Primary Care Cluster RCT to Increase Diabetes Prevention Program Referrals.

Area of Science:

• Public Health
• Clinical Implementation Science
• Diabetes Prevention

Background:

• The Diabetes Prevention Program (DPP) is effective in preventing type 2 diabetes but is underutilized.
• Increasing DPP referrals from primary care is crucial for public health initiatives.

Purpose of the Study:

• To implement and evaluate strategies to increase referrals to the Diabetes Prevention Program (DPP) at a primary care clinic.
• To assess the impact of targeted interventions on DPP referral rates for patients with prediabetes.

Main Methods:

• A pragmatic, cluster randomized, mixed-methods study design was employed.
• Intervention involved clinician education, a prediabetes champion, and EHR-based patient identification.
• Generalized estimating equation analyses and content analysis of clinician interviews were used.

Main Results:

• Intervention clusters achieved a 6.9% referral rate compared to 1.5% in control clusters.
• Adjusted analysis showed increased odds of referral for intervention clinicians, though not statistically significant.
• Clinicians found the prediabetes champion and educational sessions most helpful.

Conclusions:

• Targeted interventions show promise for increasing Diabetes Prevention Program referrals.
• Individual clinician preferences for intervention components necessitate tailored implementation approaches.
• Further research is needed to achieve statistical significance and optimize DPP referral strategies.