Real-world impacts from a decade of Quality Enhancement Research Initiative-partnered projects to translate the Diabetes Prevention Program in the Veterans Health Administration

IF 3.1 2区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Services Research Pub Date : 2024-07-05 DOI:10.1111/1475-6773.14349

Laura J. Damschroder MS, MPH, Alison Hamilton PhD, MPH, Melissa M. Farmer PhD, Bevanne Bean-Mayberry MD, MHS, Caroline Richardson MD, Catherine Chanfreau PhD, Rebecca S. Oberman MSW, MPH, Rachel Lesser MPH, Jackie Lewis, Sue D. Raffa PhD, Micheal G. Goldstein MD, Sally Haskell MD, Erin Finley PhD, Tannaz Moin MD, MBA, MSHS

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Abstract

Objectives

To describe the impacts of four Veterans Health Administration (VA) Quality Enhancement Research Initiative (QUERI) projects implementing an evidence-based lifestyle intervention known as the Diabetes Prevention Program (DPP).

Data Sources and Study Setting

2012–2024 VA administrative and survey data.

Study Design

This is a summary of findings and impacts from four effectiveness-implementation projects focused on in-person and/or online DPP across VA sites.

Data Collection/Extraction Methods

Patient demographics, participation data, and key findings and impacts were summarized across reports from the VA Diabetes-Mellitus Quality Enhancement Research Initiative (QUERI-DM) Diabetes Prevention Program (VA DPP) Trial, QUERI-DM Online DPP Trial, the Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) QUERI DPP Project, and EMPOWER 2.0 QUERI Program.

Principal Findings

Between 2012 and 2024, four VA QUERI studies enrolled 963 Veterans in DPP across 16 VA sites. All participants had overweight/obesity with one additional risk factor for type 2 diabetes (i.e., prediabetes, elevated risk score, or history of gestational diabetes) and 56% (N = 536) were women. In addition to enhancing the reach of and engagement in diabetes prevention services among Veterans, these projects resulted in three key impacts as follows: (1) informing the national redesign of VA MOVE! including recommendations to increase the number of MOVE! sessions and revise guidelines across 150+ VA sites, (2) enhancing the national evidence base to support online DPP delivery options with citations in national care guidelines outside VA, and (3) demonstrating the importance of gender-tailoring of preventive care services by and for women Veterans to enhance engagement in preventive services.

Conclusions

Over the past decade, the evolution of VA QUERI DPP projects increased the reach of and engagement in diabetes prevention services among Veterans, including women Veterans who have been harder to engage in lifestyle change programs in VA, and resulted in three key impacts informing type 2 diabetes and obesity prevention efforts within and outside of VA.

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质量提升研究计划合作项目十年来对退伍军人健康管理局糖尿病预防计划的实际影响。

目标：描述退伍军人健康管理局（VA）质量提升研究计划（QUERI）的四个项目在实施名为 "糖尿病预防计划"（DPP）的循证生活方式干预措施后产生的影响：数据收集/提取方法：患者人口统计数据、参与数据、主要发现和影响在退伍军人事务部糖尿病质量提升研究计划（QUERI-DM）糖尿病预防计划（VA DPP）试验、QUERI-DM在线DPP试验、通过参与和保留（EMPOWER）QUERI DPP项目和EMPOWER 2.0 QUERI计划的报告中进行了总结：2012 年至 2024 年间，退伍军人事务部的四项 QUERI 研究在退伍军人事务部的 16 个地点招募了 963 名退伍军人参加 DPP。所有参与者都患有超重/肥胖症，并有一个额外的 2 型糖尿病风险因素（即糖尿病前期、风险评分升高或妊娠糖尿病史），其中 56% （N = 536）为女性。除了扩大退伍军人糖尿病预防服务的覆盖面和参与度，这些项目还产生了以下三个关键影响：(1) 为退伍军人保健计划（VA MOVE！）的全国性重新设计提供了信息，包括建议增加 MOVE！课程的数量并修订 150 多个退伍军人保健站的指南；(2) 增强了全国性证据基础，以支持在线 DPP 交付选项，并在退伍军人保健计划以外的国家护理指南中引用；以及 (3) 证明了由女性退伍军人为女性退伍军人提供预防性护理服务的性别定制的重要性，以提高参与预防性服务的积极性：在过去的十年中，退伍军人事务部 QUERI DPP 项目的发展扩大了退伍军人（包括在退伍军人事务部较难参与生活方式改变计划的女性退伍军人）糖尿病预防服务的覆盖范围和参与度，并产生了三个关键影响，为退伍军人事务部内外的 2 型糖尿病和肥胖症预防工作提供了信息。

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来源期刊

Health Services Research 医学-卫生保健

CiteScore

4.80

自引率

5.90%

发文量

193

审稿时长

4-8 weeks

期刊介绍： Health Services Research (HSR) is a peer-reviewed scholarly journal that provides researchers and public and private policymakers with the latest research findings, methods, and concepts related to the financing, organization, delivery, evaluation, and outcomes of health services. Rated as one of the top journals in the fields of health policy and services and health care administration, HSR publishes outstanding articles reporting the findings of original investigations that expand knowledge and understanding of the wide-ranging field of health care and that will help to improve the health of individuals and communities.