Translating the Diabetes Prevention Program into the Community

Ackermann, Ronald T.; Finch, Emily; Brizendine, Edward J.; Zhou, Honghong; Marrero, David G.

doi:10.1016/j.amepre.2008.06.035

Cited by 573 publications

(497 citation statements)

References 32 publications

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“…For example, Jakicic et al conducted a group‐based lifestyle programme, with 42 group sessions plus individual make‐up meetings over 18 months. Their total per capita cost of space was estimated at $122 21. In other studies, a general estimate of overhead costs is provided by using a percentage of the personnel costs; using this approach, DPP estimated that the per capita cost of the lifestyle intervention was 69% of the cost of personnel or $519 during year 1 13.…”

Section: Resultsmentioning

confidence: 99%

Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial

Rushing

Wing

Wadden

et al. 2017

Obesity Science & Practice

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SummaryObjectiveThe Action for Health in Diabetes (Look AHEAD) trial was a randomized controlled clinical trial to compare the effects of 10 years of intensive lifestyle intervention (ILI) with a control condition of diabetes support and education (DSE) on health outcomes in over 5,000 participants with type 2 diabetes. The ILI had significantly greater weight losses than DSE throughout the trial. The goal of this analysis is to describe the cost of delivering the intervention.MethodsThe ILI was designed to promote weight loss and increase physical activity. It involved a combination of group plus individual intervention sessions, with decreasing frequency of contact over the 10 years. The intervention incorporated a variety of strategies, including meal replacement products, to improve weight loss outcomes. The costs of intervention delivery were derived from staff surveys of effort and from records of intervention materials from the 16 US academic clinical trial sites. Costs were calculated from the payer perspective and presented in 2012 dollars.ResultsDuring the first year, when intervention delivery was most intensive, the annual cost of intervention delivery, averaged (standard deviation) across clinical sites, was $2,864.6 ($513.3) per ILI participant compared with $202.4 ($76.6) per DSE participant. As intervention intensity declined, costs decreased, such that from years 5 to 9 of the trial, the annual cost of intervention was $1,119.8 ($227.7) per ILI participant and $102.9 ($33.0) per DSE participant. Staffing accounted for the majority of costs throughout the trial, with meal replacements and materials to promote adherence accounting for smaller shares.ConclusionsThe sustained weight losses produced by the Look AHEAD intervention were supported by intervention costs that were within the range of other weight loss programmes. Future work will include an evaluation of the cost‐effectiveness of the ILI and will contain additional follow‐up data.

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Section: Resultsmentioning

confidence: 99%

Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial

Rushing

Wing

Wadden

et al. 2017

Obesity Science & Practice

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“…There was little evidence that motivational interviewing was a major component of any of the programs with the exception of one study provided as individual sessions in the primary care setting [21]. Only two studies provided evidence of intervention fidelity, both of which were randomized pilot trials [20,21].…”

Section: Resultsmentioning

confidence: 99%

“…There were four distinct settings of diabetes prevention translational research: (a) hospital outpatient or diabetes education model of care [23][24][25] with one study a comparative effectiveness study comparing an on-site program to a telehealth program [26], (b) primary care [21,22,27] with one study combining primary care with an online program [28], (c) community settings (i.e., Young Men's Christian Association (YMCA)) [20,[29][30][31], and (d) church or workplace settings [32][33][34][35] ( Tables 2, 3, 4, and 5).…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of the translational research on the Diabetes Prevention Program

Whittemore

2011

Behav. Med. Pract. Policy Res.

141

156

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International clinical trials have demonstrated compelling evidence on the prevention or delay of type 2 diabetes (T2D) by lifestyle change programs. Numerous studies have translated the Diabetes Prevention Program (DPP) protocol to "real-world" settings. The purpose of this paper is to review the translational research of the DPP protocol in adults at-risk for T2D. This study is a systematic review based on the guidelines from the Cochrane Handbook for Systematic Reviews. There were 16 studies that translated the DPP protocol in four distinct settings: (a) hospital outpatient, (b) primary care, (c) community, and (d) work and church. Settings varied considerably in terms of reach, efficacy, adoption, implementation, and maintenance. There were strengths and limitations to each setting. Better understanding of program adaptation and mediators and moderators to program efficacy are indicated. Future research also needs to continue to explore mechanisms to improve access and long-term outcomes.

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“…Consideration may be given to others with expertise complementary to health care professionals. For example, in the Diabetes Prevention Program (DPP), community health workers facilitated strategies for individual behavior change (25).…”

Section: Multidisciplinary Team Carementioning

confidence: 99%

Type 2 Translational Research for CKD

Tuot

Corbett

Setter

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryStrategies to effectively treat people with CKD have been identified by conventional clinical research. Despite this evidence, awareness, screening, detection, diagnosis, risk factor control, treatment, and outcomes remain substandard. Translating clinical evidence into actionable measures that reduce the burden of CKD is a pressing need. Expansion from a "bench-to-bedside" paradigm (conventional type 1 translation) to research that encompasses "clinic and community" is the core concept of type 2 translation. Specifically, this is the discipline of identifying factors and using strategies that lead to adoption, maintenance, and sustainability of science-based interventions in practice. This review identifies key elements of type 2 translational research and highlights the current scope of this type of research for CKD. For type 2 translation to achieve the goals of providing high-quality care and better health outcomes, key facilitators (e.g., theory-based frameworks, adaptable interventions, and inclusion of sustainability and evaluation metrics) and essential elements (e.g., multidisciplinary team care, health information technology, and stakeholder engagement) must be integrated. The National Institute of Diabetes and Digestive and Kidney Diseases recently funded five proposals that aim to improve outcomes for people with CKD, focusing on diverse components of the healthcare continuum: patient safety and transitions; delivery of highquality, evidence-based CKD care; and elimination of disparities. The need for type 2 translational research in CKD is urgent because of preventable human suffering and unsustainable costs of providing care. Focus on the theory, framework, and approaches we have suggested may help us meet that challenge.

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Translating the Diabetes Prevention Program into the Community

Cited by 573 publications

References 32 publications

Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial

Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial

A systematic review of the translational research on the Diabetes Prevention Program

Type 2 Translational Research for CKD

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