Jump to content

  • Set Your Location
  • Sign in or Enroll
Set Your LocationSutter Tracy Community Hospital
  • Sign in or Enroll
    • Open I want to choose my medical group or hospital
    • Clear my location
Change Location
Sutter Health
  • Video Visits
  • Find Doctors
  • Find Locations
  • Treatments & Services
    • Video Visits
    • Find Doctors
    • Find Locations
    • Treatments & Services
    • COVID-19 Resources
    • Pay a Bill
    • Symptom Checker
    • Get Care Today
    • Health & Wellness
    • Classes & Events
    • Research & Clinical Trials
    • For Patients
    • About Sutter Health
    • Giving
    • Volunteering
    • Careers
    • News
    • For Medical Professionals
    • Other Business Services
Close Search
  • Home
  • Sutter Tracy
  • Research
  • Disease Management
Content

Barriers and facilitators to real-world implementation of the Diabetes Prevention Program in large healthcare systems: lifestyle coach perspectives.

Description

Halley MC, Petersen J, Nasrallah C, Szwerinski N, Romanelli R, Azar KMJ., J Gen Intern Med. doi: 10.1007/s11606-020-05744-y. [Epub ahead of print], 2020 Apr 06

Investigators

Kristen Azar, R.N., BSN, MSN/MPH, Investigator

Abstract

BACKGROUND: Group-based lifestyle change programs based on the Diabetes Prevention Program (DPP) are associated with clinically significant weight loss and decreases in cardiometabolic risk factors. However, these benefits depend on successful real-world implementation. Studies have examined implementation in community settings, but less is known about integration in healthcare systems, and particularly in large, multi-site systems with the potential for extended reach.

OBJECTIVE: To examine the barriers and facilitators to successful DPP implementation in a large multi-site healthcare system.

DESIGN: Semi-structured interviews, based on the RE-AIM framework, were conducted in person for 30-90 min each.

PARTICIPANTS: Past and present DPP lifestyle coaches in the healthcare system identified using purposive sampling.

APPROACH: Thematic analysis of qualitative data to identify key factors influencing the success of DPP implementation. An iterative consensus process was used to model the relationships among factors.

KEY RESULTS: We conducted 33 interviews across 20 clinic sites serving 12 counties. Participants described six key factors as potential barriers or facilitators to implementation, including (1) Broader Context, including the surrounding physical and sociodemographic context; (2) Institutional Context, including finances, infrastructure, and personnel; (3) Program Provision, including curriculum, administration, cost, goals, and visibility; (4) Recruitment Process, including screening and referrals; (5) Lifestyle Coaches, including their characteristics, behaviors, and morale; and (6) Cohort, including group attrition/retention and interpersonal dynamics. These factors were both highly interconnected in their impact on implementation and widely variable across sites within the healthcare system, as illustrated in our multi-level conceptual framework.

CONCLUSIONS: This study identified key factors that could serve as barriers or facilitators in the implementation of DPP in large healthcare systems, from the perspective of lifestyle coaches. With further examination, the conceptual model presented here may be used for planning and managing the implementation of group-based behavioral interventions in these settings.

Pubmed Abstract

Pubmed AbstractOpens New Window

Associated Topics

  • Diabetes, Insulin Resistance and Metabolic Syndrome
  • Disease Management
  • Food and Nutrition
  • Health Services
  • Obesity

Related Publications

World Endometriosis Society consensus on the classification of endometriosis.

Johnson NP, Hummelshoj L, Adamson GD, Keckstein J, Taylor HS, Abrao MS, Bush D, Kiesel L, Tamimi R, Sharpe-Timms KL, Rombauts L, Giudice LC; for the World Endometriosis Society Sao Paulo Consortium.
Hum Reprod. [Epub ahead of print]
2016 Dec 05

Exploring provider reactions to decision aid distribution and shared decision making: lessons from two specialties.

Hsu C, Liss DT, Frosch DL, Westbrook EO, Arterburn D.
Med Decis Making. 37(1):113-126. Epub 2016 Oct 6.
2017 Jan 01

Improved targeting accuracy of lung tumor biopsies with scanning-beam digital x-ray tomosynthesis image guidance.

Nelson G, Wu M, Hinkel C, Krishna G, Funk T, Rosenberg J, Fahrig R.
Med Phys. 43(12):6282.
2016 Dec 01

An exploratory mixed-methods crossover study comparing DVD- vs. Web-based patient decision support in three conditions: The importance of patient perspectives.

Halley MC, Rendle KA, Gillespie KA, Stanley KM, Frosch DL.
Health Expect. 18(6):2880-91. doi: 10.1111/hex.12273. Epub 2014 Sep 29.
2015 Dec 01

Medial displacement calcaneal osteotomy: a comparison of screw versus locking plate fixation.

Saxena A, Patel R.
J Foot Ankle Surg. pii: S1067-2516(16)30162-4. doi: 10.1053/j.jfas.2016.06.006. [Epub ahead of print]
2016 Sep 15
The Sutter Health Network of Care
Expertise to fit your needs
Primary Care

Check-ups, screenings and sick visits for adults and children.

Specialty Care

Expertise and advanced technologies in all areas of medicine.

Emergency Care

For serious accidents, injuries and conditions that require immediate medical care.

Urgent Care

After-hours, weekend and holiday services.

Walk-In Care

Convenient walk-in care clinics for your non-urgent health needs.

  • Contact Us
  • Find Doctors
  • Find Locations
  • Request Medical Records
  • Make a Gift
Sign in to My Health Online

Billing and Insurance

  • Pay a Bill
  • Accepted Health Plans
  • Estimate Costs
  • Medicare Advantage

About Sutter

  • About Our Network
  • Community Benefit
  • Annual Report
  • News

Our Team

  • For Employees
  • For Medical Professionals
  • For Vendors
  • For Volunteers

Careers

  • Jobs at Sutter
  • Physician Jobs
  • Graduate Medical Education

Copyright © 2023 Sutter Health. All rights reserved. Sutter Health is a registered trademark of Sutter Health ®, Reg. U.S. Patent & Trademark office.

  • ADA Accessibility
  • Privacy
  • Do Not Sell My Personal Information
  • LinkedIn Opens new window
  • YouTube Opens new window
  • Facebook Opens new window
  • Twitter Opens new window
  • Instagram Opens new window
  • Glassdoor Opens new window

Cookie Policy

We use cookies to give you the best possible user experience. By continuing to use the site, you agree to the use of cookies. Privacy Policy Cookie Preferences

Privacy Policy Cookie Preferences