title: Process Evaluation of Practice-based Diabetes Prevention Programs: What Are the Implementation Challenges?
abstract: The purpose of this report is to describe lessons learned about the feasibility of recruitment and implementation of low-income adults with prediabetes in primary care clinics into diabetes prevention programs.
  
  
  
  Mixed methods process evaluation of a pragmatic 2-group pilot comparative effectiveness study of a community-developed Healthy Living Program (HLP) and a Diabetes Prevention Program (DPP) with 58 adults.
  
  
  
  Of the total (n = 1215) assessed for eligibility, 7% (n = 92) were randomized, 58 completed the baseline assessment, and 31 completed the intervention. The process evaluation identified difficulty in systematically screening potentially eligible patients. There were several logistic and staffing challenges with program planning and initial start-up.
  
  
  
  Addressing challenges to feasibility is required for successful translation of evidence-based programs to clinical settings.
authors.affiliation: University of Rochester Medical Center, Family Medicine Research Programs, Rochester, New York (Dr Carroll, Mr Winters, Dr Fiscella)|University of Rochester Medical Center, Center for Community Health, Rochester, New York (Dr Carroll, Dr Williams)
authors.forename: Jennifer
authors.initials: J
authors.lastname: Carroll
authors.affiliation: University of Rochester Medical Center, Family Medicine Research Programs, Rochester, New York (Dr Carroll, Mr Winters, Dr Fiscella)
authors.forename: Paul
authors.initials: P
authors.lastname: Winters
authors.affiliation: University of Rochester Medical Center, Family Medicine Research Programs, Rochester, New York (Dr Carroll, Mr Winters, Dr Fiscella)
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.affiliation: University of Rochester Medical Center, Center for Community Health, Rochester, New York (Dr Carroll, Dr Williams)
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Williams
authors.affiliation: Unity Hospital Diabetes, Endocrinology and Care Management, Rochester, New York (Ms Bauch)
authors.forename: Jean
authors.initials: J
authors.lastname: Bauch
authors.affiliation: Anthony L. Jordan Health Centers, Special Programs and Services, Rochester, New York (Dr Clark)
authors.forename: Linda
authors.initials: L
authors.lastname: Clark
authors.affiliation: Rochester General Medical Group, Office of Community Medicine, Rochester, New York (Dr Sutton)
authors.forename: James
authors.initials: J
authors.lastname: Sutton
authors.affiliation: University of Rochester Medical Center, Center for Community Health Department of Medicine, Rochester, New York (Dr Bennett)
authors.forename: Nancy
authors.initials: N
authors.lastname: Bennett
mesh_terms: D000328:Adult; D057186:Comparative Effectiveness Research; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D011203:Poverty / Q000523:psychology; D011236:Prediabetic State / Q000150:complications / Q000523:psychology; D011320:Primary Health Care / Q000379:methods; D011322:Primary Prevention / Q000379:methods*; D016730:Program Development; D015397:Program Evaluation; D011897:Random Allocation