Design and Implementation of An Intervention to Improve Prediabetes Management in Primary Care

改善初级保健糖尿病前期管理的干预措施的设计和实施

基本信息

批准号：
10220371
负责人：
Eva Tseng
金额：
$ 3.12万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-10 至 2024-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10220371
关键词：
Address Adult Award Awareness Baltimore Behavioral Cardiovascular system Caring Centers for Disease Control and Prevention (U.S.)Chronic Disease Clinic Clinical Clinical Pathways Clinical Protocols Clinical Research Clinical Trials Complications of Diabetes Mellitus Computerized Medical Record Data Data Analytics Data Collection Data Set Data Sources Databases Development Development Plans Diabetes Mellitus Diabetes prevention Diagnosis Diagnostic Effectiveness Environment Evidence based intervention Funding Goals Grant Guidelines Health system Healthcare Healthcare Systems Human Resources Incidence Individual Institution Internal Medicine Intervention Intervention Studies Intervention Trial Interview Knowledge Leadership Learning Learning Module Life Style Life Style Modification Link Medical Mentored Patient-Oriented Research Career Development Award Mentors Metformin Methodology Methods Microvascular Dysfunction Modeling Monitor National Institute of Diabetes and Digestive and Kidney Diseases Neuropathy Online Systems Outcome Patients Performance Persons Pharmaceutical Preparations Play Population Prediabetes syndrome Premature Mortality Prevention Research Prevention trial Primary Health Care Provider Public Health Public Health Schools Reporting Research Research Personnel Research Training Resources Retrospective cohort study Risk Role Scientist Services Testing Time Training Training Activity Translating United States United States National Institutes of Health Universities Visit Woman Work analytical method cardiovascular disorder risk care providers career career development design diabetes prevention program diabetes risk epidemiology study evidence base evidence based guidelines follow-up group intervention high risk implementation science improved informant insurance claims insurance plan lifestyle intervention medical schools meetings patient engagement placebo group prevent primary care setting professor programs research and development routine practice screening skills success successful intervention therapy design tool trial comparing weight loss program

项目摘要

PROJECT SUMMARY/ABSTRACT Diabetes prevention is crucial for reducing the public health burden of diabetes in the United States. 84 million U.S. adults have prediabetes but 90% are undiagnosed. The NIH has prioritized finding efficient ways to translate outcomes achieved in diabetes prevention trials into routine healthcare practice. The National Diabetes Prevention Program recognizes lifestyle change programs meeting specific metrics that help prevent or delay diabetes. However, an effective model for engaging health systems and primary care providers in facilitating screening, testing and referral to these programs is lacking. There is currently no systematic approach to prediabetes management in the primary care setting, but it is essential for addressing the burden of diabetes. To address this need, we propose the following interrelated Specific Aims: 1) To conduct a retrospective cohort study to describe longitudinal primary care provider practices around the diagnosis and treatment of prediabetes using a linked claims and electronic medical record (EMR) dataset, 2) To conduct key informant interviews with stakeholders relevant to diabetes prevention, including leadership from health care system/clinics, insurance plan leaders, providers and patients, to identify barriers and facilitators to implementation, 3) To design and pilot test the diabetes prevention clinical pathway within a primary care clinic in Baltimore, MD, and evaluate its effectiveness on provider screening and intervention, and patient engagement in diabetes prevention over a period of 12 months. Dr. Eva Tseng is an Assistant Professor in the Division of General Internal Medicine and a clinical researcher at The Johns Hopkins University School of Medicine. Her long-term career goal is to become an independent clinician-investigator conducting pragmatic intervention studies with a focus on improving the prevention of diabetes in primary care. The proposed career development plan includes didactic and research training activities that will substantially build her skills in developing and implementing an intervention. These will include training in implementation science, clinical trial methods, quantitative data analytic methods for large claims/EMR databases, as well as qualitative data collection and analytic methods. This training will occur in the rich training environment of the Johns Hopkins Medical Institutions, including the Bloomberg School of Public Health and the Welch Center for Prevention, Epidemiology, and Clinical Research. She will receive guidance from her outstanding team of mentors and advisors with expertise in the methodologies needed for conducting the planned research, and a track record of mentoring and funding. The award and protected time will allow Dr. Tseng to build an independent NIH-funded research career and become a leader in pragmatic approaches to improve the prevention of diabetes in primary care with potential applications to other chronic diseases.

项目摘要/摘要预防糖尿病对于减轻美国糖尿病的公共卫生负担至关重要。 8400万美国成年人患有糖尿病前期，但有90％的人未诊断。 NIH优先寻找有效的翻译方法在预防糖尿病试验中取得的结果进入了常规医疗保健实践。国家糖尿病预防计划承认生活方式改变计划符合有助于预防或延迟的特定指标糖尿病。但是，是吸引卫生系统和初级保健提供者促进的有效模型缺乏筛选，测试和转介这些程序。目前没有系统的方法初级保健环境中的糖尿病前期管理，但对于解决糖尿病负担至关重要。为了满足这一需求，我们提出以下相互关联的特定目的：1）进行回顾研究围绕糖尿病前期诊断和治疗的纵向初级保健提供者实践的研究使用链接的索赔和电子病历（EMR）数据集，2）进行关键的线人访谈与糖尿病相关的利益相关者，包括医疗保健系统/诊所的领导，保险计划领导者，提供者和患者，确定实施障碍和促进者，3）设计和飞行员测试马里兰州巴尔的摩的初级保健诊所内预防糖尿病的临床途径，并评估其在提供商筛查和干预措施以及患者参与糖尿病预防的有效性时间为12个月。 Eva Tseng博士是普通内科司的助理教授，也是一名临床研究人员约翰·霍普金斯大学医学院。她的长期职业目标是成为独立进行务实干预研究的临床医生评论者，重点是改善预防初级保健中的糖尿病。拟议的职业发展计划包括教学和研究培训活动建立她在开发和实施干预方面的技能。这些将包括实施培训科学，临床试验方法，大型索赔/EMR数据库的定量数据分析方法以及定性数据收集和分析方法。这种培训将发生在丰富的培训环境中约翰·霍普金斯医疗机构，包括彭博公共卫生学院和韦尔奇中心预防，流行病学和临床研究。她将获得她杰出团队的指导指导者和顾问在进行计划研究所需的方法方面具有专业知识，指导和资金的记录。该奖项和受保护的时间将使Tseng博士能够建立独立NIH资助的研究职业，并成为务实方法的领导者预防初级保健中的糖尿病，并可能应用于其他慢性疾病。