"An ounce of prevention": a primary care based prevention program for pre-diabetic population

Given the existing and projected number of individuals with diabetes mellitus, there is an urgent need to implement effective prevention programs. Research trials have demonstrated reductions in risk through programs targeted at adopting a healthier lifestyle however translating this research evidence into primary care can be challenging. We examined the feasibility of implementing a pre-diabetes program into a primary care clinic in Ottawa, Canada.

"An Ounce of Prevention" Healthy Lifestyle and Diabetes Program was adapted from best evidence clinical trials and uses educational tools developed by the Diabetes Prevention Program for long-term behavior change, relies on principles of self-management, is group based and includes an integrated exercise component. We used a multimethod evaluation approach and examined feasibility and practical implementation aspects such as space, staffing, recruitment and retention issues.

We have implemented the program and have offered 10 courses from June 2010 through to August 2012 with 74 participants in total. Results of the evaluation surveys show that participants are highly satisfied with the content as well as the format of the program and think that the content is relevant to them. Recruitment of patients is time- intensive and requires dedicated resources. Evaluation of effectiveness with follow-up surveys and clinical measures has been challenging due to limited resources and is ongoing.

The translation and implementation of research evidence into clinical practice is complex and requires consideration of real-life practicalities such as time demands on participants, staffing costs, effective recruiting and ongoing evaluation.