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

Nurs Res. Jan-Feb 2009;58(1):2-12. doi: 10.1097/NNR.0b013e31818fcef3.

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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 2 / etiology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Female
  • Humans
  • Hypercholesterolemia / complications
  • Hypercholesterolemia / diagnosis
  • Hypercholesterolemia / prevention & control
  • Hypertension / complications
  • Hypertension / diagnosis
  • Hypertension / prevention & control
  • Life Style*
  • Male
  • Middle Aged
  • New England
  • Nurse Practitioners / organization & administration*
  • Nursing Evaluation Research
  • Nutritional Sciences / education
  • Obesity / complications
  • Obesity / diagnosis
  • Obesity / prevention & control
  • Patient Education as Topic / organization & administration*
  • Patient Satisfaction
  • Pilot Projects
  • Primary Health Care / organization & administration*
  • Program Evaluation
  • Prospective Studies
  • Single-Blind Method