Veronica Yank1, Randall S Stafford, Lisa Goldman Rosas, Jun Ma. 1. Division of General Medical Disciplines, Stanford University School of Medicine, Medical School Office Building, 1265 Welch Road, Mail Code 5411, Stanford, CA 94305-5411, USA. vyank@stanford.edu
Abstract
BACKGROUND: Although the Diabetes Prevention Program (DPP) lifestyle intervention reduced type 2 diabetes incidence by 58% among high-risk adults at academic centers, it requires translation into typical primary care settings. Using baseline data from the Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care (E-LITE) randomized controlled trial, we evaluated the potential of its two DPP-based interventions to reach their target populations and be adopted into routine use. METHODS:Overweight/obese adults with increased cardiometabolic risk enrolled from one primary care clinic. Using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) model, we assessed reach with data on patient identification, participation, and representativeness, and adoption with data on intervention feasibility and potential for organizational diffusion. RESULTS: The target population was identified by searching electronic health records. Contact was attempted for 2391 patients who completed initial screening by phone (56% uptake) or online (44%). Most (88%) of those screened ineligible were not within the target population; 12% were excluded because of research requirements. Conservatively estimated participation rate was 44%. Participants (n=241) included 54% men and had a mean (SD) age of 52.9 years (10.6) and body mass index of 32 kg/m(2) (5.4). Regarding adoption, all clinic physicians agreed to participate. The feasibility of intervention implementation and dissemination was enhanced by leveraging existing intervention, training, and primary care resources. CONCLUSIONS: E-LITE's lifestyle interventions had fair-to-good potential for primary care reach and adoption. Our trial evidence and structured reporting may inform real-world implementation of translational trials by health networks, physicians, and payers.
RCT Entities:
BACKGROUND: Although the Diabetes Prevention Program (DPP) lifestyle intervention reduced type 2 diabetes incidence by 58% among high-risk adults at academic centers, it requires translation into typical primary care settings. Using baseline data from the Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care (E-LITE) randomized controlled trial, we evaluated the potential of its two DPP-based interventions to reach their target populations and be adopted into routine use. METHODS: Overweight/obese adults with increased cardiometabolic risk enrolled from one primary care clinic. Using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) model, we assessed reach with data on patient identification, participation, and representativeness, and adoption with data on intervention feasibility and potential for organizational diffusion. RESULTS: The target population was identified by searching electronic health records. Contact was attempted for 2391 patients who completed initial screening by phone (56% uptake) or online (44%). Most (88%) of those screened ineligible were not within the target population; 12% were excluded because of research requirements. Conservatively estimated participation rate was 44%. Participants (n=241) included 54% men and had a mean (SD) age of 52.9 years (10.6) and body mass index of 32 kg/m(2) (5.4). Regarding adoption, all clinic physicians agreed to participate. The feasibility of intervention implementation and dissemination was enhanced by leveraging existing intervention, training, and primary care resources. CONCLUSIONS: E-LITE's lifestyle interventions had fair-to-good potential for primary care reach and adoption. Our trial evidence and structured reporting may inform real-world implementation of translational trials by health networks, physicians, and payers.
Authors: M Kaye Kramer; Andrea M Kriska; Elizabeth M Venditti; Rachel G Miller; Maria M Brooks; Lora E Burke; Linda M Siminerio; Francis X Solano; Trevor J Orchard Journal: Am J Prev Med Date: 2009-12 Impact factor: 5.043
Authors: William C Knowler; Sarah E Fowler; Richard F Hamman; Costas A Christophi; Heather J Hoffman; Anne T Brenneman; Janet O Brown-Friday; Ronald Goldberg; Elizabeth Venditti; David M Nathan Journal: Lancet Date: 2009-10-29 Impact factor: 79.321
Authors: Helen A Amundson; Marcene K Butcher; Dorothy Gohdes; Taryn O Hall; Todd S Harwell; Steven D Helgerson; Karl K Vanderwood Journal: Diabetes Educ Date: 2009 Mar-Apr Impact factor: 2.140
Authors: Jeffrey A Katula; Mara Z Vitolins; Erica L Rosenberger; Caroline S Blackwell; Timothy M Morgan; Michael S Lawlor; David C Goff Journal: Diabetes Care Date: 2011-05-18 Impact factor: 19.112
Authors: Melanie A Stopponi; Gwen L Alexander; Jennifer B McClure; Nikki M Carroll; George W Divine; Josephine H Calvi; Sharon J Rolnick; Victor J Strecher; Christine Cole Johnson; Debra P Ritzwoller Journal: J Med Internet Res Date: 2009-08-26 Impact factor: 5.428
Authors: Rachel G Tabak; Kàimi A Sinclair; Ana A Baumann; Susan B Racette; Anne Sebert Kuhlmann; Michelle D Johnson-Jennings; Ross C Brownson Journal: Transl Behav Med Date: 2015-09-16 Impact factor: 3.046
Authors: Lisa G Rosas; Nan Lv; Lan Xiao; Megan A Lewis; Patricia Zavella; M Kaye Kramer; Veronica Luna; Jun Ma Journal: Contemp Clin Trials Date: 2016-03-16 Impact factor: 2.226
Authors: Hannes Gatterer; Sven Haacke; Martin Burtscher; Martin Faulhaber; Andreas Melmer; Christoph Ebenbichler; Kingman P Strohl; Josef Högel; Nikolaus C Netzer Journal: Obes Facts Date: 2015-05-20 Impact factor: 3.942
Authors: Samantha M Harden; Bridget Gaglio; Jo Ann Shoup; Kimberlee A Kinney; Sallie Beth Johnson; Fabiana Brito; Kacie C A Blackman; Jamie M Zoellner; Jennie L Hill; Fabio A Almeida; Russell E Glasgow; Paul A Estabrooks Journal: Syst Rev Date: 2015-11-08