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Predictors of completing a primary health care diabetes prevention intervention programme in people at high risk of type 2 diabetes: Experiences of the DE-PLAN project.

Abstract It has been shown that real-life implementation studies for the prevention of type 2 diabetes (DM2) performed in different settings and populations can be effective. However, not enough information is available on factors influencing the reach of DM2 prevention programmes. This study examines the predictors of completing an intervention programme targeted at people at high risk of DM2 in Krakow, Poland as part of the DE-PLAN project.A total of 262 middle-aged people, everyday patients of 9 general practitioners' (GP) practices, at high risk of DM2 (Finnish Diabetes Risk Score (FINDRISK) >14) agreed to participate in the lifestyle intervention to prevent DM2. Intervention consisted of 11 lifestyle counseling sessions, organized physical activity sessions followed by motivational phone calls and letters. Measurements were performed at baseline and 1 year after the initiation of the intervention.Seventy percent of the study participants enrolled completed the core curriculum (n = 184), 22% were men. When compared to noncompleters, completers had a healthier baseline diabetes risk profile (P <.05). People who completed the intervention were less frequently employed versus noncompleters (P = .037), less often had hypertension (P = .043), and more frequently consumed vegetables and fruit daily (P = .055).In multiple logistic regression model, employment reduced the likelihood of completing the intervention 2 times (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.25-0.81). Higher glucose 2 hours after glucose load and hypertension were the independent factors decreasing the chance to participate in the intervention (OR 0.79, 95% 0.69-0.92 and OR 0.52, 95% CI 0.27-0.99, respectively). Daily consumption of vegetables and fruits increased the likelihood of completing the intervention (OR 1.86, 95% 1.01-3.41).In conclusion, people with healthier behavior and risk profile are more predisposed to complete diabetes prevention interventions. Male, those who work and those with a worse health profile, are less likely to participate and complete interventions. Targeted strategies are needed in real-life diabetes prevention interventions to improve male participation and to reach those who are working as well as people with a higher risk profile.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29384876
OWN - NLM
STAT- In-Process
LR  - 20180131
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 5
DP  - 2018 Feb
TI  - Predictors of completing a primary health care diabetes prevention intervention
      programme in people at high risk of type 2 diabetes: Experiences of the DE-PLAN
      project.
PG  - e9790
LID - 10.1097/MD.0000000000009790 [doi]
AB  - It has been shown that real-life implementation studies for the prevention of
      type 2 diabetes (DM2) performed in different settings and populations can be
      effective. However, not enough information is available on factors influencing
      the reach of DM2 prevention programmes. This study examines the predictors of
      completing an intervention programme targeted at people at high risk of DM2 in
      Krakow, Poland as part of the DE-PLAN project.A total of 262 middle-aged people, 
      everyday patients of 9 general practitioners' (GP) practices, at high risk of DM2
      (Finnish Diabetes Risk Score (FINDRISK) &gt;14) agreed to participate in the
      lifestyle intervention to prevent DM2. Intervention consisted of 11 lifestyle
      counseling sessions, organized physical activity sessions followed by
      motivational phone calls and letters. Measurements were performed at baseline and
      1 year after the initiation of the intervention.Seventy percent of the study
      participants enrolled completed the core curriculum (n = 184), 22% were men. When
      compared to noncompleters, completers had a healthier baseline diabetes risk
      profile (P &lt;.05). People who completed the intervention were less frequently
      employed versus noncompleters (P = .037), less often had hypertension (P = .043),
      and more frequently consumed vegetables and fruit daily (P = .055).In multiple
      logistic regression model, employment reduced the likelihood of completing the
      intervention 2 times (odds ratio [OR] 0.45, 95% confidence interval [CI]
      0.25-0.81). Higher glucose 2 hours after glucose load and hypertension were the
      independent factors decreasing the chance to participate in the intervention (OR 
      0.79, 95% 0.69-0.92 and OR 0.52, 95% CI 0.27-0.99, respectively). Daily
      consumption of vegetables and fruits increased the likelihood of completing the
      intervention (OR 1.86, 95% 1.01-3.41).In conclusion, people with healthier
      behavior and risk profile are more predisposed to complete diabetes prevention
      interventions. Male, those who work and those with a worse health profile, are
      less likely to participate and complete interventions. Targeted strategies are
      needed in real-life diabetes prevention interventions to improve male
      participation and to reach those who are working as well as people with a higher 
      risk profile.
FAU - Gilis-Januszewska, Aleksandra
AU  - Gilis-Januszewska A
AD  - Department of Endocrinology, Jagiellonian University, Medical College, Kopernika,
      Krakow, Poland.
FAU - Lindstrom, Jaana
AU  - Lindstrom J
AD  - Chronic Disease Prevention Unit, National Institute for Health and Welfare (THL),
      Helsinki, Finland.
FAU - Barengo, Noel C
AU  - Barengo NC
AD  - Department of Medical and Population Health Science, Herbert Wertheim College of 
      Medicine, Florida International University, Miami, USA.
FAU - Tuomilehto, Jaakko
AU  - Tuomilehto J
AD  - Dasman Diabetes Institute, Dasman, Kuwait.
AD  - Centre for Vascular Prevention, Danube-University Krems, Krems, Austria.
AD  - Department of Chronic Disease Prevention, National Institute for Health and
      Welfare.
AD  - Department of Public Health, University of Helsinki, Helsinki, Finland.
AD  - Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.
FAU - Schwarz, Peter Eh
AU  - Schwarz PE
AD  - Department for Prevention &amp; Care of Diabetes, Medical Clinic Unit III, University
      Clinic, Carl Gustav Carus at Technical University Dresden.
AD  - Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University
      Hospital and Faculty of Medicine, Technical University Dresden, Dresden.
AD  - German Center for Diabetes Research, Neuherberg, Germany.
FAU - Wojtowicz, Ewa
AU  - Wojtowicz E
AD  - Department of Endocrinology.
FAU - Piwonska-Solska, Beata
AU  - Piwonska-Solska B
AD  - Department of Endocrinology.
FAU - Szybinski, Zbigniew
AU  - Szybinski Z
AD  - Department of Endocrinology.
FAU - Windak, Adam
AU  - Windak A
AD  - Department of Family Medicine, Chair of Medicine and Gerontology, Jagiellonian
      University, Medical College, Krakow, Poland.
FAU - Hubalewska-Dydejczyk, Alicja
AU  - Hubalewska-Dydejczyk A
AD  - Department of Endocrinology.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2018/02/01 06:00
MHDA- 2018/02/01 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/01 06:00 [medline]
AID - 10.1097/MD.0000000000009790 [doi]
AID - 00005792-201802020-00038 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Feb;97(5):e9790. doi: 10.1097/MD.0000000000009790.