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威尔士全民糖尿病预防计划第 1 波推广的形成过程和基于价值的评估所带来的挑战和经验教训。

The challenges and lessons from a formative process and value-based evaluation of the wave 1 roll-out of the all Wales Diabetes Prevention Programme.

机构信息

Diabetes Research Group, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK.

Swansea Centre for Health Economics, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK.

出版信息

BMC Public Health. 2024 Sep 13;24(1):2499. doi: 10.1186/s12889-024-19946-0.

Abstract

BACKGROUND

The All Wales Diabetes Prevention Programme (AWDPP) is a Wales wide, public health initiative designed to systematically identify adults at risk of developing type 2 diabetes and offer a 30-minute person-centred lifestyle conversation focused on diet and physical activity. An independent formative process and value-based evaluation was commissioned to examine the implementation of this programme in 14 primary care cluster areas across Wales during the initial roll-out.

METHODS

This evaluation was undertaken to ascertain the views on early implementation of the programme from service users, health care professionals and key stakeholders. The evaluation was informed by the Medical Research Council Framework for Process Evaluation and Wales Prudent Healthcare principles. As part of the value-based assessment, a preliminary cost-consequence analysis was conducted to understand the short-term economic impact of the implementation of the programme.

RESULTS

Service users who took part in the evaluation highly valued the programme and nearly half had been previously unaware that they were at risk of developing type 2 diabetes. Delivering the programme presented challenges but there was significant enthusiasm and support from all stakeholders. Overall, the programme was being delivered as intended albeit with evidence of some variation in the application of the programme eligibility criteria.

CONCLUSIONS

In Wave 1 of the AWDPP roll-out, the intent to deliver the programme in line with Prudent Healthcare was successful and promising in terms of demonstrating value. Opinions expressed by service users suggest the AWDPP matters to them; raising awareness, promoting knowledge and capacity to change behaviours and motivate and raise confidence.

摘要

背景

全威尔士糖尿病预防计划(AWDPP)是一项全威尔士范围的公共卫生倡议,旨在系统地识别有患 2 型糖尿病风险的成年人,并提供 30 分钟以个人为中心的生活方式对话,重点关注饮食和身体活动。为了审查该计划在威尔士 14 个初级保健集群地区的初步实施情况,委托进行了独立的形成性过程和基于价值的评估。

方法

这项评估旨在从服务使用者、医疗保健专业人员和主要利益相关者那里了解该计划早期实施的意见。该评估是根据医学研究委员会的过程评估框架和威尔士审慎医疗保健原则进行的。作为基于价值评估的一部分,进行了初步的成本-后果分析,以了解该计划实施的短期经济影响。

结果

参与评估的服务使用者高度重视该计划,近一半人以前不知道自己有患 2 型糖尿病的风险。该计划的实施带来了挑战,但所有利益相关者都表现出了极大的热情和支持。总体而言,该计划正在按计划实施,尽管在该计划资格标准的应用方面存在一些差异。

结论

在 AWDPP 推出的第 1 波中,按照审慎医疗保健原则提供该计划的意图是成功的,并且在展示价值方面很有希望。服务使用者表达的意见表明,AWDPP 对他们很重要;提高认识、促进知识和改变行为的能力,并激励和提高信心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3618/11401378/86122ee879b3/12889_2024_19946_Figa_HTML.jpg

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