geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Increasing efficacy of primary care-based counseling for diabetes prevention: rationale and design of the ADAPT (Avoiding Diabetes Thru Action Plan Targeting) trial


, : Increasing efficacy of primary care-based counseling for diabetes prevention: rationale and design of the ADAPT (Avoiding Diabetes Thru Action Plan Targeting) trial. Implementation Science 7: 6-6

Studies have shown that lifestyle behavior changes are most effective to prevent onset of diabetes in high-risk patients. Primary care providers are charged with encouraging behavior change among their patients at risk for diabetes, yet the practice environment and training in primary care often do not support effective provider counseling. The goal of this study is to develop an electronic health record-embedded tool to facilitate shared patient-provider goal setting to promote behavioral change and prevent diabetes. Methods The ADAPT (Avoiding Diabetes Thru Action Plan Targeting) trial leverages an innovative system that integrates evidence-based interventions for behavioral change with already-existing technology to enhance primary care providers' effectiveness to counsel about lifestyle behavior changes. Using principles of behavior change theory, the multidisciplinary design team utilized in-depth interviews and in vivo usability testing to produce a prototype diabetes prevention counseling system embedded in the electronic health record. Results The core element of the tool is a streamlined, shared goal-setting module within the electronic health record system. The team then conducted a series of innovative, "near-live" usability testing simulations to refine the tool and enhance workflow integration. The system also incorporates a pre-encounter survey to elicit patients' behavior-change goals to help tailor patient-provider goal setting during the clinical encounter and to encourage shared decision making. Lastly, the patients interact with a website that collects their longitudinal behavior data and allows them to visualize their progress over time and compare their progress with other study members. The finalized ADAPT system is now being piloted in a small randomized control trial of providers using the system with prediabetes patients over a six-month period. Conclusions The ADAPT system combines the influential powers of shared goal setting and feedback, tailoring, modeling, contracting, reminders, and social comparisons to integrate evidence-based behavior-change principles into the electronic health record to maximize provider counseling efficacy during routine primary care clinical encounters. If successful, the ADAPT system may represent an adaptable and scalable technology-enabled behavior-change tool for all primary care providers. Trial Registration ClinicalTrials.gov Identifier.

US$19.90

PMID: 22269066

DOI: 10.1186/1748-5908-7-6


Other references

Favret M.E.; Yousten A.A., 1987: Preliminary characterization of bacillus thuringiensis bacteriocin. Abstracts of the Annual Meeting of the American Society for Microbiology 87: 192

Jallon, P.; Fankhauser, L.; Perrig, S.; Sax, H.; Neftel, K., 2003: A cluster of Cefepime induced encephalopathy in a university hospital. Background: Beta-lactam antibiotics can induce dose dependent neurotoxicity by interfering with the GABA-ergic system of the brain. Impaired renal function is the main risk factor. We report 29 cases of Cefepime induced encephalopathy (CIE) observ...

Comijs, H.C.; Gerritsen, L.; Penninx, B.W.J.H.; Bremmer, M.A.; Deeg, D.J.H.; Geerlings, M.I., 2010: The association between serum cortisol and cognitive decline in older persons. To investigate whether serum cortisol levels are associated with cognitive performance and cognitive decline in elderly persons and whether this association differs by age, sex, and depression status. Data from the Longitudinal Aging Study Amsterd...

Kumer, K.P.; Nwangwu, J.T.; Nwangwu, P.U., 1983: Perspectives on digoxin absorption from small bowel resections. Digoxin is a commonly prescribed medication for a variety of cardiovascular abnormalities. The therapeutic index of digoxin is considered narrow and drug is absorbed predominantly from the duodenum and upper jejunum. When the small intestine is in...

Gunderson J., 1984: Ancephaline gregarines form introduced from intertidal invertebrates in central california usa. Journal Of Protozoology: 24a

Gatenby, P.; Flook, M.; Spalding, D.; Tait, P., 2009: Percutaneous transhepatic cholecystoduodenal stent for empyema of the gallbladder. Acute cholecystitis is treated by antibiotics and cholecystectomy. When the gallbladder neck is obstructed in the presence of infection, preventing pus from draining via the cystic duct, an empyema of the gallbladder develops. Under these circumst...

Oominato, K.; Nozaki, M.; Nagawa, A.; Takahashi, A.; Kawauchi, H.; Sower, S.A., 1997: Occurrence of possible gonadotropin cells in the pituitary of sea lampreys. Zoological Science (Tokyo) 14(SUPPL ): 20, Dec

Collier Barnard L., 1988: Crusader on the beach. Pages 64-67, 74-79, 140 1988

Cates, A.W.; Pollard, A.E., 1998: A model study of intramural dispersion of action potential duration in the canine pulmonary conus. Regional gradients of action potential duration (APD) due to electrophysiological differences between endocardial, midmyocardial, and epicardial myocytes may exist across the ventricular wall. In addition, activation sequence-induced gradients of...

Collin, J.E., 1921: A contribution towards the knowledge of the Anthomyid genera Hammomyia and Hylephila of Rondani Diptera. Transactions of the Entomological Society of London, 1920: 305-326