title: Action research led to a feasible lifestyle intervention in general practice for people with prediabetes.
abstract: OBJECTIVE
  To develop and pilot a feasible lifestyle intervention for people with prediabetes tailored for general practice. The study was designed to explore (i) what resources and competencies would be required and (ii) which intervention components should be included.
  
  
  METHODS
  In the first of two action research cycles various interventions were explored in general practice. The second cycle tested the intervention described by the end of the first cycle. In total, 64 patients, 8 GPs and 10 nurses participated.
  
  
  RESULTS
  An intervention comprising six consultations to be delivered during the first year after identified prediabetes was found feasible by the general practice staff in terms of resources. Practice nurses possessed the adequate competences to undertake the core part of the intervention. The intervention comprised fixed elements according to structure, time consumption and educational principles, and flexible elements according to educational material and focus points for behaviour change. Clinical relevant reductions in patients' BMI and HbA1c were found.
  
  
  CONCLUSIONS
  A prediabetes lifestyle intervention for Danish general practice with potential for diabetes prevention was developed based on action research. The transferability of the developed intervention to other general practices depends on the GPs priorities, availability of practice nurses to deliver the core part, and the remuneration system for general practice. The long-term feasibility in larger patient populations is unknown.
authors.affiliation: Section for Health Promotion and Health Services and Section of General Practice, Department of Public Health, Aarhus University, Denmark. Electronic address: htm@alm.au.dk.
authors.forename: Helle Terkildsen
authors.initials: HT
authors.lastname: Maindal
authors.affiliation: Steno Health Promotion Centre, Steno Diabetes Centre, Gentofte, Denmark. Electronic address: AHBO@steno.dk.
authors.forename: Ane
authors.initials: A
authors.lastname: Bonde
authors.affiliation: Steno Health Promotion Centre, Steno Diabetes Centre, Gentofte, Denmark. Electronic address: JXAH@steno.dk.
authors.forename: Jens
authors.initials: J
authors.lastname: Aagaard-Hansen
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002983:Clinical Competence; D003718:Denmark; D005240:Feasibility Studies; D005260:Female; D058006:General Practice; D006442:Glycated Hemoglobin / Q000378:metabolism; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009740:Nursing Staff; D010353:Patient Education as Topic; D010865:Pilot Projects; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis / Q000451:nursing / Q000628:therapy*; D012017:Referral and Consultation; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Action research; Feasibility; General practice; Health behaviour; Health services research; Lifestyle; Prediabetes