# Enhancing Evidence-based Diabetes Control Among Local Health Departments

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2020 · $538,437

## Abstract

PROJECT SUMMARY
Background: Nearly 26 million people in the US—or 8.3% of the population—has diabetes. Premature death
and disability can be prevented for persons with diabetes through implementation of evidence-based programs
and policies (EBPPs). Local health departments (LHDs) are uniquely positioned to implement diabetes control
EBPPs because of their knowledge of, and focus on, community-level needs, contexts, and resources. There is
a significant gap, however, between known diabetes control EBPPs and actual diabetes control activities
conducted by LHDs.
Goal: This proposal seeks to reduce the burden of diabetes by increasing adoption of EBPPs among LHD
practitioners.
Methods: This is a two-phase study that takes a comprehensive approach to elucidate effective tactics for
dissemination and implementation (D&I) of EBPPs among LHD practitioners. Phase 1: We will refine and test
measures to assess the adoption of EBPPs in LHDs, building on pilot work. Phase 2: We will conduct a qualitative
needs assessment of 15 LHDs in Missouri to understand factors influencing the adoption of diabetes control
EBPPs. We will then conduct a pre/post, experimental (group-randomized) study of 30 LHDs in Missouri to
evaluate the effectiveness of active D&I approaches. The intervention arm of this study (15 LHDs) will receive a
flexible “menu” of D&I approaches that account for local contextual and organizational factors. The control arm
(15 LHDs) will receive a minimal “usual care” intervention. We will conduct multivariate regression analyses to
model the factors important to improving adoption of diabetes control EBPPs, and will conduct social network
analysis to understand the relationships and contextual issues that influence EBPP adoption. We will translate
and disseminate findings from Phases 1 and 2 to LHD practitioners and practice-related stakeholders in order to
support the sustainable practice of diabetes control among LHDs.
Innovations and Impact: This study is innovative and impactful because it will: 1) be the first to identify effective
approaches for increasing the adoption of diabetes control EBPPs among LHDs in the US; 2) be the first to
develop valid and reliable objective measures of EBPP adoption levels in LHDs; 3) augment Diffusion of
Innovation Theory with constructs from Institutional Theory; 4) include tactics novel to US public health practice
(e.g., use of knowledge brokers); 5) use social network analysis and qualitative needs assessment together with
traditional statistical modeling for a comprehensive understanding of the predictors of EBPP adoption; and 6)
use a stakeholder-driven, flexible “menu” approach from which to select a set of D&I activities that have the
greatest salience and feasibility among the LHDs enrolled in our D&I trial. This research is expected to result in
a replicable D&I model that can significantly impact diabetes and chronic disease control among LHDs.

## Key facts

- **NIH application ID:** 9977167
- **Project number:** 5R01DK109913-05
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Ross C Brownson
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $538,437
- **Award type:** 5
- **Project period:** 2016-07-15 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9977167

## Citation

> US National Institutes of Health, RePORTER application 9977167, Enhancing Evidence-based Diabetes Control Among Local Health Departments (5R01DK109913-05). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9977167. Licensed CC0.

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