Translating the diabetes prevention program to primary care: a pilot study.

Abstract:

BACKGROUND:Research on the translation of efficacious lifestyle change programs to prevent type 2 diabetes into community or clinical settings is needed. OBJECTIVE:The objective of this study was to examine the reach, implementation, and efficacy of a 6-month lifestyle program implemented in primary care by nurse practitioners (NPs) for adults at risk of type 2 diabetes. METHODS:The NP sites (n = 4) were randomized to an enhanced standard care program (one NP and one nutrition session) or a lifestyle program (enhanced standard care and six NP sessions). These NPs recruited adults at risk of diabetes from their practice (n = 58), with an acceptance rate of 70%. RESULTS:The program reached a diverse, obese, and moderately low income sample. The NPs were able to successfully implement the protocols. The average length of the program was 9.3 months. Attendance was high (98%), and attrition was low (12%). The NPs were able to adopt the educational, behavioral, and psychosocial strategies of the intervention easily. Motivational interviewing was more difficult for NPs. Mixed-model repeated-measures analysis indicated significant trends or improvement in both groups for nutrition and exercise behavior. Participants of the lifestyle program demonstrated trends for better high-density lipoprotein (HDL) and exercise behavior compared with the enhanced standard care participants. Twenty-five percent of lifestyle participants met treatment goals of 5% weight loss compared with 11% of standard care participants. DISCUSSION:A lifestyle program can be implemented in primary care by NPs, reach the targeted population, and be modestly successful. Further research is indicated.

journal_name

Nurs Res

journal_title

Nursing research

authors

Whittemore R,Melkus G,Wagner J,Dziura J,Northrup V,Grey M

doi

10.1097/NNR.0b013e31818fcef3

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

2-12

issue

1

eissn

0029-6562

issn

1538-9847

pii

00006199-200901000-00002

journal_volume

58

pub_type

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