Related Experiment Videos
Translating the diabetes prevention program to primary care: a pilot study
Robin Whittemore1, Gail Melkus, Julie Wagner
1Yale School of Nursing, New Haven, Connecticut 06536-0740, USA. robin.whittemore@yale.edu
Background:
Research on the translation of efficacious lifestyle change programs to prevent type 2 diabetes into community or clinical settings is needed.
Objective:
The objective of this study was to examine the reach, implementation, and efficacy of a 6-month lifestyle program implemented in primary care by nurse practitioners (NPs) for adults at risk of type 2 diabetes.
Methods:
The NP sites (n = 4) were randomized to an enhanced standard care program (one NP and one nutrition session) or a lifestyle program (enhanced standard care and six NP sessions). These NPs recruited adults at risk of diabetes from their practice (n = 58), with an acceptance rate of 70%.
Results:
The program reached a diverse, obese, and moderately low income sample. The NPs were able to successfully implement the protocols. The average length of the program was 9.3 months. Attendance was high (98%), and attrition was low (12%). The NPs were able to adopt the educational, behavioral, and psychosocial strategies of the intervention easily. Motivational interviewing was more difficult for NPs. Mixed-model repeated-measures analysis indicated significant trends or improvement in both groups for nutrition and exercise behavior. Participants of the lifestyle program demonstrated trends for better high-density lipoprotein (HDL) and exercise behavior compared with the enhanced standard care participants. Twenty-five percent of lifestyle participants met treatment goals of 5% weight loss compared with 11% of standard care participants.
Discussion:
A lifestyle program can be implemented in primary care by NPs, reach the targeted population, and be modestly successful. Further research is indicated.
Related Concept Videos
Preventive Healthcare Services
Levels of Health Promotion and Illness Prevention
In primary prevention, actions taken before disease onset prevent the disease from...
Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
Type II Diabetes I: Introduction
Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Diabetes Mellitus: Type 2 and Gestational