Translating Knowledge into Action to Prevent Type 2 Diabetes: Medicare Expansion of the National Diabetes Prevention Program Lifestyle Intervention
Translating Knowledge into Action to Prevent Type 2 Diabetes: Medicare Expansion of the National Diabetes Prevention Program Lifestyle Intervention
复制标题
DOI：
10.1111/1468-0009.12443
复制
发表时间：
2020-01-28
影响因子：
6.6
通讯作者：
Alley, Dawn
中科院分区：
文献类型：
--
作者：
Burd, Carlye;Gruss, Stephanie;Alley, Dawn
政策要点：虽然2型糖尿病等可预防的慢性病会带来巨大的成本和健康负担，但很少有生活方式干预措施在国家政策层面得到推广。将国家糖尿病预防计划生活方式干预从研究转化为医疗保险覆盖的服务，可以作为国家采用其他有可能改善人口健康的干预措施的典范。国家糖尿病预防计划的成功翻译依赖于政府机构、学术研究人员、社区医疗保健提供者、支付方和其他各方的合作。许多循证卫生干预措施从未在国家实施。本文分析了支持翻译和国家实施生活方式改变干预以预防或延缓糖尿病前期个体2型糖尿病的因素。方法：我们使用“从知识到行动”的框架，该框架是为了描绘科学如何转化为有效的健康计划而开发的，我们研究了2002年糖尿病预防计划试验的循证干预如何转化为疾病控制和预防中心的大规模国家糖尿病预防计划，最终导致为生活方式干预支付作为医疗保险覆盖的服务。我们分析的主要发现包括研究人员、政策制定者和支付方之间合作的重要性，以鼓励早期采用者；制定以证据为基础的国家标准，以支持广泛采用干预措施；并利用社区组织的公共投入将干预扩大到国家层面。该分析为其他高价值、可扩展的干预措施提供了及时的经验教训，这些干预措施试图超越证据收集阶段，进入转化和制度化阶段。
Policy PointsAlthough preventable chronic conditions such as type 2 diabetes carry a significant cost and health burden, few lifestyle interventions have been scaled at a national policy level. The translation of the National Diabetes Prevention Program lifestyle intervention from research to a Medicare-covered service can serve as a model for national adoption of other interventions that have the potential to improve population health. The successful translation of the National Diabetes Prevention Program has depended on the collaboration of government agencies, academic researchers, community-based healthcare providers, payers, and other parties. Context Many evidence-based health interventions never achieve national implementation. This article analyzes factors that supported the translation and national implementation of a lifestyle change intervention to prevent or delay type 2 diabetes in individuals with prediabetes. Methods We used the Knowledge to Action framework, which was developed to map how science is translated into effective health programs, to examine how the evidence-based intervention from the 2002 Diabetes Prevention Program trial was translated into the Centers for Disease Control and Prevention's large-scale National Diabetes Prevention Program, eventually resulting in payment for the lifestyle intervention as a Medicare-covered service. Findings Key findings of our analysis include the importance of a collaboration among researchers, policymakers, and payers to encourage early adopters; development of evidence-based, national standards to support widespread adoption of the intervention; and use of public input from community organizations to scale the intervention to a national level. Conclusions This analysis offers timely lessons for other high-value, scalable interventions attempting to move beyond the evidence-gathering phase and into translation and institutionalization.