Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial
Abstract Background Structured lifestyle change education reduces the burden of cardiometabolic diseases such as diabetes. Delivery of these programs at worksites could overcome barriers to program adoption and improve program sustainability and reach; however, tailoring to the worksite setting is e...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Implementation Science Communications |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43058-023-00516-1 |
| _version_ | 1797559409653579776 |
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| author | Mary Beth Weber Elizabeth C. Rhodes Harish Ranjani Panniyammakal Jeemon Mohammed K. Ali Monique M. Hennink Ranjit M. Anjana Viswanathan Mohan K. M. Venkat Narayan Dorairaj Prabhakaran |
| author_facet | Mary Beth Weber Elizabeth C. Rhodes Harish Ranjani Panniyammakal Jeemon Mohammed K. Ali Monique M. Hennink Ranjit M. Anjana Viswanathan Mohan K. M. Venkat Narayan Dorairaj Prabhakaran |
| author_sort | Mary Beth Weber |
| collection | DOAJ |
| description | Abstract Background Structured lifestyle change education reduces the burden of cardiometabolic diseases such as diabetes. Delivery of these programs at worksites could overcome barriers to program adoption and improve program sustainability and reach; however, tailoring to the worksite setting is essential. Methods The Integrating Diabetes Prevention in Workplaces (INDIA-WORKS) study tested the implementation and effectiveness of a multi-level program for reducing cardiometabolic disease risk factors at 11 large and diverse worksites across India. Herein, we describe and classify program adaptations reported during in-depth interviews and focus group discussions with worksite managers, program staff, and peer educators involved in program delivery, and program participants and drop-outs. We used thematic analysis to identify key themes in the data and classified reported program adaptations using the FRAME classification system. Results Adaptations were led by worksite managers, peer educators, and program staff members. They occurred both pre- and during program implementation and were both planned (proactive) and unplanned (proactive and reactive). The most frequently reported adaptations to the individual-level intervention were curriculum changes to tailor lessons to the local context, make the program more appealing to the workers at the site, or add a wider variety of exercise options. Other content adaptations included improvements to the screening protocol, intervention scheduling, and outreach plans to tailor participant recruitment and retention to the sites. Environment-level content adaptations included expanding or leveraging healthy food and exercise options at the worksites. Challenges to adaptation included scheduling and worksite-level challenges. Participants discussed the need to continue adapting the program in the future to continue making it relevant for worksite settings and engaging for employees. Conclusion This study describes and classifies site-specific modifications to a structured lifestyle change education program with worksite-wide health improvements in India. This adds to the literature on implementation adaptation in general and worksite wellness in India, a country with a large and growing workforce with, or at risk of, serious cardiometabolic diseases. This information is key for program scale-up, dissemination, and implementation in other settings. Trial registration Clinicaltrials.gov NCT02813668. Registered June 27, 2016 |
| first_indexed | 2024-03-10T17:44:58Z |
| format | Article |
| id | doaj.art-8609c86ca0ff4305a05dd13af777ea3a |
| institution | Directory Open Access Journal |
| issn | 2662-2211 |
| language | English |
| last_indexed | 2024-03-10T17:44:58Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj.art-8609c86ca0ff4305a05dd13af777ea3a2023-11-20T09:34:37ZengBMCImplementation Science Communications2662-22112023-11-014111510.1186/s43058-023-00516-1Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trialMary Beth Weber0Elizabeth C. Rhodes1Harish Ranjani2Panniyammakal Jeemon3Mohammed K. Ali4Monique M. Hennink5Ranjit M. Anjana6Viswanathan Mohan7K. M. Venkat Narayan8Dorairaj Prabhakaran9Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory UniversityEmory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory UniversityMadras Diabetes Research Foundation/Dr. Mohan’s Diabetes Specialities CentreAchutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and TechnologyEmory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory UniversityHubert Department of Global Health, Rollins School of Public Health, Emory UniversityMadras Diabetes Research Foundation/Dr. Mohan’s Diabetes Specialities CentreMadras Diabetes Research Foundation/Dr. Mohan’s Diabetes Specialities CentreEmory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory UniversityPublic Health Foundation of IndiaAbstract Background Structured lifestyle change education reduces the burden of cardiometabolic diseases such as diabetes. Delivery of these programs at worksites could overcome barriers to program adoption and improve program sustainability and reach; however, tailoring to the worksite setting is essential. Methods The Integrating Diabetes Prevention in Workplaces (INDIA-WORKS) study tested the implementation and effectiveness of a multi-level program for reducing cardiometabolic disease risk factors at 11 large and diverse worksites across India. Herein, we describe and classify program adaptations reported during in-depth interviews and focus group discussions with worksite managers, program staff, and peer educators involved in program delivery, and program participants and drop-outs. We used thematic analysis to identify key themes in the data and classified reported program adaptations using the FRAME classification system. Results Adaptations were led by worksite managers, peer educators, and program staff members. They occurred both pre- and during program implementation and were both planned (proactive) and unplanned (proactive and reactive). The most frequently reported adaptations to the individual-level intervention were curriculum changes to tailor lessons to the local context, make the program more appealing to the workers at the site, or add a wider variety of exercise options. Other content adaptations included improvements to the screening protocol, intervention scheduling, and outreach plans to tailor participant recruitment and retention to the sites. Environment-level content adaptations included expanding or leveraging healthy food and exercise options at the worksites. Challenges to adaptation included scheduling and worksite-level challenges. Participants discussed the need to continue adapting the program in the future to continue making it relevant for worksite settings and engaging for employees. Conclusion This study describes and classifies site-specific modifications to a structured lifestyle change education program with worksite-wide health improvements in India. This adds to the literature on implementation adaptation in general and worksite wellness in India, a country with a large and growing workforce with, or at risk of, serious cardiometabolic diseases. This information is key for program scale-up, dissemination, and implementation in other settings. Trial registration Clinicaltrials.gov NCT02813668. Registered June 27, 2016https://doi.org/10.1186/s43058-023-00516-1ImplementationAdaptationWorksitesIndiaCardiometabolic diseaseDiabetes |
| spellingShingle | Mary Beth Weber Elizabeth C. Rhodes Harish Ranjani Panniyammakal Jeemon Mohammed K. Ali Monique M. Hennink Ranjit M. Anjana Viswanathan Mohan K. M. Venkat Narayan Dorairaj Prabhakaran Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial Implementation Science Communications Implementation Adaptation Worksites India Cardiometabolic disease Diabetes |
| title | Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial |
| title_full | Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial |
| title_fullStr | Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial |
| title_full_unstemmed | Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial |
| title_short | Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial |
| title_sort | adapting and scaling a proven diabetes prevention program across 11 worksites in india the india works trial |
| topic | Implementation Adaptation Worksites India Cardiometabolic disease Diabetes |
| url | https://doi.org/10.1186/s43058-023-00516-1 |
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