Factors influencing participant enrolment in a diabetes prevention program in general practice: lessons from the Sydney diabetes prevention program

BMC Public Health

Stephen Colagiuri²  Daniel Davies²  Chris Rissel¹  Kamalesh Venugopal¹  Philip Vita²  Rachel A Laws¹ 

[1] Prevention Research Collaboration, School of Public Health, University of Sydney, New South Wales, 2006, Australia;Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, University of Sydney, New South Wales, 2006, Australia

关键词: Research translation;    Risk factors;    Enrolment;    Program participation;    Diabetes prevention;   

Others  :  1163041
DOI  :  10.1186/1471-2458-12-822

 received in 2012-03-18, accepted in 2012-09-10,  发布年份 2012

【 摘 要 】

Background

The effectiveness of lifestyle interventions in reducing diabetes incidence has been well established. Little is known, however, about factors influencing the reach of diabetes prevention programs. This study examines the predictors of enrolment in the Sydney Diabetes Prevention Program (SDPP), a community-based diabetes prevention program conducted in general practice, New South Wales, Australia from 2008–2011.

Methods

SDPP was an effectiveness trial. Participating general practitioners (GPs) from three Divisions of General Practice invited individuals aged 50–65 years without known diabetes to complete the Australian Type 2 Diabetes Risk Assessment tool. Individuals at high risk of diabetes were invited to participate in a lifestyle modification program. A multivariate model using generalized estimating equations to control for clustering of enrolment outcomes by GPs was used to examine independent predictors of enrolment in the program. Predictors included age, gender, indigenous status, region of birth, socio-economic status, family history of diabetes, history of high glucose, use of anti-hypertensive medication, smoking status, fruit and vegetable intake, physical activity level and waist measurement.

Results

Of the 1821 eligible people identified as high risk, one third chose not to enrol in the lifestyle program. In multivariant analysis, physically inactive individuals (OR: 1.48, P = 0.004) and those with a family history of diabetes (OR: 1.67, P = 0.000) and history of high blood glucose levels (OR: 1.48, P = 0.001) were significantly more likely to enrol in the program. However, high risk individuals who smoked (OR: 0.52, P = 0.000), were born in a country with high diabetes risk (OR: 0.52, P = 0.000), were taking blood pressure lowering medications (OR: 0.80, P = 0.040) and consumed little fruit and vegetables (OR: 0.76, P = 0.047) were significantly less likely to take up the program.

Conclusions

Targeted strategies are likely to be needed to engage groups such as smokers and high risk ethnic groups. Further research is required to better understand factors influencing enrolment in diabetes prevention programs in the primary health care setting, both at the GP and individual level.

【 授权许可】

   
2012 Laws et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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