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Using the Translating Research into Practice framework to develop a diabetes prevention intervention in primary care:

Eva Tseng1,2, Katherine Smith3, Jeanne M Clark4,2,5

  • 1Johns Hopkins University School of Medicine, Baltimore, Maryland, USA etseng3@jhmi.edu.

BMJ Open Quality
|June 5, 2024
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Summary

A new clinical pathway, START Diabetes Prevention, was developed to increase pre-diabetes intervention uptake in primary care. This evidence-based approach addresses barriers and facilitates better diabetes prevention strategies.

Keywords:
Chronic disease managementDIABETES MELLITUSDecision support, clinicalImplementation sciencePRIMARY CARE

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Area of Science:

  • Public Health
  • Health Services Research
  • Clinical Interventions

Background:

  • Pre-diabetes affects one-third of US adults, increasing type 2 diabetes risk.
  • Effective interventions like the Diabetes Prevention Program exist but face implementation gaps.
  • Translating research into routine care for pre-diabetes prevention remains a challenge.

Purpose of the Study:

  • To apply the Translating Research into Practice (TRiP) framework to develop an intervention for pre-diabetes prevention.
  • To identify barriers and facilitators to implementing diabetes prevention strategies in primary care.
  • To create an actionable plan and performance measures to increase intervention uptake.

Main Methods:

  • Utilized the TRiP framework across three phases: evidence summary, barrier identification, and performance measurement.
  • Conducted retrospective analysis of electronic health records for pre-diabetes management practices.
  • Performed in-depth interviews with primary care physicians, payor leaders, and patients.

Main Results:

  • Retrospective analysis showed low uptake of diabetes prevention interventions for pre-diabetic patients.
  • Stakeholder interviews revealed knowledge gaps among patients and clinicians regarding pre-diabetes and prevention programs.
  • Developed the START Diabetes Prevention Clinical Pathway, a change package with performance measures and resources.

Conclusions:

  • The TRiP framework facilitated the development of a tailored intervention to increase pre-diabetes treatment uptake.
  • The START Diabetes Prevention Clinical Pathway offers an adaptable model for primary care settings.
  • This intervention strategy can be applied to prevent other chronic conditions.