Real‐world impacts from a decade of Quality Enhancement Research Initiative‐partnered projects to translate the Diabetes Prevention Program in the Veterans Health Administration

Author:

Damschroder Laura J.1ORCID,Hamilton Alison23,Farmer Melissa M.2,Bean‐Mayberry Bevanne23,Richardson Caroline4,Chanfreau Catherine25,Oberman Rebecca S.2ORCID,Lesser Rachel2,Lewis Jackie2,Raffa Sue D.6,Goldstein Micheal G.46,Haskell Sally78,Finley Erin29,Moin Tannaz23ORCID

Affiliation:

1. Ann Arbor VA Medical Center for Clinical Management Research Ann Arbor Michigan USA

2. VA Center for the Study of Healthcare Innovation, Implementation & Policy Los Angeles California USA

3. David Geffen School of Medicine at the University of California Los Angeles (UCLA) Los Angeles California USA

4. Warren Alpert Medical School at Brown University Providence Rhode Island USA

5. VHA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Healthcare System Salt Lake City Utah USA

6. VHA National Center for Health Promotion and Disease Prevention Durham North Carolina USA

7. VHA Office of Women's Health Washington DC USA

8. Yale School of Medicine New Haven Connecticut USA

9. Long School of Medicine University of Texas Health Science Center San Antonio San Antonio Texas USA

Abstract

AbstractObjectivesTo describe the impacts of four Veterans Health Administration (VA) Quality Enhancement Research Initiative (QUERI) projects implementing an evidence‐based lifestyle intervention known as the Diabetes Prevention Program (DPP).Data Sources and Study Setting2012–2024 VA administrative and survey data.Study DesignThis is a summary of findings and impacts from four effectiveness‐implementation projects focused on in‐person and/or online DPP across VA sites.Data Collection/Extraction MethodsPatient demographics, participation data, and key findings and impacts were summarized across reports from the VA Diabetes‐Mellitus Quality Enhancement Research Initiative (QUERI‐DM) Diabetes Prevention Program (VA DPP) Trial, QUERI‐DM Online DPP Trial, the Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) QUERI DPP Project, and EMPOWER 2.0 QUERI Program.Principal FindingsBetween 2012 and 2024, four VA QUERI studies enrolled 963 Veterans in DPP across 16 VA sites. All participants had overweight/obesity with one additional risk factor for type 2 diabetes (i.e., prediabetes, elevated risk score, or history of gestational diabetes) and 56% (N = 536) were women. In addition to enhancing the reach of and engagement in diabetes prevention services among Veterans, these projects resulted in three key impacts as follows: (1) informing the national redesign of VA MOVE! including recommendations to increase the number of MOVE! sessions and revise guidelines across 150+ VA sites, (2) enhancing the national evidence base to support online DPP delivery options with citations in national care guidelines outside VA, and (3) demonstrating the importance of gender‐tailoring of preventive care services by and for women Veterans to enhance engagement in preventive services.ConclusionsOver the past decade, the evolution of VA QUERI DPP projects increased the reach of and engagement in diabetes prevention services among Veterans, including women Veterans who have been harder to engage in lifestyle change programs in VA, and resulted in three key impacts informing type 2 diabetes and obesity prevention efforts within and outside of VA.

Funder

Quality Enhancement Research Initiative

National Center for Chronic Disease Prevention and Health Promotion

Health Services Research and Development

Publisher

Wiley

Reference50 articles.

1. Economic Costs of Diabetes in the U.S. in 2017

2. CDC.National diabetes statistics report website.2023.https://www.cdc.gov/diabetes/data/statistics-report/index.html

3. VA QUERI Diabetes Mellitus.https://www.hsrd.research.va.gov/publications/internal/querifactsheetDMB.pdf

4. US veterans administration diabetes risk (VADR) national cohort: cohort profile

5. Prevalence of and Trends in Diabetes Among Veterans, United States, 2005–2014

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