The Diabetes Primary Prevention Initiative Interventions Focus Area

A Case Study and Recommendations


      In 2005, CDC began the Diabetes Primary Prevention Initiative Interventions Focus Area (DPPI-IFA), which funded five state Diabetes Prevention and Control Programs (DPCPs) to translate diabetes primary prevention trials into real-world settings by developing and implementing a framework for state-level diabetes primary prevention.


      The purpose of this case study, conducted in 2007, was to describe DPPI-IFA implementation, including facilitators and challenges to the initiative.


      Case studies of the five DPCPs in the DPPI-IFA involving site visits with key informant interviews of state staff and partners and archival record collection.


      Partners recruited for DPPI-IFA activities included local or state public health agencies (three of five DPCPs); regional or state nonprofit organizations (five DPCPs); businesses or employers (three DPCPs); and healthcare organizations (four DPCPs). The DPCPs implemented a variety of interventions in three main domains: diabetes primary prevention and prediabetes awareness, screening activities and lifestyle interventions, and prediabetes-related health policy efforts. Preliminary outcomes are described at the individual and organization/partnership levels. Results suggest the importance of utilizing preexisting partnerships to extend work into diabetes prevention, providing even small amounts of funding to partners, and prior program planning for diabetes prevention. Challenges for the DPPI-IFA included recruiting participants, establishing links with providers to obtain diagnostic testing for people screened for prediabetes, and offering a lifestyle intervention.


      The DPPI-IFA represents a unique effort by state public health programs in the translation of diabetes primary prevention trials into real-world settings. The experiences of the DPPI-IFA programs offer valuable lessons for future community-based diabetes prevention initiatives, especially regarding the need to strengthen clinical–community partnerships for referral of people with prediabetes to evidence-based lifestyle programs.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Cowie C.C.
        • Rust K.F.
        • Ford E.S.
        • et al.
        Full accounting of diabetes and prediabetes in the U.S. population, 1988–1994 and 2005–2006.
        Diabetes Care. 2009; 32: 287-294
        • Santaguida P.L.
        • Balion C.
        • Hunt D.
        Diagnosis, prognosis, and treatment of impaired glucose tolerance and impaired fasting glucose.
        Agency for Healthcare Research and Quality, Rockville MDAugust 2005 (Report No.: AHRQ Pub. No. 05-E026-1)
        • Diabetes Prevention Program Research Group
        The diabetes prevention program: reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.
        N Engl J Med. 2002; 346: 393-403
        • Diabetes Prevention Program Research Group
        The Diabetes Prevention Program (DPP): description of lifestyle intervention.
        Diabetes Care. 2002; 25: 2165-2171
        • Pan X.R.
        • Li G.W.
        • Hu Y.H.
        • et al.
        Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance.
        Diabetes Care. 1997; 20: 537-544
        • Tuomilehto J.
        • Lindstrom J.
        • Eriksson J.G.
        • et al.
        Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.
        N Engl J Med. 2001; 344: 1343-1350
        • Norris S.L.
        • Zhang X.
        • Avenell A.
        • et al.
        Long-term effectiveness of weight-loss interventions in adults with pre-diabetes: a review.
        Am J Prev Med. 2005; 28: 126-139
        • Herman W.H.
        • Hoerger T.J.
        • Brandle M.
        • et al.
        The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with impaired glucose tolerance.
        Ann Intern Med. 2005; 142: 323-332
        • Hoerger T.J.
        • Hicks K.A.
        • Sorensen S.W.
        • et al.
        Cost-effectiveness of screening for pre-diabetes among overweight and obese U.S. adults.
        Diabetes Care. 2007; 30: 2874-2879
        • Garfield S.A.
        • Malozowski S.
        • Chin M.H.
        • et al.
        Considerations for diabetes translational research in real-world settings.
        Diabetes Care. 2003; 26: 2670-2674
        • Bowman B.A.
        • Gregg E.W.
        • Williams D.E.
        • Engelgau M.M.
        • Jack Jr, L.J.
        Translating the science of primary, secondary, and tertiary prevention to inform the public health response to diabetes.
        J Public Health Manag Practice. 2003; : S8-S14
        • Narayan K.M.
        • Benjamin E.
        • Gregg E.W.
        • Norris S.L.
        • Engelgau M.M.
        Diabetes translation research: where are we and where do we want to be?.
        Ann Intern Med. 2004; 140: 958-963
        • American Diabetes Association
        Standards of medical care in diabetes—2008.
        Diabetes Care. 2008; 31: S12-S54
        • Chronic Disease Directors
        The primary prevention of diabetesRecommendations from the Chronic Disease Directors Project; 2005.
        • Goodman R.M.
        • Larsen B.A.
        • Marmet P.F.
        • et al.
        The public health role in the primary prevention of diabetes: recommendations from the chronic disease directors' project.
        J Public Health Manag Pract. 2008; 14: 15-25
        • CDC
        Framework for program evaluation in public health.
        MMWR Recomm Rep. 1999; 48: 1-40
        • Yin R.K.
        Case study research: design and methods.
        Sage Publications, Thousand Oaks CA1994
        • Patton M.Q.
        Utilization focused evaluation: the new century text.
        3rd ed. Sage Publications, Thousand Oaks CA1997
        • National Diabetes Education Program, NIH
        Your game plan for preventing type 2 diabetes: health care provider's toolkit, 2003.
        • Absetz P.
        • Valve R.
        • Oldenburg B.
        • et al.
        Type 2 diabetes prevention in the “real world.”.
        Diabetes Care. 2007; 30: 2465-2470
        • Boltri J.M.
        • Davis-Smith Y.M.
        • Seale J.P.
        • Shellenberger S.
        • Okosun I.S.
        • Cornelius M.E.
        Diabetes prevention in a faith-based setting: results of translational research.
        J Public Health Manag Practice. 2008; 14: 29-32
        • Ackermann R.T.
        • Finch E.A.
        • Brizendine E.
        • Zhour H.
        • Marrero D.G.
        Translating the diabetes prevention program into the community: the DEPLOY pilot study.
        Am J Prev Med. 2008; 35: 357-363
        • Engelgau M.M.
        • Narayan K.M.V.
        • Vinicor F.
        Identifying the target population for primary prevention: the trade-offs.
        Diabetes Care. 2002; 25: 2098-2099
        • CDC Primary Prevention Working Group
        Primary prevention of type 2 diabetes mellitus by lifestyle intervention: implications for health policy.
        Ann Intern Med. 2004; 140: 941-957
        • Lasker R.D.
        • Committee on Medicine and Public Health
        Medicine and public health: the power of collaboration.
        • Sloane P.D.
        • Bates J.
        • Gadon M.
        • Irmiter C.
        • Donahue K.
        Effective clinical partnerships between primary care medical practices and public health agencies.