Application of implementation mapping to develop strategies for integrating the National Diabetes Prevention Program into primary care clinics

• DOI: 10.3389/fpubh.2023.933253
• Publication Date: 2023-04-26T05:47:36Z
• Authors: William B. Perkison; Serena A. Rodriguez; Fernanda Velasco-...; Patenne D. Mathews; Catherine Pulicken; Sidra S. Beg; Natalia I. Heredia; Pierre Fwelo; Grace E. White; Belinda M. Reininger; John W. McWhorter; Roshanda Chenier; Maria E. Fernandez
• Keywords: Reimbursement; Implementation research; Program Design Language

Background Diabetes is considered one of the most prevalent and preventable chronic health conditions in United States. Research has shown that evidence-based prevention measures lifestyle changes can help lower risk developing diabetes. The National Prevention Program (National DPP) an program recognized by Centers for Disease Control Prevention; it designed to reduce diabetes through intensive group counseling nutrition, physical activity, behavioral management. Factors known influence this program’s implementation, especially primary care settings, have included limited awareness program, lack standard clinical processes facilitate referrals, reimbursement incentives support delivery. A framework or approach address these other barriers practice needed. Objective We used Implementation Mapping, a systematic planning framework, plan adoption, maintenance DPP clinics Greater Houston area. followed framework’s five iterative tasks develop strategies helped increase adoption implementation. Methods conducted needs assessment survey interviews with participating clinics. identified clinic personnel who were responsible use, including adopters, implementers, maintainers, potential facilitators performance objectives, sub-behaviors necessary achieve each clinic’s goals, stage classic science theory dissemination implementation models frameworks identify determinants maintenance. Evidence- theory-based methods selected operationalized into tailored executed four sites. outcomes are being measured several different approaches. Electronic Health Records (EHR) will measure referral rates DPP. Surveys be assess level providers staff’s acceptability, appropriateness feasibility, usefulness DPP, aggregate biometric data disease management prediabetes Results Participating Federally Qualified Center, rural center, two private practices. Most personnel, leadership at sites, not aware Steps development objectives (implementation actions) identifying psychosocial contextual determinants. provider-to-provider education, electronic record optimization, protocols materials (e.g., project plan, policies). Conclusion been prevent delay among at-risk patients. Yet, there remain many challenges Mapping systematically design them. To further advance prevention, future research efforts should examine promote such as increased use better billing infrastructure assist scale spread across U.S.