Providing diabetes prevention services and navigating care transitions: perspectives from primary care providers

This qualitative study examined how primary care providers (PCPs) prioritize addressing diabetes prevention with patients newly diagnosed with prediabetes and identified barriers and facilitators to providing diabetes prevention services (DPS). To examine transitions of care, we also evaluated how PCPs received and acted on screening information obtained outside of a primary care visit among their patients with prediabetes.

We interviewed PCPs practicing in Chicago using semi-structured interviews guided by the updated Consolidated Framework for Implementation Research (CFIR 2.0) from March to May 2023. Framework analysis in combination with hybrid coding was used to analyze transcripts.

Nineteen PCPs were interviewed, and most (58%) prioritized talking to patients with prediabetes about diabetes prevention. Major themes identified included: (1) social determinants of health (SDOH) undermining diabetes prevention care, (2) perceptions of barriers and facilitators differing by provider background, and (3) delay of DPS due to prioritizing the patient's other needs. Providers noted challenges in sharing information across health systems despite existing interoperability platforms.

Our study observed challenges in providing DPS, particularly among PCPs serving patients impacted by SDOH. We also identified opportunities for improving transitions of care and engagement between patients with prediabetes and PCPs.