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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

Nursing Research

|December 19, 2008

Summary

Nurse practitioners (NPs) successfully implemented a lifestyle program in primary care for adults at risk of type 2 diabetes. The program reached a diverse population and showed modest success in improving health behaviors and weight loss.

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Area of Science:

Primary care research
Lifestyle interventions
Diabetes prevention

Background:

Translating lifestyle change programs for type 2 diabetes prevention into community or clinical settings requires further research.
Primary care settings are crucial for implementing preventative health programs.

Purpose of the Study:

To examine the reach, implementation, and efficacy of a 6-month lifestyle program.
To assess the program's success when delivered by nurse practitioners (NPs) to adults at risk of type 2 diabetes.

Main Methods:

Four primary care NP sites were randomized to either enhanced standard care or a lifestyle intervention program.
Adults at risk for type 2 diabetes (n = 58) were recruited, with a 70% acceptance rate.
The lifestyle program included enhanced standard care plus six NP sessions, focusing on education, behavior, and psychosocial strategies.

Main Results:

The program successfully reached a diverse, obese, and moderately low-income sample.
High attendance (98%) and low attrition (12%) were observed, with NPs adopting intervention strategies easily, though motivational interviewing proved more challenging.
Both groups showed improved nutrition and exercise behaviors; the lifestyle group trended towards better high-density lipoprotein (HDL) and exercise, with 25% achieving 5% weight loss versus 11% in the standard care group.

Conclusions:

A lifestyle program can be effectively implemented in primary care by NPs.
The program demonstrated the ability to reach the target population and achieve modest success.
Further research is recommended to optimize and expand such interventions.