Evaluation of a Diabetes Screening Clinical Decision Support Tool.

Introduction: The authors evaluated whether an electronic health record clinical decision support system improves diabetes screening across a health system.

Methods: Study population included adults without diabetes attending a visit at 27 primary care clinics. Outcomes included the monthly screening laboratory order rate and completion rate among eligible patient visits.

START Diabetes Prevention: A Multi-Level Strategy for Primary Care Clinics.

Background: Prediabetes, a high-risk state for developing diabetes, affects more than 1 in 3 adults nationally. However, <5% of people with prediabetes are receiving any treatment for prediabetes. Prior intervention studies for increasing prediabetes treatment uptake have largely focused on individual barriers with few multi-level interventions that address clinician- and system-level barriers.

Lower-Intensity Interventions for Prediabetes: A Systematic Review.

Introduction: Systematic reviews of interventions for diabetes prevention have focused on lifestyle interventions, including the Diabetes Prevention Program (DPP) and translations of the DPP. However, nationally, few people with prediabetes have joined or completed a DPP, with one cited barrier being committing to a yearlong program. This study was a systematic review to evaluate the effectiveness of lower-intensity lifestyle interventions for prediabetes on weight change, glycemia, and health behaviors.

Engaging Payors and Primary Care Physicians Together in Improving Diabetes Prevention.

Background: Type 2 diabetes can be prevented through lifestyle programs like the Diabetes Prevention Programs (DPP), but few people with prediabetes participate in them, in part because their insurance does not reliably cover DPPs. Prior studies have not focused on payor-level barriers.

Objective: To understand barriers to DPP uptake that exist and intersect at different levels (patients, PCPs, and payors) to inform strategies to improve diabetes prevention in primary care settings through interviews with PCPs and payors.

Long-term exposure to ambient fine particulate matter (PM2.5) and associations with cardiopulmonary diseases and lung cancer in Taiwan: a nationwide longitudinal cohort study.

Background: Although a number of studies have reported on the health effects of fine particulate matter (PM2.5) exposure, particularly in North American and European countries as well as China, the evidence about intermediate to high levels of PM2.5 exposures is still limited.

Clinical Care Among Individuals with Prediabetes in Primary Care: a Retrospective Cohort Study.

Background: The incidence of diabetes in the general US population (6.7 per 1000 adults in 2018) has not changed significantly since 2000, suggesting that individuals with prediabetes are not connecting to evidence-based interventions.

Objective: We sought to describe the clinical care of individuals with prediabetes, determine patient factors associated with this care, and evaluate risk for diabetes development.

Identification of Prediabetes Discussions in Unstructured Clinical Documentation: Validation of a Natural Language Processing Algorithm.

Background: Prediabetes affects 1 in 3 US adults. Most are not receiving evidence-based interventions, so understanding how providers discuss prediabetes with patients will inform how to improve their care.

Objective: This study aimed to develop a natural language processing (NLP) algorithm using machine learning techniques to identify discussions of prediabetes in narrative documentation.

Effects of Behavioral Weight Loss and Metformin on IGFs in Cancer Survivors: A Randomized Trial.

Context: Higher levels of insulin-like growth factor-1 (IGF-1) are associated with increased risk of cancers and higher mortality. Therapies that reduce IGF-1 have considerable appeal as means to prevent recurrence.

Design: Randomized, 3-parallel-arm controlled clinical trial.

Effects of the Dietary Approaches to Stop Hypertension Diet and Sodium Reduction on Blood Pressure in Persons With Diabetes.

Elevated blood pressure and blood pressure-related morbidity are extraordinarily common in persons with diabetes. The Dietary Approaches to Stop Hypertension dietary pattern and dietary sodium reduction are recommended as lifestyle interventions in individuals with diabetes. However, these recommendations have largely been based on studies conducted in persons without diabetes.

Methods and Risks of Bias in Natural Experiments in Obesity: Opportunities for the Future Informed by a Systematic Review.

Objective: This paper promotes rigorous methods and designs currently underutilized in obesity research, informed by a recent systematic review of the methods and risks of bias in studies of policies, programs, and built environment changes for obesity prevention and control.

Methods: To determine the current state of the field, relevant databases from 2000 to 2017 were searched to identify studies that fit the inclusion criteria. Study design, analytic approach, and other details of study methods were abstracted.

National Survey of Primary Care Physicians' Knowledge, Practices, and Perceptions of Prediabetes.

Background: Despite strong evidence and national policy supporting type 2 diabetes prevention, little is known about type 2 diabetes prevention in the primary care setting.

Objective: Our objective was to assess primary care physicians' knowledge and practice regarding perceived barriers and potential interventions to improving management of prediabetes.

Design: Cross-sectional mailed survey.

A National Survey of Internal Medicine Primary Care Residency Program Directors.

Background: The United States is facing a primary care physician shortage. Internal medicine (IM) primary care residency programs have expanded substantially in the past several decades, but there is a paucity of literature on their characteristics and graduate outcomes.

Objective: We aimed to characterize the current US IM primary care residency landscape, assess graduate outcomes, and identify unique programmatic or curricular factors that may be associated with a high proportion of graduates pursuing primary care careers.

Influence of subsidies and promotional strategies on outcomes in a beneficiary-based commercial weight-loss programme.

To determine whether initial engagement, continued participation, and weight loss vary by subsidy and promotional strategies in a beneficiary-based, commercial weight-loss programme. We conducted a retrospective analysis of data from 2013 to 2016. Our dependent variables included initial engagement (≥1 calls; ≥2 weights), coach calls and weight change.

Effect of a Behavioral Weight Loss Intervention in People With Serious Mental Illness and Diabetes.

Objective: Given the high prevalence of obesity and diabetes in patients with serious mental illness (SMI) and the lack of evidence on the effects of weight loss programs in SMI patients with diabetes, we evaluated the effectiveness of a behavioral weight loss intervention among SMI participants with and without diabetes.

Research Design And Methods: Using data from ACHIEVE, a randomized controlled trial to evaluate the effects of a behavioral weight loss intervention among overweight/obese people with SMI, we assessed and compared weight change from baseline to 18 months in participants with and without diabetes using a longitudinal mixed-effects model.

Results: Of the 291 trial participants, 82 (28.

Systematic Review of Natural Experiments for Childhood Obesity Prevention and Control.

Context: The National Academy of Medicine recommends childhood obesity prevention efforts making healthier options the passive choice. This review evaluated the effectiveness of population-level policies and programs from natural experiments for childhood obesity prevention.

Evidence Acquistion: The search included PubMed, CINAHL, PsycINFO, and EconLit from 2000 to 2017 for policies evaluated by natural experiments reporting childhood BMI outcomes.

Effectiveness of Policies and Programs to Combat Adult Obesity: a Systematic Review.

Background: This systematic review identifies programs, policies, and built-environment changes targeting prevention and control of adult obesity and evaluates their effectiveness.

Methods: We searched PubMed, CINAHL, PsycINFO, and EconLit from January 2000 to March 2018. We included natural experiment studies evaluating a program, policy, or built-environment change targeting adult obesity and reporting weight/body mass index (BMI).

Methods for Evaluating Natural Experiments in Obesity: A Systematic Review.

Background: Given the obesity pandemic, rigorous methodological approaches, including natural experiments, are needed.

Purpose: To identify studies that report effects of programs, policies, or built environment changes on obesity prevention and control and to describe their methods.

Data Sources: PubMed, CINAHL, PsycINFO, and EconLit (January 2000 to August 2017).

Survey of primary care providers' knowledge of screening for, diagnosing and managing prediabetes.

Background: Prediabetes affects 86 million US adults, but primary care providers' (PCPs') knowledge, practices, attitudes and beliefs toward prediabetes are unclear.

Objective: Assess PCPs' (1) knowledge of risk factors that should prompt prediabetes screening, laboratory criteria for diagnosing prediabetes and guidelines for management of prediabetes; (2) management practices around prediabetes; (3) attitudes and beliefs about prediabetes.

Design: Self-administered written survey of PCPs.

Metformin Use in Prediabetes Among U.S. Adults, 2005-2012.

Objective: To determine the prevalence of and characteristics associated with metformin use among U.S. adults with prediabetes using the National Health and Nutrition Examination Survey (NHANES) 2005-2012.