A Context-Adapted Diabetes Prevention Program (Small Steps for Big Changes) in Australia: Protocol for a Hybrid Implementation-Effectiveness Study
Notice bibliographique
Résumé
BACKGROUND: With type 2 diabetes rates escalating worldwide, including in Australia, effective, acceptable, sustainable, and scalable diabetes prevention programs are needed. Small Steps for Big Changes (SSBC) is a Canadian-developed, community-delivered diet and exercise counseling intervention for individuals at risk of type 2 diabetes. The 3- to 6-week intervention can be delivered by trained non-health professionals, with all SSBC coaches receiving training in the delivery of the program, including motivational interviewing. However, the suitability and feasibility of the program in the Australian context are unknown. To address this gap, funding has been secured to adapt, implement, and evaluate SSBC in Australia (SSBC Australia), providing evidence on its effectiveness, acceptability, and implementation in this context. OBJECTIVE: The aim of the study is to describe the protocol for the type 2 cluster nonrandomized single-arm hybrid effectiveness-implementation trial of SSBC Australia. METHODS: SSBC Australia will be delivered and evaluated in 5 community-based sites across 2 organizations in South-East Queensland, Australia. One organization (1 site) will trial training students on clinical and project placements as coaches. The evaluation period is 4 years. For the first 2 years, sites receive funding for program delivery, after which, ongoing delivery will be self-funded. The recruitment target is 500 participants completing the 6-session intervention across the 5 sites within 2 years, with approximately 50 coaches trained. Data will be collected from the organization, site, coach, and client using a variety of methods (surveys, objective assessments, interviews, site audits, website analytics, meeting minutes, and project tracking). The integrated Practical, Robust, Implementation Sustainability Model and Reach, Effectiveness, Adoption, Implementation, Maintenance framework and the Affordability, Practicality, Effectiveness and Cost-Effectiveness, Acceptability, Side-Effects/Safety, and Equity criteria will guide implementation and evaluation and inform iterative adaptations as required. Data will be collected on the context for delivery; adoption and reach (number of coaches and clients and their characteristics); effectiveness of the coach training and the intervention (client pre- and post changes in measured clinical indicators [body composition, cardiorespiratory fitness, strength, and balance], self-reported health behaviors [movement behaviors, healthy eating, and program behaviors], psychosocial indicators [self-efficacy and social supports], quality of life, diabetes status, and health care use); implementation of the coach training and program delivery (fidelity and acceptability); and maintenance of program delivery (sites) and client outcomes at 3, 6, and 12 months post end-of-program. RESULTS: Ethics approval and trial registration were completed. All 5 sites have been recruited and undergone preimplementation evaluation, with SSBC Australia coach training underway. Client recruitment started in September 2025. CONCLUSIONS: This study will provide evidence whether the contextually adapted SSBC diabetes prevention program can be successfully implemented and is effective within an Australian context. Findings will inform potential expansion to additional community sites and health service contexts. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12624001194550; https://tinyurl.com/588jkmva. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/81195.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,081 | 0,053 |
| Méta-épidémiologie (sens strict) | 0,004 | 0,004 |
| Méta-épidémiologie (sens large) | 0,007 | 0,005 |
| Bibliométrie | 0,003 | 0,003 |
| Études des sciences et des technologies | 0,005 | 0,004 |
| Communication savante | 0,004 | 0,004 |
| Science ouverte | 0,004 | 0,004 |
| Intégrité de la recherche | 0,007 | 0,010 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,064 | 0,013 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».