Feasibility Study ◽  
Diabetes Prevention ◽  
Supply And Demand ◽  
Prevention Programs

Scale-up of the Kerala Diabetes Prevention Program (K-DPP) in Kerala, India: implementation evaluation findings

2020 ◽  
Vol 10 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Ranjana Ravindranath ◽  
Brian Oldenburg ◽  
Sajitha Balachandran ◽  
Gomathyamma Krishnakurup Mini ◽  
Kishori Mahat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Cardiometabolic Risk ◽  
Controlled Trial ◽  
Large Population ◽  
Scale Up ◽  
Diabetes Prevention Program ◽  
Cardiometabolic Risk Factors ◽  
Peer Leaders

Abstract The cluster-randomized controlled trial of the Kerala Diabetes Prevention Program (K-DPP) demonstrated some significant improvements in cardiometabolic risk factors and other outcomes. We aimed to refine and improve K-DPP for wider implementation in the Kerala state of India. The specific objectives of the scale-up program were (a) to develop a scalable program delivery model and related capacity building in Kerala and (b) to achieve significant improvements in cardiometabolic risk factors in the target population. A total of 118 key trainers of a large women’s organization trained 15,000 peer leaders in three districts of Kerala. Each of these peer leaders was required to deliver 12 monthly sessions to ~25 people, reaching an estimated total of 375,000 adults over 12 months. We evaluated the number of sessions conducted, the participation of men, and program reach. We also assessed the effectiveness of the program in a random sample of 1,200 adults before and after the intervention and performed a biochemical evaluation on a subsample of 321. Of the 15,222 peer leaders who were trained, 1,475 (9.7%) returned their evaluation forms, of which, 98% reported conducting at least 1 session, 88% ≥6 sessions, and 74% all 12 sessions. Tobacco use among men reduced from 30% to 25% (p = .02) and alcohol use from 40% to 32% (p = .001). Overall, mean waist circumference reduced from 89.5 to 87.5 cm (p < .001). Although there were some study shortcomings, the approach to scale-up and its implementation was quite effective in reaching a large population in Kerala and there were also some significant improvements in key cardiometabolic risk factors following the 1 year intervention.

scholarly journals An ounce of prevention is worth a pound of cure: considerations for pharmacists delivering the National Diabetes Prevention Program

2021 ◽  
Vol 19 (2) ◽  
pp. 2426
Author(s):  
Dave L. Dixon ◽  
Evan M. Sisson ◽  
Lauren G. Pamulapati ◽  
Rowan Spence ◽  
Teresa M. Salgado
Keyword(s):  
United States ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Scale Up ◽  
Diabetes Prevention Program ◽  
The United States ◽  
Community Pharmacies ◽  
Local Health ◽  
Factors Affecting ◽  
Personnel Recruitment

Prediabetes is highly prevalent in the United States affecting over 88 million adults. In 2010, the Centers for Disease Control and Prevention (CDC) established the National Diabetes Prevention Program (NDPP), an intensive lifestyle program consisting of a 16-lesson curriculum focused on diet, exercise, and behavior modification, with the ultimate goal to reduce progression from prediabetes to diabetes. Despite tens of millions of adults potentially qualifying to participate in the program, the uptake of the NDPP has been exceedingly low. As a result, the CDC has focused its efforts on engaging with local health departments and community partners, including community pharmacies, across the United States to scale-up enrollment in the NDPP. In this commentary we discuss factors affecting implementation of the NDPP in community pharmacies and other settings where pharmacists practice, including training, space, personnel, recruitment and enrollment, retention, and sustainability.

scholarly journals How is the Behavior Change Technique Content of the NHS Diabetes Prevention Program Understood by Participants? A Qualitative Study of Fidelity, With a Focus on Receipt

2021 ◽  
Author(s):  
Lisa M Miles ◽  
Rhiannon E Hawkes ◽  
David P French
Keyword(s):  
Problem Solving ◽  
Qualitative Study ◽  
Behavior Change ◽  
Prevention Program ◽  
Behavioral Interventions ◽  
Diabetes Prevention ◽  
Group Discussion ◽  
Diabetes Prevention Program ◽  
Action Planning ◽  
Self Monitoring

Abstract Background The National Health Service (NHS) Diabetes Prevention Program (DPP) is a nationally implemented behavioral intervention for adults at high risk of developing Type 2 diabetes in England, based on a program specification that stipulates inclusion of 19 specific behavior change techniques (BCTs). Previous work has identified drift in fidelity from these NHS England specifications through providers’ program manuals, training, and delivery, especially in relation to BCTs targeting self-regulatory processes. Purpose This qualitative study investigates intervention receipt, i.e., how the self-regulatory BCT content of the NHS-DPP is understood by participants. Methods Twenty participants from eight NHS-DPP locations were interviewed; topics included participants’ understanding of self-monitoring of behavior, goal setting, feedback, problem solving, and action planning. Transcripts were analyzed thematically using the framework method. Results There was a wide variation in understanding among participants for some BCTs, as well as between BCTs. Participants described their understanding of “self-monitoring of behaviors” with ease and valued BCTs focused on outcomes (weight loss). Some participants learned how to set appropriate behavioral goals. Participants struggled to recall “action planning” or “problem solving” or found these techniques challenging to understand, unless additional support was provided (e.g., through group discussion). Conclusions Participants’ lack of understanding of some self-regulatory BCTs is consistent with the drift across fidelity domains previously identified from NHS design specifications. Behavioral interventions should build-in necessary support for participants to help them understand some BCTs such as action planning and problem solving. Alternatively, these self-regulatory BCTs may be intrinsically difficult to use for this population.

Fitness facility staff demonstrate high fidelity when implementing an evidence-based diabetes prevention program

2021 ◽  
Author(s):  
Tineke E Dineen ◽  
Tekarra Banser ◽  
Corliss Bean ◽  
Mary E Jung
Keyword(s):  
Prevention Program ◽  
Diabetes Prevention ◽  
Community Organization ◽  
Scale Up ◽  
Diabetes Prevention Program ◽  
Evidence Based ◽  
High Fidelity ◽  
Program Outcomes ◽  
Fitness Facility ◽  
Facility Staff

Abstract Translating evidence-based diabetes prevention programs into the community is needed to make promising interventions accessible to individuals at-risk of type 2 diabetes. To increase the likelihood of successful translation, implementation evaluations should be conducted to understand program outcomes and provide feedback for future scale-up sites. The purpose of this research was to examine the delivery of, and engagement with, an evidence-based diet and exercise diabetes prevention program when delivered by fitness facility staff within a community organization. Ten staff from a community organization were trained to deliver the diabetes prevention program. Between August 2019–March 2020, 26 clients enrolled in the program and were assigned to one of the ten staff. Three fidelity components were accessed. First, staff completed session-specific fidelity checklists (n = 156). Second, two audio-recorded counseling sessions from all clients underwent an independent coder fidelity check (n = 49). Third, staff recorded client goals on session-specific fidelity checklists and all goals were independently assessed for (a) staff goal-setting fidelity, (b) client intervention receipt, and (c) client goal enactment by two coders (n = 285). Average self-reported fidelity was 90% for all six sessions. Independent coder scores for both counseling sessions were 83% and 81%. Overall staff helped clients create goals in line with program content and had a goal achievement of 78%. The program was implemented with high fidelity by staff at a community organization and clients engaged with the program. Findings increase confidence that program effects are due to the intervention itself and provide feedback to refine implementation strategies to support future scale-up efforts.

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