The National Diabetes Prevention Program (National DPP) is rapidly expanding in an effort to help those at high risk of type 2 diabetes prevent or delay the disease. In 2012, the Centers for Disease Control and Prevention funded six national organizations to scale and sustain multistate delivery of the National DPP lifestyle change intervention (LCI). This study aims to describe reach, adoption, and maintenance during the 4-year funding period and to assess associations between site-level factors and program effectiveness regarding participant attendance and participation duration. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide the evaluation from October 2012 to September 2016. Multilevel linear regressions were used to examine associations between participant-level demographics and site-level strategies and number of sessions attended, attendance in months 7–12, and duration of participation. The six funded national organizations increased the number of participating sites from 68 in 2012 to 164 by 2016 across 38 states and enrolled 14,876 eligible participants. By September 2016, coverage for the National DPP LCI was secured for 42 private insurers and 7 public payers. Nearly 200 employers were recruited to offer the LCI on site to their employees. Site-level strategies significantly associated with higher overall attendance, attendance in months 7–12, and longer participation duration included using self-referral or word of mouth as a recruitment strategy, providing non-monetary incentives for participation, and using cultural adaptations to address participants’ needs. Sites receiving referrals from healthcare providers or health systems also had higher attendance in months 7–12 and longer participation duration. At the participant level, better outcomes were achieved among those aged 65+ (vs. 18–44 or 45–64), those who were overweight (vs. obesity), those who were non-Hispanic white (vs. non-Hispanic black or multiracial/other races), and those eligible based on a blood test or history of gestational diabetes mellitus (vs. screening positive on a risk test). In a time of rapid dissemination of the National DPP LCI the findings of this evaluation can be used to enhance program implementation and translate lessons learned to similar organizations and settings.

中文翻译：

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使用 RE-AIM 框架确定国家糖尿病预防计划实施中有前景的做法


国家糖尿病预防计划 (National DPP) 正在迅速扩大，以帮助那些 2 型糖尿病高危人群预防或延缓该病的发生。 2012 年，疾病控制与预防中心资助了六个国家组织，以扩大和维持国家 DPP 生活方式改变干预 (LCI) 的多州实施。本研究旨在描述 4 年资助期内的覆盖范围、采用和维护，并评估现场因素与参与者出勤率和参与持续时间方面的计划有效性之间的关联。覆盖范围、有效性、采用、实施和维护 (RE-AIM) 框架用于指导 2012 年 10 月至 2016 年 9 月的评估。使用多层线性回归来检查参与者级别人口统计数据与站点级别策略和数量之间的关联参加的会议次数、第 7-12 个月的出席情况以及参与持续时间。六个受资助的国家组织将参与地点的数量从 2012 年的 68 个增加到 2016 年的 164 个，遍布 38 个州，并招收了 14,876 名符合资格的参与者。截至 2016 年 9 月，42 家私人保险公司和 7 家公共付款人已获得国家 DPP LCI 的承保。近 200 家雇主被招募来为其员工提供现场 LCI。站点级策略与更高的总体出勤率、7-12 个月的出勤率和更长的参与持续时间显着相关，包括使用自我推荐或口碑作为招聘策略、为参与提供非金钱激励以及使用文化适应来解决参与者的需求。 接受医疗保健提供者或卫生系统推荐的网站在第 7 至 12 个月的出席率也更高，参与持续时间也更长。在参与者层面，65 岁以上人群（对比 18-44 岁或 45-64 岁）、超重人群（对比肥胖）、非西班牙裔白人（对比非西班牙裔黑人）取得了更好的结果或多种族/其他种族），以及根据血液检查或妊娠糖尿病病史符合资格的人（相对于风险测试筛查呈阳性）。在国家 DPP LCI 快速传播的时代，本次评估的结果可用于加强计划实施并将吸取的经验教训转化为类似的组织和环境。