Disseminating Public Health Evidence to Support Prevention and Control of Diabetes Among Local Health Departments
Study Details
Study Description
Brief Summary
The purpose of this study is to identify and evaluate dissemination strategies to support the uptake of evidence-based programs and policies (EBPPs) for diabetes prevention and control among local-level public health practitioners. Dissemination strategies such as multi-day in-person training workshops, electronic information exchange modalities, and remote technical assistance are hypothesized to associate with improved access and use of public health evidence and organizational supports for program and policy decision making based on evidence-based public health.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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N/A |
Detailed Description
Evidence-based public health approaches to prevent and control diabetes and other chronic diseases have been identified in recent decades, and could have a profound effect on diabetes incidence and quality and length of life of those diagnosed. However, barriers to implement approaches continue because of lack of organizational support, limited resources, competing priorities, and limited skill among the public health workforce. The purpose of this study is to determine effective ways to promote the adoption of evidence based public health practice related to diabetes and chronic disease prevention and control among local health departments (LHDs). This stepped-wedge cluster randomized trial aims to evaluate active dissemination strategies on local-level public health practitioners to increase adoption and use of evidence-based programs and policies for diabetes and chronic disease prevention and control among LHDs in Missouri. Twelve LHDs will be recruited and randomly assigned to one of three groups that cross over from usual practice to receive the intervention (dissemination) strategies at 8-month intervals; the intervention duration for groups ranges from 8 to 24 months. LHD staff and the university-based study team are jointly identifying, refining and selecting dissemination strategies. Intervention strategies may include multi-day in-person training workshops, electronic information exchange modalities, and remote technical assistance. Evaluation methods include surveys at baseline and at each 8-month interval, abstraction of LHD chronic disease prevention program plans and progress reports, and social network analysis.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| No Intervention: Control The control group will conduct usual public health practice. |
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| Active Comparator: Intervention Participating local health departments will help develop and choose several dissemination activities they prefer for their local health department to receive. Dissemination activities may include multi-day in-person training workshops, electronic information exchange modalities, remote technical assistance, and information on ways to enhance organizational climates favorable to evidence-based diabetes and chronic disease prevention and control. |
Other: Dissemination of public health knowledge
Participating local health departments will help develop and choose dissemination strategies they prefer for their staff working in and supporting diabetes and chronic disease prevention and control to receive. Dissemination strategies may include multi-day in-person training workshops, electronic information exchange modalities, remote technical assistance, and information on ways to enhance organizational climates favorable to evidence-based diabetes prevention and control.
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Outcome Measures
Primary Outcome Measures
- Evidence-based decision making (EBDM) competencies [24 months post baseline]
Self-report Likert scale items measure perceived importance and availability of specific public health practitioner skill sets for EBDM.
- Awareness of EBDM [24 months post baseline]
Self-report Likert scale item measures personal awareness of opportunities to learn about EBDM among local level chronic disease control public health practitioners.
- Use of EBDM [24 months post baseline]
Self-report Likert scale items measure personal use of EBDM among local level chronic disease control public health practitioners.
- Supervisory Support and Expectations for EBDM use [24 months post baseline]
Self-report Likert scale items measure perceived direct supervisory support, value, and expectations for EBDM use by employees.
- Work group evaluation maintenance [24 months post baseline]
Self-report Likert scale of work units' support of community needs assessment, utilization of evaluation for pre and post program implementation use as well as for dissemination purposes.
- Work group EBDM resources maintenance [24 months post baseline]
Self-report Likert scale items measure perceived work unit's current skill capacity for EBDM as well as the availability of training and electronic resources to employees for EBDM.
- Work group climate for EBDM [24 months post baseline]
Self-report Likert scale items measure work group's perceived level of incorporation of employee and partner informational feedback into decision making.
- Agency Leadership [24 months post baseline]
Self-report Likert scale items measure agency leadership support for EBDM.
- Agency Relationships and Partnerships [24 months post baseline]
Self-report Likert scale items measure the importance of the type of agency partnerships and support they provide.
Secondary Outcome Measures
- Intra- and inter-organization communication around evidence-based programs and policies (EBPPs) [24 months post baseline]
Self-report social network questionnaire with items that capture other agency work groups and community agencies in which the chronic disease work group has contact, and measures the extent of the contact and how the current relationship is described.
Eligibility Criteria
Criteria
Inclusion Criteria:
- Local Health Departments (LHDs, cluster) in the state of Missouri and corresponding public health workforce (individuals within cluster); screenings.
Exclusion Criteria:
- LHDs that have less than 5 employees working in or supporting diabetes or chronic disease control, which includes program areas of diabetes prevention and management, obesity prevention, physical activity, nutrition, cardiovascular health, and cancer
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Prevention Research Center, Brown School, Washington University in St. Louis | Saint Louis | Missouri | United States | 63130 |
Sponsors and Collaborators
- Washington University School of Medicine
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Investigators
- Principal Investigator: Ross C Brownson, PhD, Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, Division of Public Health Sciences, Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine
Study Documents (Full-Text)
None provided.More Information
Additional Information:
Publications
None provided.- 201705026
- 5R01DK109913