Evaluating the Implementation of Digital and In-Person Diabetes Prevention Program in a Large, Integrated Health System: Natural Experiment Study Design.
Evaluating the Implementation of Digital and In-Person Diabetes Prevention Program in a Large, Integrated Health System: Natural Experiment Study Design.
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DOI：
10.7812/tpp/21.056
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发表时间：
2021-12-13
影响因子：
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通讯作者：
Fortmann, Stephen P
中科院分区：
文献类型：
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作者：
Fitzpatrick, Stephanie L;Mayhew, Meghan;Fortmann, Stephen P
导言：糖尿病预防计划（DPP）在面对面和数字医疗机构的实施一直在增加。方法：在2016年至2018年期间，通过Kaiser Permanente Northwest患者门户网站邀请19至75岁的前驱糖尿病（血红蛋白A1c或糖化血红蛋白5.7-6.4）和肥胖（体重指数≥30kg/m2）患者参加数字（n=4124）和现场（n=2669） DPP。主要（体重）和次要（血红蛋白A1c或糖化血红蛋白水平）结果数据将从电子健康记录中获得。将进行成本效益分析以及对患者（注册和未注册DPP）和利益相关者的定性访谈，以检查进一步的实施、可接受性和可持续性。结论：我们将使用混合方法、自然实验设计来评估Kaiser Permanente Northwest对数字和现场DPP的实施，这是基于与这两种DPP交付模式有效性相关的现有证据，并将为在大型卫生系统中长期实施和维持DPP的最佳实践提供新的知识。
INTRODUCTION: Implementation of a Diabetes Prevention Program (DPP) in both in-person and digital health-care settings has been increasing. The purpose of this article is to describe the protocol of a mixed-methods, natural experiment study designed to evaluate the implementation of DPP in a large, integrated health system.METHODS: Kaiser Permanente Northwest patients who were 19 to 75 years with prediabetes (hemoglobin A1c or glycated hemoglobin, 5.7-6.4) and obesity (body mass index ≥ 30kg/m2) were invited, via the Kaiser Permanente Northwest patient portal, to participate in the digital (n=4124) and in-person (n=2669) DPP during 2016 through 2018. Primary (weight) and secondary (hemoglobin A1c or glycated hemoglobin level) outcome data will be obtained from electronic health records. A cost-effectiveness analysis as well as qualitative interviews with patients (enrolled and not enrolled in the DPP) and stakeholders will be conducted to examine further implementation, acceptability, and sustainability.CONCLUSION: The mixed-methods, natural experiment design we will use to evaluate Kaiser Permanente Northwest's implementation of the digital and in-person DPP builds on existing evidence related to the effectiveness of these two DPP delivery modes and will contribute new knowledge related to best practices for implementing and sustaining the DPP within large health systems over the long term.