Translació a l'atenció primària d'una intervenció sostenible sobre l'estil de vida per reduir l'impacte de la diabetis tipus 2. Factibilitat i implementació del projecte DP-Transfers a Catalunya.

Identificador:  TDX:3408

Handle: https://hdl.handle.net/20.500.11797/TDX3408

Autors:  Mestre Miravet, Santiago

Resum:
Translating diabetes prevention based on lifestyle changes is complicated and has hardly been evaluated during reallife clinical practice. The aim of the thesis was to design, adapt, develop and evaluate a large-scale face-to-face screening and intervention program focused on at-risk subjects (FINDRISC>11 and/or prediabetes). The DPTRANSFERS study (translation of the DE-PLAN model into Catalan primary care) is described, as well as the process analysis carried out at the end of the screening period (2 years). The translation was feasible in 95 (77,2%) of 123 registered centers with the contribution of 343 (53%) professionals. 2381 users participated in the screening and 1713 (72%) accessed intervention (190 groups; 9 ± 0.8 participants/group). The translation process was classified as possible (1 intervention group) in 39 centers (31,7%); probable (2 groups) in 37 (30%) or as effective (3 or more groups) in 19 centers (15,5%). No statistical differences were found according to the geographic location of the centers. There were 469 dropouts, 279 (59.5%) due to the discontinuity of the participants and 190 (40.5%) due to technical problems of the health team with a lower adherence in urban settings. Implementing the intervention on a large scale is feasible with public resources but a quarter of centers and half of professionals show a substantial resistance. In order to expand the program, transfer channels should be diversified.