Rationale

• Few studies have examined Diabetes Prevention Program (DPP) adaptations in a healthcare setting
• The adoption of an evidence-based diabetes prevention program in a healthcare system provides a unique opportunity to examine is implementation, clinical effectiveness, and the impact of implementation on clinical effectiveness in order to inform best practice for the provision of such programs embedded in routine care
• What happens when the infrastructure of a clinical trial is removed and the program used by people in the real-world rather than study participants?

Specific Aims

• Aim 1: Evaluate the clinical effectiveness of Group Lifestyle Balance (GLB)
• Aim 2: Evaluation the impact of GLB on healthcare utilization, cost, and cost-effectiveness
• Aim 3: Evaluate GLB implementation within and across Sutter Health regions and clinics

a) process evaluation of implementation

b) examine the impact of differences in implementation and fidelity on clinical effectiveness

c) plan for wider dissemination of findings outside Sutter Health