Implementation of the DP-Transfers Project in Catalonia—A Translational Method to Improve Diabetes Screening and Prevention in Primary Care

Background: DP-TRANSFERS(Diabetes Prevention-Transferring findings from European research to society) is a large scale national program aimed at translating a lifestyle diabetes prevention intervention (DE-PLAN-CAT) in primary care centers in Catalonia. Methods: Multidisciplinary committee evaluated the programme. Participants without diabetes aged 45-75 years (FINDRISC>11 and/or prediabetes) were posible candidates. Implementation was a 4-channel transfer approach (institutional relationships, facilitator WS, collaborative groupware, programme website) and built upon a 3-step (screening, intervention, follow-up) real-life strategy. The 2-year lifestyle intervention program included an initial 9-hour and 15-hour continuity module, 6 and 10 sessions respectively. A 3-level (centre, professionals and participants) descriptive analysis was conducted using cluster sampling by contributing centres to assess results and barriers identified one year after implementation. Results: Between June2016 and July2017, 103 PHCC 1.4 million inhabitants (27.9% of all centres), 5professionals agreed to participate. After 1 year,83 centres (80.6%) remained active and 3professionals (60.3%) were involved. Implementation was not feasible in 20 centres (19.4%) 5 main barriers: lack of staff support; discontinuity of the initial effort; increase of workload; shift in professional status and lack of acceptance. Overall, 1819 people were screened and 1458 (80.1%) followed the lifestyle intervention, with 1190 (81.6% or 65.4% of those screened) participating in the basic module and 912 in the continuity (62.5% or 50.1%, respectively). Conclusions: Large-scale lifestyle intervention in primary care can be properly implemented using existing public health resources. Regrettably, one fifth of the centres and more than one third of the professionals showed substantial resistance to performing these additional activities.