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Scaling-up from an implementation trial to state-wide coverage : results from the preliminary Melbourne Diabetes Prevention Study

Janus, Edward D., Best, James D., Davis-Lameloise, Nathalie, Philpot, Benjamin, Hernan, Andrea, Bennett, Catherine M., O'Reilly, Sharleen, Carter, Rob, Vartiainen, Erkki and Dunbar, James A. 2012, Scaling-up from an implementation trial to state-wide coverage : results from the preliminary Melbourne Diabetes Prevention Study, BioMed Central Ltd, vol. 13, no. 152, pp. 1-6.

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Title Scaling-up from an implementation trial to state-wide coverage : results from the preliminary Melbourne Diabetes Prevention Study
Author(s) Janus, Edward D.
Best, James D.
Davis-Lameloise, Nathalie
Philpot, Benjamin
Hernan, AndreaORCID iD for Hernan, Andrea orcid.org/0000-0003-4542-1186
Bennett, Catherine M.ORCID iD for Bennett, Catherine M. orcid.org/0000-0001-9581-1612
O'Reilly, SharleenORCID iD for O'Reilly, Sharleen orcid.org/0000-0003-3547-6634
Carter, RobORCID iD for Carter, Rob orcid.org/0000-0002-1586-5619
Vartiainen, Erkki
Dunbar, James A.ORCID iD for Dunbar, James A. orcid.org/0000-0003-0866-4365
Journal name BioMed Central Ltd
Volume number 13
Issue number 152
Start page 1
End page 6
Total pages 6
Publisher BioMed Central
Place of publication London, England
Publication date 2012
ISSN 1745-6215
Keyword(s) Type 2 diabetes
Effectiveness
Randomised controlled trial
Implementation
Intervention
Lifestyle
Prevention
Summary Background
The successful Greater Green Triangle Diabetes Prevention Program (GGT DPP), a small implementation trial, has been scaled-up to the Victorian state-wide ‘Life!’ programme with over 10,000 individuals enrolled. The Melbourne Diabetes Prevention Study (MDPS) is an evaluation of the translation from the GGT DPP to the Life! programme. We report results from the preliminary phase (pMDPS) of this evaluation.
Methods
The pMDPS is a randomised controlled trial with 92 individuals aged 50 to 75 at high risk of developing type 2 diabetes randomised to Life! or usual care. Intervention consisted of six structured 90-minute group sessions: five fortnightly sessions and the final session at 8 months. Participants underwent anthropometric and laboratory tests at baseline and 12 months, and provided self-reported psychosocial, dietary, and physical activity measures. Intervention group participants additionally underwent these tests at 3 months. Paired t tests were used to analyse within-group changes over time. Chi-square tests were used to analyse differences between groups in goals met at 12 months. Differences between groups for changes over time were tested with generalised estimating equations and analysis of covariance.
Results
Intervention participants significantly improved at 12 months in mean body mass index (−0.98 kg/m2, standard error (SE) = 0.26), weight (−2.65 kg, SE = 0.72), waist circumference (−7.45 cm, SE = 1.15), and systolic blood pressure (−3.18 mmHg, SE = 1.26), increased high-density lipoprotein-cholesterol (0.07 mmol/l, SE = 0.03), reduced energy from total (−2.00%, SE = 0.78) and saturated fat (−1.54%, SE = 0.41), and increased fibre intake (1.98 g/1,000 kcal energy, SE = 0.47). In controls, oral glucose at 2 hours deteriorated (0.59 mmol/l, SE = 0.27). Only waist circumference reduced significantly (−4.02 cm, SE = 0.95).

Intervention participants significantly outperformed controls over 12 months for body mass index and fibre intake. After baseline adjustment, they also showed greater weight loss and reduced saturated fat versus total energy intake.

At least 5% weight loss was achieved by 32% of intervention participants versus 0% controls.
Conclusions
pMDPS results indicate that scaling-up from implementation trial to state-wide programme is possible. The system design for Life! was fit for purpose of scaling-up from efficacy to effectiveness.
Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Language eng
Field of Research 111717 Primary Health Care
Socio Economic Objective 920104 Diabetes
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2012, Janus et al.; licensee BioMed Central Ltd.
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30050419

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.