Diabetes-Related Services and Programs in Small Local Public Health Departments, 2009-2010

Hosler, Akiko S.; Zeinomar, Nur; Asare, Kofi

doi:10.5888/pcd9.100069

Cited by 6 publications

(11 citation statements)

References 20 publications

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“…Their results revealed that most small local health departments delivered diabetes-related patient care services, while the proportion of local health departments with any primary prevention programs to address diabetes, or obesity prevention, was much lower. 24 Another study examining the presence of obesity prevention programs and diabetes screening programs across local health departments nationwide found that slightly more local health departments had an obesity prevention program (56%) than diabetes screening programs (51%), and approximately one-third had both programs. 25 The current results support that local health departments of all sizes are integrating primary prevention approaches into their inventory of diabetes prevention and control activities.…”

Section: Discussionmentioning

confidence: 99%

“…The findings from the current study provide insight on the variety of diabetes prevention and control EBPPs that local health departments are currently implementing and the perceived feasibility of these EBPPs. Among the EBPPs that may improve care of individuals with type 2 diabetes or approaches that address secondary prevention of diabetes, 11,24 local health departments most frequently implemented diabetes self-management in community gathering places and combined nutrition and physical activity promotion programs. Similarly, these 2 strategies were considered the most feasible to implement by local health departments not currently employing these interventions.…”

Section: Discussionmentioning

confidence: 99%

“…The results of this study are mixed compared to previous research findings. A 2012 study by Hosler and colleagues 24 assessed the diabetes-related services and programs delivered by small health departments. Their results revealed that most small local health departments delivered diabetes-related patient care services while the proportion of local health departments with any primary prevention programs to address diabetes, or obesity prevention, was much lower.…”

Section: Discussionmentioning

confidence: 99%

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Evidence-Based Diabetes Prevention and Control Programs and Policies in Local Health Departments

et al. 2015

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Purpose The purpose of this study is to: (1) assess implementation of evidence-based programs and policies (EBPPs) related to diabetes prevention and control in local health departments; (2) assess feasibility of non-implemented diabetes prevention and control EBPPs; and (3) examine individual- and organizational-level factors associated with implementation of diabetes prevention and control EBPPs. Methods An online survey was administered in January 2015 to key representatives of all local health departments in Missouri. Descriptive statistics were used to describe implementation and perceived feasibility of 20 diabetes prevention and control EBPPs. Logistic regression was used to examine the association between individual and organizational factors and diabetes prevention and control EBPP implementation. Results One hundred local health departments participated (89% response rate) in the online survey. Most frequently implemented diabetes-related EBPPs in local health departments included: nutrition education for agency or community members; increased fruit and vegetable access in community settings; and community-wide campaigns to promote physical activity. Increased encouragement to others in the department to use evidence-based decision making and agency incentives to help employees use evidence-based decision making were positively associated with implementation of diabetes prevention and control EBPPs. Conclusions Local health departments are the “front line” of public health and this study demonstrates the important role these organizations play in implementing diabetes prevention and control EBPPs. Potential leverage points for more widespread adoption of diabetes-related EBPPs in local health departments include education about and encouragement of evidence-based decision making and organizational incentives for employees to integrate evidence-based decision making into their diabetes prevention and control activities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evidence-Based Diabetes Prevention and Control Programs and Policies in Local Health Departments

et al. 2015

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“…While public health systems are beginning to play an increasing role in the implementation of evidenced-based interventions targeting chronic health conditions, little is known about how evidence-based programs can be best implemented and sustained in these systems [39–42]. Related to recruitment, fidelity to the protocol was high in terms of delivery agents being able to recruit 89% of the cohorts.…”

Section: Discussionmentioning

confidence: 99%

SIPsmartER delivered through rural, local health districts: adoption and implementation outcomes

et al. 2019

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Background SIPsmartER is a 6-month evidenced-based, multi-component behavioral intervention that targets sugar-sweetened beverages among adults. It consists of three in-person group classes, one teach-back call, and 11 automated phone calls. Given SIPsmartER’s previously demonstrated effectiveness, understanding its adoption, implementation, and potential for integration within a system that reaches health disparate communities is important to enhance its public health impact. During this pilot dissemination and implementation trial, SIPsmartER was delivered by trained staff from local health districts (delivery agents) in rural, Appalachian Virginia. SIPsmartER’s execution was supported by consultee-centered implementation strategies. Methods In this mixed-methods process evaluation, adoption and implementation indicators of the program and its implementation strategy (e.g., fidelity, feasibility, appropriateness, acceptability) were measured using tracking logs, delivery agent surveys and interviews, and fidelity checklists. Quantitative data were analyzed with descriptive statistics. Qualitative data were inductively coded. Results Delivery agents implemented SIPsmartER to the expected number of cohorts (n = 12), recruited 89% of cohorts, and taught 86% of expected small group classes with > 90% fidelity. The planned implementation strategies were also executed with high fidelity. Delivery agents completing the two-day training, pre-lesson meetings, fidelity checklists, and post-lesson meetings at rates of 86, 75, 100, and 100%, respectively. Additionally, delivery agents completed 5% (n = 3 of 66) and 10% (n = 6 of 59) of teach-back and missed class calls, respectively. On survey items using 6-point scales, delivery agents reported, on average, higher feasibility, appropriateness, and acceptability related to delivering the group classes (range 4.3 to 5.6) than executing missed class and teach-back calls (range 2.6 to 4.6). They also, on average, found the implementation strategy activities to be helpful (range 4.9 to 6.0). Delivery agents identified strengths and weakness related to recruitment, lesson delivery, call completion, and the implementation strategy. Conclusions In-person classes and the consultee-centered implementation strategies were viewed as acceptable, appropriate, and feasible and were executed with high fidelity. However, implementation outcomes for teach-back and missed class calls and recruitment were not as strong. Findings will inform the future full-scale dissemination and implementation of SIPsmartER, as well as other evidence-based interventions, into rural health districts as a means to improve population health.

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“…These attributes allow for LHDs to assess a public health problem, adapt an appropriate program or policy, cultivate partnerships, and assure research-tested interventions—or evidence-based programs and policies (EBPPs) are effectively delivered and implemented [ 13 – 16 ]. LHDs are playing an increasing role in diabetes control through activities such as obesity prevention [ 17 , 18 ], diabetes self-management [ 19 , 20 ], and development of registries to monitor diabetes at a population-level and intervene in a timely and targeted manner [ 21 ]. A pilot study of LHDs in Missouri assessed the use of 20 diabetes-related EBPPs, feasibility of EBPPs, and personal/organizational barriers to evidence-based practice [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Enhancing evidence-based diabetes and chronic disease control among local health departments: a multi-phase dissemination study with a stepped-wedge cluster randomized trial component

et al. 2017

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BackgroundThe rates of diabetes and prediabetes in the USA are growing, significantly impacting the quality and length of life of those diagnosed and financially burdening society. Premature death and disability can be prevented through implementation of evidence-based programs and policies (EBPPs). Local health departments (LHDs) are uniquely positioned to implement diabetes control EBPPs because of their knowledge of, and focus on, community-level needs, contexts, and resources. There is a significant gap, however, between known diabetes control EBPPs and actual diabetes control activities conducted by LHDs. The purpose of this study is to determine how best to support the use of evidence-based public health for diabetes (and related chronic diseases) control among local-level public health practitioners.Methods/designThis paper describes the methods for a two-phase study with a stepped-wedge cluster randomized trial that will evaluate dissemination strategies to increase the uptake of public health knowledge and EBPPs for diabetes control among LHDs. Phase 1 includes development of measures to assess practitioner views on and organizational supports for evidence-based public health, data collection using a national online survey of LHD chronic disease practitioners, and a needs assessment of factors influencing the uptake of diabetes control EBPPs among LHDs within one state in the USA. Phase 2 involves conducting a stepped-wedge cluster randomized trial to assess effectiveness of dissemination strategies with local-level practitioners at LHDs to enhance capacity and organizational support for evidence-based diabetes prevention and control. Twelve LHDs will be selected and randomly assigned to one of the three groups that cross over from usual practice to receive the intervention (dissemination) strategies at 8-month intervals; the intervention duration for groups ranges from 8 to 24 months. Intervention (dissemination) strategies may include multi-day in-person workshops, electronic information exchange methods, technical assistance through a knowledge broker, and organizational changes to support evidence-based public health approaches. Evaluation methods comprise surveys at baseline and the three crossover time points, abstraction of local-level diabetes and chronic disease control program plans and progress reports, and social network analysis to understand the relationships and contextual issues that influence EBPP adoption.Trial registrationClinicalTrial.gov, NCT03211832Electronic supplementary materialThe online version of this article (10.1186/s13012-017-0650-4) contains supplementary material, which is available to authorized users.

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Diabetes-Related Services and Programs in Small Local Public Health Departments, 2009-2010

Cited by 6 publications

References 20 publications

Evidence-Based Diabetes Prevention and Control Programs and Policies in Local Health Departments

Evidence-Based Diabetes Prevention and Control Programs and Policies in Local Health Departments

SIPsmartER delivered through rural, local health districts: adoption and implementation outcomes

Enhancing evidence-based diabetes and chronic disease control among local health departments: a multi-phase dissemination study with a stepped-wedge cluster randomized trial component

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