Evaluating Real-world Diabetes Prevention Programs in a Multi-campus University System and a Three-state Regional Health Network

评估多校区大学系统和三州区域卫生网络中的现实世界糖尿病预防计划

• 批准号: 10554970
• 负责人: OBIDIUGWU KENRIK, DURU
• 金额: $ 57万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10554970
• 关键词: Evaluating; Real; world; Diabetes; Prevention; Evaluating; Real; world; Diabetes; Prevention

Project Summary/Abstract In an innovative scientific partnership between researchers, the UC Office of the President (UCOP), and Intermountain Healthcare, we will leverage existing electronic health record (EHR), insurance claims and DPP cohort data to examine the long-term effectiveness and cost-effectiveness of the Diabetes Prevention Program (DPP), as well as barriers and facilitators of participation in DPP in real-world settings. We proposed a rigorous evaluation using diverse data sources from the University of California (UC), which is a multi-campus university system and one of the largest employers in the State of California, and Intermountain Healthcare, which is a three-state regional health network. We will create a merged multi- ethnic and geographically diverse electronic cohort of adults at-risk of developing type 2 diabetes who enrolled in DPP and propensity-matched controls who did not enroll in DPP. We will include all DPP delivery models that have been in existence for nearly a decade in both systems. To assess the effectiveness of real-world DPP delivery, we will examine percent weight change at 5-years follow-up among adults at risk for developing type 2 diabetes, comparing those who completed DPP with those who did not enroll, and also comparing those who started but did not complete DPP with those who did not enroll (primary outcome). Secondary outcomes will examine changes in cardiovascular risk factors (e.g., blood pressure, tobacco use), rates of incident type 2 diabetes and diabetes-related healthcare service utilization and related costs. To assess the cost-effectiveness of real-world DPP delivery, we will estimate cost per case of type 2 diabetes prevented and cost per quality-adjusted life years (QALYs) gained at 5-years follow-up. We will also examine whether long-term effectiveness and cost-effectiveness vary by several factors, including DPP entry criteria (e.g., blood test vs. risk test), program delivery mode, social determinants of health, age group, or race and ethnicity. To examine barriers and facilitators to DPP participation, we will survey a representative subset of DPP participants and non-participants. We will leverage our team's expertise in DPP evaluation and track record of collaboration, and we will work closely with the coordinating center to carry out this comprehensive multi-site evaluation study. Findings from this study will inform future UC System and Intermountain Healthcare strategies addressing obesity and type 2 diabetes prevention, as well as dissemination of effective strategies to other large university systems, healthcare systems and employers.

项目摘要/摘要 在研究人员，UC总统办公室（UCOP）和 Intermountain Healthcare，我们将利用现有的电子健康记录（EHR），保险索赔和 DPP队列数据以检查预防糖尿病的长期有效性和成本效益 计划（DPP），以及在现实世界中参与DPP的障碍和促进者。我们 提出了使用加利福尼亚大学（UC）的不同数据源进行严格的评估，这是 多校大学系统，加利福尼亚州最大的雇主之一， Intermountain Healthcare，这是一个三州区域卫生网络。我们将创建一个合并的多 种族和地理上多样化的电子队列成年人在危险中的2型糖尿病风险 没有参加DPP的DPP和倾向匹配的对照组。我们将包括所有DPP交付 在两个系统中已经存在近十年的模型。评估有效性 现实世界中的DPP交付，我们将检查有风险的成年人在5年随访时重量变化的百分比变化 对于开发2型糖尿病，将完成DPP的人与未注册的人进行比较，以及 还将那些开始但未完成DPP的人与未注册的人进行比较（主要 结果）。次要结果将检查心血管危险因素的变化（例如，血压， 烟草使用），事件2型糖尿病和糖尿病相关的医疗保健服务的利用率和 相关费用。为了评估现实世界中DPP交付的成本效益，我们将估计每案例的成本 2型糖尿病可以预防和每次调整质量调整的终身年份（QALYS）的成本在5年的随访中获得。我们 还将检查长期有效性和成本效益是否因几个因素而有所不同，包括 DPP进入标准（例如，血液测试与风险测试），计划输送模式，健康的社会决定因素，年龄 团体或种族和种族。为了检查障碍和促进者以参与DPP，我们将调查 DPP参与者和非参与者的代表性子集。我们将利用团队的专业知识 DPP评估和协作的记录，我们将与协调中心紧密合作 进行这项全面的多站点评估研究。这项研究的发现将为未来的UC提供信息 系统和国际医疗保健策略也针对肥胖和2型糖尿病预防 作为将有效策略传播给其他大型大学系统，医疗保健系统和 雇主。