Translating the Why WAIT Toolkit for Primary Care Practie

描述（由申请人提供）：翻译为什么等待初级保健实践工具包将适应为什么等待程序的行为干预组成部分，并评估在初级保健实践中实施的可行性。主要目标是将当前非常成功的Why WAIT计划的一个组成部分转化为可以广泛传播到初级保健环境的模型，其中超过85%的糖尿病患者在美国接受医疗保健，并评估在该环境中实施适应计划的可行性。具体目标是：目标1方案调整：将成功的Why Wait计划的行为治疗部分转化为初级保健实践（PCP），并为患者和提供者提供适当的交付方法和信息。目标2可行性评估：通过项目评估和与提供者和患者的定性研究，评估在初级保健环境中实施适应性组件的可行性。目的3全规模评价的随机试验设计：确定随机对照试验的研究设计，并招募足够的基层医疗机构进行完全适应的Why WAIT计划的随机对照试验。在成功完成拟议的目标后，我们将能够适应整个计划，并使用严格的随机分组试验进行全面测试，最大限度地提高普遍性，最大限度地减少偏倚。人际接触与基于媒体的支持的创新组合将导致一个为什么等待计划，这将是一个非常有用的PCP，在已知的限制，如时间和资源。与PCP和糖尿病患者的定性深入讨论将为Why Wait计划的翻译提供信息，以解决这一受众面临的需求和障碍。这将产生一个计划，该计划将被PCP有效地用于更大比例的糖尿病人群，并将通过减肥和糖尿病管理产生比专业诊所更大的公共卫生影响。这一努力的最终结果将增加为患者提供管理其疾病的工具的机会，从而降低T2DM的死亡率和发病率。 公共卫生相关性：拟议的研究将翻译为什么等待计划的行为干预部分，并评估在初级保健实践中实施的可行性。由此产生的计划将被PCP有效地使用，以达到更大比例的糖尿病人群，并将通过减肥和糖尿病管理产生比专业诊所更大的公共卫生影响。这一努力的最终结果将增加为患者提供管理其疾病的工具的机会，从而降低T2DM的死亡率和发病率。

DESCRIPTION (provided by applicant): Translating the Why WAIT Toolkit for Primary Care Practice will adapt the behavioral intervention component of the Why WAIT program and evaluate the feasibility of implementing it in primary care practices. The primary goal is to translate one component of the current and highly successful Why WAIT program into a model that can be widely disseminated to the primary care setting, where more than 85% of patients with diabetes receive their health care in the US and to evaluate the feasibility of implementing the adapted program in that setting. The specific aims are: Aim 1 Program Adaptation: Translate the behavioral therapy component of the successful Why WAIT program to primary care practices (PCP) with appropriate delivery approaches and messaging for both patients and providers. Aim 2 Feasibility assessment: Evaluate the feasibility of implementing the adapted component in primary care setting through program evaluation and qualitative research with providers and patients. Aim 3 Design of randomized trial for full scale evaluation: Finalize study design of the randomized controlled trial and recruit sufficient primary care practice sites for a randomized controlled trial of the fully adapted Why WAIT program Upon successful completion of the proposed objectives, we will be in a position adapt the entire program and to fully test it using a rigorous cluster randomized trial that maximizes generalizabity and minimizes bias. The innovative combination of interpersonal contact with media based support will result in a Why WAIT program that will be a extremely useful for PCPs, operating within known constraints, such as time and resources. The qualitative in-depth discussion with PCPs and diabetes patients, will inform the translation of the Why WAIT program to address the needs and obstacles faced by this audience. This will result in a program that will be used effectively by PCPs to reach a larger proportion of the diabetes population and will have a greater Public Health impact through weight reduction and diabetes management than programs located in specialty clinics. The final result of this effort will increase the opportunities to provide the tools to patients to manage their disease and thereby to reduce the mortality and morbidity consequences of T2DM. PUBLIC HEALTH RELEVANCE: The proposed study will translate the behavioral intervention component of the Why WAIT program and evaluate the feasibility of implementing it in primary care practices. The resulting program will be used effectively by PCPs to reach a larger proportion of the diabetes population and will have a greater Public Health impact through weight reduction and diabetes management than programs located in specialty clinics. The final result of this effort will increase the opportunities to provide the tools to patients to manage their disease and thereby to reduce the mortality and morbidity consequences of T2DM.