title: Scaling up diabetes prevention in Victoria, Australia: policy development, implementation, and evaluation.
abstract: OBJECTIVE The Australian lifestyle intervention program Life! is only the second reported, large-scale diabetes prevention program. This article describes the genesis and the successful establishment of Life! and its key outcomes for participants and implementation. RESEARCH DESIGN AND METHODS Life!, a behavior-change intervention, comprises six group sessions over 8 months. The Victorian Department of Health funded Diabetes Australia-Victoria to implement the program. Experience of the Greater Green Triangle diabetes prevention implementation trial was used for intervention design, workforce development, training, and infrastructure. Clinical and anthropometric data from participants, used for program evaluation, were recorded on a central database. RESULTS Life! has a statewide workforce of 302 trained facilitators within 137 organizations. Over 29,000 Victorians showed interest in Life!, and 15,000 individuals have been referred to the program. In total, 8,412 participants commenced a Life! program between October 2007 and June 2011, and 37% of the original participants completed the 8-month program. Participants completing sessions 1 to 5 lost an average of 1.4 kg weight (P < 0.001) and waist circumference of 2.5 cm (P < 0.001). Those completing six sessions lost an average of 2.4 kg weight (P < 0.001) and waist circumference of 3.8 cm (P < 0.001). The weight loss of 2.4 kg represents 2.7% of participants' starting body weight. CONCLUSIONS The impact of Life! is attributable to applying available evidence for the system's design of the intervention and collaboration between policy makers, implementers, and evaluators using the principles of continuous quality improvement to support successful, large-scale recruitment and implementation.
authors: Corresponding author: James A. Dunbar, director@greaterhealth.org.
authors: James A
authors: JA
authors: Dunbar
authors: Abirami
authors: A
authors: Jayawardena
authors: Greg
authors: G
authors: Johnson
authors: Karen
authors: K
authors: Roger
authors: Amy
authors: A
authors: Timoshanko
authors: Vincent L
authors: VL
authors: Versace
authors: Jane
authors: J
authors: Shill
authors: Benjamin
authors: B
authors: Philpot
authors: Erkki
authors: E
authors: Vartiainen
authors: Tiina
authors: T
authors: Laatikainen
authors: James D
authors: JD
authors: Best
authors: Edward D
authors: ED
authors: Janus
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D002648:Child; D003920:Diabetes Mellitus / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011050:Policy Making; D016032:Randomized Controlled Trials as Topic; D014739:Victoria; D055105:Waist Circumference; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*; D055815:Young Adult