Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Blvd, 8th Fl, Los Angeles, CA 90010. Email:
Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, California.
Prev Chronic Dis. 2017 Aug 24;14:E69. doi: 10.5888/pcd14.160433.
Preventing type 2 diabetes is a public health priority in the United States. An estimated 86 million Americans aged 20 years or older have prediabetes, 90% of whom are unaware they have it. The National Diabetes Prevention Program (NDPP) has the potential to reduce the incidence of type 2 diabetes; however, little is known about the best way to institutionalize such a program in a jurisdiction with a racially/ethnically diverse population. The objective of this study was to develop a practice-grounded framework for implementing the NDPP in Los Angeles County.
In 2015, the Los Angeles County Department of Public Health (LACDPH) partnered with Ad Lucem Consulting to conduct a 3-stage formative assessment that consisted of 1) in-depth interviews with key informants representing community-based organizations to learn about their experiences implementing the NDPP and similar lifestyle-change programs and 2) 2 strategic planning sessions to obtain input and feedback from the Los Angeles County Diabetes Prevention Coalition. LACDPH identified core activities to increase identification of people with type 2 diabetes and referral and enrollment of eligible populations in the NDPP.
We worked with LACDPH and key informants to develop a 3-pronged framework of core activities to implement NDPP: expanding outreach and education, improving health care referral systems and protocols, and increasing access to and insurance coverage for NDPP. The framework will use a diverse partner network to advance these strategies.
The framework has the potential to identify people with prediabetes and to expand NDPP among priority populations in Los Angeles County and other large jurisdictions by using a diverse partner network.
预防 2 型糖尿病是美国的一项公共卫生重点。据估计，有 8600 万 20 岁或以上的美国人患有前驱糖尿病，其中 90%的人不知道自己患有前驱糖尿病。国家糖尿病预防计划（NDPP）有可能降低 2 型糖尿病的发病率；然而，对于在一个种族/民族多样化的管辖区中如何最好地将这样的计划制度化，人们知之甚少。本研究的目的是为在洛杉矶县实施 NDPP 制定一个基于实践的框架。
2015 年，洛杉矶县公共卫生部（LACDPH）与 Ad Lucem Consulting 合作，进行了 3 个阶段的形成性评估，包括 1）对代表社区组织的主要知情人进行深入访谈，了解他们实施 NDPP 和类似生活方式改变计划的经验；2）2 次战略规划会议，以获得洛杉矶县糖尿病预防联盟的投入和反馈。LACDPH 确定了增加 2 型糖尿病患者的识别以及将符合条件的人群转介和纳入 NDPP 的核心活动。
我们与 LACDPH 和主要知情人合作，制定了一个实施 NDPP 的三管齐下的核心活动框架：扩大外联和教育，改善医疗保健转介系统和协议，以及增加 NDPP 的获得途径和保险覆盖范围。该框架将利用多元化的合作伙伴网络来推进这些战略。
该框架有可能通过利用多元化的合作伙伴网络，在洛杉矶县和其他大型管辖区确定前驱糖尿病患者，并扩大 NDPP 在重点人群中的应用。
