Background The NHS Diabetes Prevention Programme (NHS-DPP) has been delivered by four commercial organizations across England, to prevent people with impaired glucose tolerance developing Type 2 diabetes. Evidence reviews underpinning the NHS-DPP design specification identified 19 Behavior Change Techniques (BCTs) that are the intervention “active ingredients.” It is important to understand the discrepancies between BCTs specified in design and BCTs actually delivered. Purpose To compare observed fidelity of delivery of BCTs that were delivered to (a) the NHS-DPP design specification, and (b) the programme manuals of four provider organizations. Methods Audio-recordings were made of complete delivery of NHS-DPP courses at eight diverse sites (two courses per provider organization). The eight courses consisted of 111 group sessions, with 409 patients and 35 facilitators. BCT Taxonomy v1 was used to reliably code the contents of NHS-DPP design specification documents, programme manuals for each provider organization, and observed NHS-DPP group sessions. Results The NHS-DPP design specification indicated 19 BCTs that should be delivered, whereas only seven (37%) were delivered during the programme in all eight courses. By contrast, between 70% and 89% of BCTs specified in programme manuals were delivered. There was substantial under-delivery of BCTs that were designed to improve self-regulation of behavior, for example, those involving problem solving and self-monitoring of behavior. Conclusions A lack of fidelity in delivery to the underlying evidence base was apparent, due to poor translation of design specification to programme manuals. By contrast, the fidelity of delivery to the programme manuals was relatively good. Future commissioning should focus on ensuring the evidence base is more accurately translated into the programme manual contents.

中文翻译：

---

NHS 糖尿病预防计划干预措施是否按计划实施？干预交付保真度的观察性研究

背景 NHS 糖尿病预防计划 (NHS-DPP) 已由英格兰的四个商业组织实施，以防止葡萄糖耐量受损的人患上 2 型糖尿病。支持 NHS-DPP 设计规范的证据审查确定了 19 种行为改变技术 (BCT)，它们是干预的“有效成分”。了解设计中指定的 BCT 与实际交付的 BCT 之间的差异非常重要。目的 比较观察到的交付给 (a) NHS-DPP 设计规范和 (b) 四个提供者组织的计划手册的 BCT 交付的保真度。方法 对八个不同地点的 NHS-DPP 课程的完整交付进行录音（每个提供者组织两门课程）。八门课程包括111个小组课程，有 409 名患者和 35 名辅导员。BCT Taxonomy v1 用于可靠地编码 NHS-DPP 设计规范文档、每个提供者组织的计划手册以及观察到的 NHS-DPP 小组会议的内容。结果 NHS-DPP 设计规范表明应该提供 19 门 BCT，而在所有八门课程的计划中只提供了 7 门（37%）。相比之下，项目手册中规定的 70% 到 89% 的 BCT 得到了交付。旨在改善行为自我调节的 BCT（例如，涉及解决问题和行为自我监控的 BCT）存在大量交付不足。结论 由于设计规范到程序手册的翻译不佳，因此在交付基础证据库时缺乏保真度是显而易见的。相比之下，对程序手册的交付忠实度相对较好。未来的调试应侧重于确保证据基础更准确地转化为程序手册内容。