title: Evidence-Based Diabetes Prevention and Control Programs and Policies in Local Health Departments.
abstract: The purpose of this study is to: (1) assess implementation of evidence-based programs and policies (EBPPs) related to diabetes prevention and control in local health departments, (2) assess feasibility of non-implemented diabetes prevention and control EBPPs, and (3) examine individual- and organizational-level factors associated with implementation of diabetes prevention and control EBPPs.
  
  
  
  An online survey was administered in January 2015 to key representatives of all local health departments in Missouri. Descriptive statistics were used to describe implementation and perceived feasibility of 20 diabetes prevention and control EBPPs. Logistic regression was used to examine the association between individual and organizational factors and diabetes prevention and control EBPP implementation.
  
  
  
  One hundred local health departments participated (89% response rate) in the online survey. Most frequently implemented diabetes-related EBPPs in local health departments included: nutrition education for agency or community members, increased fruit and vegetable access in community settings, and community-wide campaigns to promote physical activity. Increased encouragement to others in the department to use evidence-based decision making and agency incentives to help employees use evidence-based decision making were positively associated with implementation of diabetes prevention and control EBPPs.
  
  
  
  Local health departments are on the "front line" of public health, and this study demonstrates the important role these organizations play in implementing diabetes prevention and control EBPPs. Potential leverage points for more widespread adoption of diabetes-related EBPPs in local health departments include education about and encouragement of evidence-based decision making and organizational incentives for employees to integrate evidence-based decision making into their diabetes prevention and control activities.
authors: Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri (Ms Zwald, Ms Elliott, Dr Brownson)
authors: Marissa
authors: M
authors: Zwald
authors: Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri (Ms Zwald, Ms Elliott, Dr Brownson)
authors: Lindsay
authors: L
authors: Elliott
authors: Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri (Ms Zwald, Ms Elliott, Dr Brownson)|Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri (Dr Brownson)
authors: Ross C
authors: RC
authors: Brownson
authors: Missouri Association of Local Public Health Agencies, Columbia, Missouri (Ms Skala)
authors: Mahree
authors: M
authors: Skala
mesh_terms: D003153:Community Health Services; D003657:Decision Making; D003920:Diabetes Mellitus / Q000517:prevention & control*; D055317:Evidence-Based Practice; D005240:Feasibility Studies; D006284:Health Plan Implementation; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009111:Local Government; D008923:Missouri; D015397:Program Evaluation; D015980:Public Health Practice