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Multidisciplinary Approach to Obesity Management: A Case Report
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Type-2 diabetes primary prevention program implemented in routine primary care: a process evaluation study.

Alvaro Sánchez1,2, Carmen Silvestre3, Natalia Campo4

  • 1Primary Care Research Unit of Bizkaia, Basque Health Service (Osakidetza), Bilbao, Spain. alvaro.sanchezperez@osakidetza.net.

Trials
|May 22, 2016
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Summary

Implementing a type-2 diabetes prevention program in primary care showed modest clinician adoption and patient reach. Variability across centers impacted standardized application, highlighting the need for context-specific strategies in diabetes prevention efforts.

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Area of Science:

  • Public Health
  • Clinical Research
  • Health Services Research

Background:

  • Process evaluation is crucial for understanding mechanisms influencing trial results and practice transferability.
  • This study documents the translation of a type-2 diabetes (T2D) prevention program into primary care settings.
  • Key process indicators assessed included clinician adoption, patient recruitment, and intervention exposure.

Purpose of the Study:

  • To document the implementation of a T2D prevention program in routine primary care.
  • To assess process indicators related to clinician adoption, patient recruitment, and intervention exposure.
  • To evaluate the translation of a T2D prevention program into diverse primary care contexts.

Main Methods:

  • An observational, descriptive process evaluation of the Prevention of Diabetes in Euskadi cluster randomized trial.
  • Utilized a passive dissemination strategy with training and materials for intervention translation.
  • Guided by the RE-AIM framework for process evaluation.

Main Results:

  • 31.4% of family physicians and 57.6% of nurses participated; 6.2% of targeted patients were screened.
  • 48% of eligible high-risk patients were reached by the intervention.
  • Significant variability in process indicators was observed across participating primary care centers.

Conclusions:

  • Passive dissemination yielded modest adoption and reach, limiting standardized application in varied settings.
  • Center-specific strategies influenced process outcomes, indicating context-dependent implementation.
  • Contextual variability necessitates rigorous analytical approaches for intervention effect evaluation.