Characteristic | VA-DPP | |
---|---|---|
Systems perspective | ||
1 | Context is critical | VA-DPP intervention is clearly focused on preventing diabetes among Veterans with pre-diabetes within an integrated health system |
2 | Multilevel complexity | Diabetes prevention involves multi-component, comprehensive lifestyle interventions; the VA-DPP coaches deliver personalized treatment |
3 | Focus on systems characteristics | VA health system leaders supported the program and efforts were made to gain buy-in from VA site leaders and staff; implementation and delivery were tailored to sites |
Robust, practical goals | ||
4 | Representativeness and reach | Minimal eligibility criteria to reach wider population of Veterans in need |
5 | Generalizability | Designed to assess generalizability of the DPP’s results for the largely male Veteran population |
6 | Pragmatic and practical | Showed VA leaders the feasibility of implementing this program in the VA; it also showed the potential effectiveness of VA-DPP for Veterans |
7 | Scalability and sustainability | The VA-DPP was piloted at three sites in order to determine feasibility across all VA sites nationally designed to utilize existing clinical processes when possible in order to promote sustainability, although existing clinical processes limited recruitment |
Research methods to enhance relevance | ||
8 | Rigorous | The VA-DPP maintained scientific rigor by using systematic assignment to intervention arms, but also focused on replicability by integrating the study into existing clinical processes as much as possible |
9 | Rapid | VA health system leaders decided to make systemic changes based on early findings (at 6 months) indicating greater weight loss with the VA-DPP |
10 | Adaptive | This research partnership was based on previous collaborations on similar weight loss interventions for Veterans |
11 | Integration of methods; triangulation | Quantitative data (patient weights, HbA1cs, questionnaires, fidelity checklists) and qualitative data (patient and staff interviews) were integrated to assess VA-DPP implementation and effectiveness |
12 | Relevance | The VA-DPP was a high priority for senior leaders |
Flexibility | ||
13 | Multiplicity | The partnership between researchers and health system leaders brought different viewpoints with how to implement the VA-DPP |
14 | Respect for diverse approaches; humility | The researchers and health system leaders collaboratively decided on the best approach for conducting the VA-DPP evaluation |