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.

Implementation strategies from deployment of the National Diabetes Prevention Program in Pennsylvania community pharmacies

2020 ◽  
Vol 60 (3) ◽  
pp. S29-S36.e1 ◽  
Author(s):  
Amber D. Lapping ◽  
Joni C. Carroll ◽  
Kim C. Coley ◽  
Melissa A. Somma McGivney ◽  
Katie Doong ◽  
...  
Keyword(s):  
Prevention Program ◽  
Diabetes Prevention ◽  
Implementation Strategies ◽  
Diabetes Prevention Program ◽  
Community Pharmacies

scholarly journals Availability of the National Diabetes Prevention Program in United States Counties, March 2017

2018 ◽  
Vol 15 ◽  
Author(s):  
Bina Jayapaul-Philip ◽  
Shifan Dai ◽  
Karen Kirtland ◽  
Alyson Haslam ◽  
Kunthea Nhim
Keyword(s):  
United States ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program

scholarly journals Estimated number of eligible Part B beneficiaries for the medicare diabetes prevention program at the county level and by urban–rural classification

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241757
Author(s):  
Boon Peng Ng ◽  
Yiling J. Cheng ◽  
Stephanie Rutledge ◽  
Michael J. Cannon ◽  
Ping Zhang ◽  
...  
Keyword(s):  
Prevention Program ◽  
Diabetes Prevention ◽  
Lifestyle Modification ◽  
Diabetes Prevention Program ◽  
The United States ◽  
County Level ◽  
Eligibility Criteria ◽  
Urban Rural ◽  
Financial Burdens ◽  
Demographic Patterns

Introduction Diabetes imposes large health and financial burdens on Medicare beneficiaries. Type 2 diabetes can be prevented or delayed through lifestyle modification programs. In 2018, Medicare began to offer the Medicare Diabetes Prevention Program (MDPP), a lifestyle intervention, to eligible beneficiaries nationwide. The number of MDPP-eligible beneficiaries is not known, but this information is essential in efforts to expand the program and increase enrollment. This study aimed to estimate the number and spatial variation of MDPP-eligible Part B beneficiaries at the county level and by urban–rural classification. Methods Data from 2011–2016 National Health and Nutrition Examination Surveys and a survey-weighted logistic regression model were used to estimate proportions of prediabetes in the United States by sex, age, and race/ethnicity based on the MDPP eligibility criteria. The results from the predictive model were applied to 2015 Medicare Part B beneficiaries to estimate the number of MDPP-eligible beneficiaries. The National Center for Health Statistics’ Urban–Rural Classification Scheme for Counties from 2013 were used to define urban and rural categories. Results An estimated 5.2 million (95% CI = 3.5–7.0 million) Part B beneficiaries were eligible for the MDPP. By state, estimates ranged from 13,000 (95% CI = 8,500–18,000) in Alaska to 469,000 (95% CI = 296,000–641,000) in California. There were 2,149 counties with ≤1,000 eligible beneficiaries and 11 with >25,000. Consistent with demographic patterns, urban counties had more eligible beneficiaries than rural counties. Conclusions These estimates could be used to plan locations for new MDPPs and reach eligible Part B beneficiaries for enrollment.

Outcomes of a smart-phone delivered diabetes prevention program for patients with prediabetes: 1-year real-world service evaluation (Preprint)

2020 ◽  
Author(s):  
Charlotte Summers
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Weight ◽  
Glycaemic Control ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Smart Phone ◽  
Diabetes Prevention Program ◽  
The United States

BACKGROUND Prediabetes is the state of elevated blood glucose levels with glycaemic parameters above normal but below the (type 2) diabetes threshold. Prediabetes is considered a state of high risk for developing type 2 diabetes with yearly transition rate of 5%-10% to type 2 diabetes. There are almost 86 million adults with prediabetes in the United States alone. The world-wide prevalence of impaired glucose tolerance (IGT; a parameter of prediabetes) in 2010 was estimated to be 343 million (7.8%). Prediabetes is a global burden, with the International Diabetes Federation projecting an increase in prevalence of prediabetes to 471 million globally by 2035. OBJECTIVE Our objective was to evaluate the 1-year outcomes of the smart-phone delivered Low Carb Program for Prediabetes, a nutritionally focused, 12-session educational intervention for glycaemic control and weight loss for adults with prediabetes (i.e. a type 2 diabetes prevention program). The program reinforces carbohydrate restriction using behavioural techniques including goal setting, peer support, and behavioural self-monitoring. METHODS The study used a quasi-experimental research design comprised of an open-label, single-arm, pre-post intervention using a sample of convenience. We followed all of the 260 adults with prediabetes who had activated their referral to the program as a result of an NHS consultation between December 2018 and March 2019 and followed them for 12 months (N=260; mean age 44.7, SD 9.48 years; 36.1% (94/260) women; mean glycated haemoglobin A1c (HbA1c) 6.25%, SD 0.11%; mean body weight 77.1kg, SD 17.5kg; taking mean 0.41, SD 0.49 diabetes medications). RESULTS Of the 260 participants followed, 221 (85%) individuals reported outcomes at 12 months. 122 (46.9%) completed 80% or more of lessons of the program. Of the 260 participants with a starting HbA1c at or above the prediabetes threshold of 6.0%, 124 (49.6%) reduced their HbA1c to below the threshold. Over a third (33.8%, 88/260) of all participants lost at least 5% of their body weight. Overall, glycaemic control and weight loss improved, especially for participants who completed all modules of the program. For example, participants who engaged in at least 10 of the 12 weekly modules reduced their HbA1c from 6.3% to 5.8% (P<.001) and lost an average of 4.38kg or 5.4% of their body weight (P<.001). CONCLUSIONS A smart-phone delivered program that teaches a carbohydrate-reduced diet to adults with prediabetes with behaviour change support can be scalable and effective for glycaemic control, weight loss and can act as an engaging intervention for diabetes prevention.

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 &lt; .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.

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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