Effectiveness of a National Health Care Community Partnership to Prevent Diabetes

国家医疗保健社区合作伙伴关系预防糖尿病的有效性

• 批准号: 8338354
• 负责人: Ronald T. Ackermann
• 金额: $ 47.92万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2015-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8338354
• 关键词: Effectiveness; National; Health; Care; Community

DESCRIPTION (provided by applicant): Project Abstract Today over 60 million Americans have prediabetes, and it is estimated that almost one quarter of these individuals could develop diabetes within the next 5 to 7 years. The Diabetes Prevention Program (DPP) demonstrated that an intensive lifestyle intervention resulting in modest weight loss and increased physical activity can delay or prevent the development of type 2 diabetes for adults with prediabetes. Unfortunately, the DPP lifestyle intervention was not initially designed for delivery on a public health scale, and the costs and intensity of this intervention have delayed any passive dissemination of this approach since the DPP's results were first released some 9 years ago. However, recent studies by our group at Indiana University have demonstrated that delivery of a group-based adaptation of the DPP lifestyle intervention by trained YMCA employees can achieve weight loss and behavioral changes similar to the DPP but for only about 1/8 the cost. Now, through a new partnership involving UnitedHealth Group (UHG) and the YMCA of USA, efforts are actively underway to scale this model for DPP delivery nationally. In this exciting collaboration, UHG will provide a new administrative service for employer groups and other health purchasers that will help to identify adults with pre-diabetes, reach out to these high risk persons, and assist them in enrolling in the YMCA's group-based DPP intervention program. UHG will then manage a system of value-driven payments to the YMCA, based on levels of participation and weight loss achieved by each high risk person who is enrolled. Although this will not suffice as the only means for addressing the prevention and control of diabetes on a population scale, this new partnership creates an exciting opportunity to evaluate the feasibility and sustainability of a generalizable way for delivering the DPP nationally through efforts that involve a large commercial health payer and a leading community organization. With the strong support of both UnitedHealth Group and the YMCA to provide extensive and ongoing access to several administrative data sources, we propose to evaluate the reach, implementation, costs, effectiveness, and maintenance of these efforts for tens of thousands of high risk adults in multiple regions throughout the U.S. Through a national survey of large employers, we will also collect information regarding incentives and payment for weight management and chronic disease prevention services. Through these efforts, we hope to understand more about the factors that impact reach and effectiveness of this new program as the structure of payment varies across different UHG markets, and we also hope to identify how changes in the delivery model or benefit structure over time might help to enhance reach to more employer groups and to improve participation and weight loss success for more individuals. Should our evaluation find this partnered prevention strategy to be cost- effective and sustainable, these results will be pivotal to the timely dissemination of an important new component of nationwide efforts to prevent type 2 diabetes among over 60 million Americans who already have prediabetes today.

描述（由申请人提供）：今天有超过6000万美国人的项目摘要具有糖尿病前期，据估计，这些人中有将近四分之一可以在未来5至7年内患上糖尿病。糖尿病预防计划（DPP）表明，严格的生活方式干预导致体重减轻和体育锻炼的增加可能会延迟或阻止患有糖尿病前期成年人的2型糖尿病。不幸的是，DPP的生活方式干预最初不是为公共卫生量表提供的，并且这种干预的成本和强度已延迟了这种方法的任何被动传播，因为DPP的结果大约在9年前首次发布。但是，我们的小组在印第安纳大学的最新研究表明，通过训练有素的YMCA员工对DPP生活方式干预的基于小组的改编可以实现与DPP相似的体重减轻和行为变化，但仅占成本约为1/8。现在，通过涉及UnitedHealth集团（UHG）和美国基督教青年会的新合作伙伴关系，正在积极进行努力，以将该模型扩展为全国DPP交付。在这一令人兴奋的合作中，UHG将为雇主团体和其他健康购买者提供新的行政服务，这些服务将有助于识别患有糖尿病前的成年人，与这些高风险人员接触，并帮助他们参加基于YMCA的基于小组的DPP干预计划。然后，UHG将基于每个入学的高风险人所达到的参与水平和体重减轻水平，管理向基督教青年会的价值驱动付款系统。尽管这是不足以解决人口规模预防和控制糖尿病的唯一手段，但这种新的伙伴关系创造了一个令人兴奋的机会，可以通过涉及大型商业健康付款人和领先的社区组织来评估一种可推广方式来评估全国DPP的可行性和可持续性。在UnitedHealth集团和基督教青年会的大力支持下，我们建议对几个行政数据源提供广泛的访问，我们建议评估全国各地的大型雇主的范围，实施，成本，有效性，并维护这些努力，以促进全国性雇主的全国调查中的多个高风险成年人，我们还将通过一项针对体重管理和付款管理和付款的信息进行奖励。通过这些努力，我们希望更多地了解影响该新计划的影响和有效性的因素，因为付款结构在不同的UHG市场各不相同，我们也希望确定随着时间的推移，交付模型或收益结构的变化如何有助于提高更多雇主群体的影响力，并改善更多个人的参与和体重减轻。如果我们的评估发现这种合作的预防策略是具有成本效益和可持续性的，那么这些结果将是及时传播全国范围内重要组成部分的重要组成部分，以防止在当今已经拥有Prediabetes的超过6000万美国人中2型糖尿病。