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Improving the Recruitment and Retention in the Intensive Diabetes Prevention Program at Hong Kong in District Health Centers (IDPP-DHC)

4. november 2026 opdateret af: Arkers, Wong, The Hong Kong Polytechnic University

Optimizing Implementation of the Intensive Diabetes Prevention Program in District Health Centres: A Hybrid Type 3 Study to Enhance Recruitment and Retention for Prediabetes Management

The IDPP provides lifestyle support for people with prediabetes at DHCs in Hong Kong . However, low recruitment and retention limit its impact. This study aims to improve recruitment and retention by examining the benefits of enhanced participant engagement, staff training, and structured reminders and follow-up compared with usual program delivery.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Objectives: The IDPP provides lifestyle support for people with prediabetes at DHCs in Hong Kong. However, low recruitment and retention limit its impact. This study aims to examine whether optimized implementation strategies improve recruitment and retention while maintaining or improving participants' health outcomes.

Hypotheses to be tested: Compared with usual program delivery. optimized implementation strategies will improve recruitment. retention, and other outcomes while maintaining the clinical outcomes.

Design and subjects: This is a implementation study using a two arms cluster randomized controlled trial. The study will recruit 170 adults aged 18 or above with prediabetes.

Instruments: Program records and structured checklists will assess participation and delivery of the implementation strategies. The Chinese Patient Perceptions of Empowerment Scale and the Chinese 12-item Short Form Health Survey version 2 will assess empowerment and quality of life. Interviews will explore participants' and staff members' experiences.

Intervention: The intervention group will receive the one-year IDPP with enhanced nurse consultations, staff training, appointment reminders, and follow-up after missed appointments. Nurse consultation will include personal goal-setting and shared decisions about lifestyle changes. The control group will receive the usual local IDPP services.

Main outcomes: The primary outcomes are recruitment and retention rates. Other implementation outcomes include acceptability, adoption and sustainability. Secondary health outcomes include blood sugar control, BMI, quality of life and empowerment.

Data analysis: Generalized estimating equations will examine changes in clinical outcomes over time and differences between groups. Recruitment and retention rates will be compared between groups. Interview will undergo thematic analysis.

Expected results: The optimized strategies are expected to help more people join and remain in the IDPP while maintaining or improving health outcomes. The findings will inform the delivery and long-term use of diabetes prevention services in community settings.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

170

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  1. Aged 18 years or older
  2. A baseline HbA1c level of 6.0% to 6.4%
  3. An existing appointment for services provided by a DHC

Exclusion Criteria:

  1. A diagnosis of diabetes mellitus
  2. Current use of oral hypoglycemic agents or medications known to cause significant weight changes
  3. Coexisting conditions that prevent participation, such as active malignancy or cognitive impairment

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Sundhedstjenesteforskning
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: IDPP With Optimized Implementation Strategies

Participant will receive the one year IDPP with enhanced nurse consultations and follow-up.

The implementation includes an enhanced nurse consultations. Nurses will help participants understand prediabetes, set personal goals and review lifestyle changes. DHC staff will send reminders three days before scheduled consultations. Provider training and ongoing feedback will support program delivery.

Aktiv komparator: Usual IDPP

Participants will receive the one year IDPP according to existing DHC services.

The usual IDPP offers four voluntary group education sessions delivered by DHC staffs. There is also a nurse consultation at the DHC.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Recruitment and Retention rates
Tidsramme: 12 - month

Feasibility (Primary outcome: Recruitment and Retention rates) Recruitment will be calculated as the proportion of eligible patients who agree to participate in the IDPP out of the total eligible population that reached the DHCs.

Retention rate will be defined as the proportion of participants who complete both nurse consultation sessions and at least two of the four group-based educational sessions over a one-year period.

12 - month

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Acceptability
Tidsramme: 12 - month

Acceptability will be evaluated using semi-structured interviews with participants and providers following the implementation phase.

12 - month
Adoption
Tidsramme: 12 - month

Adoption will assess the extent to which participants and providers engage with and adhere to the optimized IDPP strategies.

12 - month
Appropriateness
Tidsramme: 12-month

The perceived relevance and compatibility of the implementation strategies with participant needs, existing workflows, and center resources. Data will be collected through semi-structured interviews with participants and staff.

12-month
Fidelity
Tidsramme: 12 - month

Fidelity, or the extent to which the implementation strategies are delivered as consistently and as intended

12 - month
Implementation cost
Tidsramme: 12 m- month

Implementation cost will be assessed from an organizational perspective, capturing direct cost associated with delivering the optimized IDPP. Data will be collected through tracking staff time and operational expenses, and by conducting analysis of incremental cost-effectiveness.

12 m- month
Sustainability
Tidsramme: 12 - month

Sustainability will be assessed as the extent to which the optimized strategies remain integrated into routine DHC operations after external research support ends.

12 - month
HbA1c
Tidsramme: Baseline, 6-month, 12-month, 18-month

Mean change in HbA1c level will be measured from blood samples drawn by DHC nurses and analyzed to reflect average blood glucose levels over the previous 2-3months.

Baseline, 6-month, 12-month, 18-month
BMI
Tidsramme: Baseline, 6-month, 12-month, 18-month

Change from baseline in BMI, calculated as weight in kilograms divided by height in meters squared.

Baseline, 6-month, 12-month, 18-month
Lipid profile
Tidsramme: Baseline, 6-month, 12-month, 18-month

Lipid profile ( including cholesterol level, high-density lipoprotein, and low-density lipoprotein) will be collected by DHC nurses.

Baseline, 6-month, 12-month, 18-month
Perceptions of empowerment
Tidsramme: Baseline, 6-month, 12-month, 18-month

Perceptions of empowerment will be measured using the Chinese version of the Patient Perceptions of Empowerment Scale (PPES) , an 11-item validated tool with a content validity index of 0.93. The PPES evaluates empowerment across four domains: information (three items), decision-making (two items), individualized autonomy (three items), and staff-management (three items). This tool has proven reliable for assessing empowerment in clinical and research settings.

Baseline, 6-month, 12-month, 18-month
Quality of life
Tidsramme: Baseline, 6-month, 12-month, 18-month

QoL will be assessed using the Chinese version of the 12-item Short Form Health Survey version 2 (SF-12), which has demonstrated reliability in local populations.

Baseline, 6-month, 12-month, 18-month
Health services utilization
Tidsramme: Baseline, 6-month, 12-month, 18-month

Health services utilizations will be assessed by tracking unscheduled visits to general outpatient departments, general practitioners, emergency departments, and hospitals during the six months preceding each data collection timepoint.

Baseline, 6-month, 12-month, 18-month

Samarbejdspartnere og efterforskere

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Sponsor

Datoer for undersøgelser

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Studer store datoer

Studiestart (Anslået)

1. december 2026

Primær færdiggørelse (Anslået)

1. juni 2028

Studieafslutning (Anslået)

1. december 2028

Datoer for studieregistrering

Først indsendt

4. november 2026

Først indsendt, der opfyldte QC-kriterier

4. november 2026

Først opslået (Faktiske)

10. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

10. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • IDPP-20261202
  • 23241241 (Andet bevillings-/finansieringsnummer: Health and Medical Research Fund)

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