Improving the Recruitment and Retention in the Intensive Diabetes Prevention Program at Hong Kong in District Health Centers (IDPP-DHC)
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.
Обзор исследования
Статус
Статус
Условия
Условия
Вмешательство/лечение
Вмешательство/лечение
Подробное описание
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.
Тип исследования
Тип исследования
Регистрация (Оцененный)
Регистрация
Фаза
Фаза
- Непригодный
Контакты и местонахождение
Контакты исследования
Контакты исследования
- Имя: Arkers Kwan Ching Wong
- Номер телефона: 852+60324152
- Электронная почта: arkers.wong@polyu.edu.hk
Критерии участия
Критерии приемлемости
Критерии приемлемости
Возраст, подходящий для обучения
Принимает здоровых добровольцев
Полы, имеющие право на обучение
Описание
Inclusion Criteria:
- Aged 18 years or older
- A baseline HbA1c level of 6.0% to 6.4%
- An existing appointment for services provided by a DHC
Exclusion Criteria:
- A diagnosis of diabetes mellitus
- Current use of oral hypoglycemic agents or medications known to cause significant weight changes
- Coexisting conditions that prevent participation, such as active malignancy or cognitive impairment
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Исследования в области здравоохранения
- Распределение: Рандомизированный
- Интервенционная модель: Параллельное назначение
- Маскировка: Двойной
Количество рук
Оружие и интервенции
Группа участников / АрмияГруппа участников / Армия |
Вмешательство/лечениеВмешательство/лечение |
|---|---|
|
Экспериментальный: 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. |
|
Активный компаратор: 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. |
Что измеряет исследование?
Первичные показатели результатов
Первичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Recruitment and Retention rates
Временное ограничение: 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
|
Вторичные показатели результатов
Вторичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Acceptability
Временное ограничение: 12 - month
|
Acceptability will be evaluated using semi-structured interviews with participants and providers following the implementation phase. |
12 - month
|
|
Adoption
Временное ограничение: 12 - month
|
Adoption will assess the extent to which participants and providers engage with and adhere to the optimized IDPP strategies. |
12 - month
|
|
Appropriateness
Временное ограничение: 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
Временное ограничение: 12 - month
|
Fidelity, or the extent to which the implementation strategies are delivered as consistently and as intended |
12 - month
|
|
Implementation cost
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
|
Соавторы и исследователи
Спонсор
Спонсор
Даты записи исследования
Изучение основных дат
Начало исследования (Оцененный)
Начало исследования
Первичное завершение (Оцененный)
Первичное завершение
Завершение исследования (Оцененный)
Завершение исследования
Даты регистрации исследования
Первый отправленный
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Действительный)
Первый опубликованный
Обновления учебных записей
Последнее опубликованное обновление (Действительный)
Последнее опубликованное обновление
Последнее отправленное обновление, отвечающее критериям контроля качества
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Ключевые слова
Дополнительные соответствующие термины MeSH
Другие идентификационные номера исследования
Другие идентификационные номера исследования
- IDPP-20261202
- 23241241 (Другой номер гранта/финансирования: Health and Medical Research Fund)
Планирование данных отдельных участников (IPD)
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Информация о лекарствах и устройствах, исследовательские документы
Изучает лекарственный продукт, регулируемый FDA США.
Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.
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