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Table 1 Mapping of intervention content

From: Using evidence-based guidelines to inform service provision: a structured mapping exercise within the National Health Service Diabetes Prevention Programme in England

Components Documentary sources
NICE guidelines PH38 Demonstrator site phase Wave 1 phase
NHS draft DPP specification Collated demonstrator sites NHS DPP specification Collated wave 1 providers
Aims Lifestyle-change programmes to provide advice and support on physical activity, weight management and diet Behavioural intervention with three main goals (1) Dietary improvements (2) Physical activity (3) Weight reduction Most programmes developed by demonstrator sites included the content components specified in NICE PH38 guidance and the NHS DPP service specification. Increasing physical activity was reported in six out of the seven sites; promoting weight loss in five out of the seven sites and improving dietary habits in six out of the seven sites Behavioural intervention targeting: (1) weight loss (or maintenance), (2) achievement of UK dietary recommendations related to fibre, F&A, oily fish, saturated salt, and free sugars; (3) achievement of the CMO physical activity recommendations All four providers included core sessions covering topics on type 2 diabetes and risk factors, weight loss and maintenance, diet, and physical activity. In agreement with recommendations, all sites provided a curriculum for their programmes with sufficient detail on the content of the sessions. All sites reported following UK weight loss, dietary and physical activity recommendations outlined within the NHS DPP specification
Format Groups of 10–15 people or one-to-one basis or mixture Run at different times and days (evenings/weekends) Group sessions, face-to-face though individual can also be included The majority of demonstrator sites programmes were delivering interventions in a mixture of group sessions, face-to-face sessions, and individual sessions. One site was an exception using a telephone-based intervention. Two sites also included a digital component in their programmes Group sessions, face-to-face. Max. 20 part. Individual sessions can also be included. Sessions to be delivered in a format, at times and venues that are appropriate for different groups in the community (e.g. weekend). Family of peer support accommodated where helpful for user All providers had group-based in-person. Two reported the acceptance of accompanying friends or family members
Additional contact Not mentioned Not mentioned Two sites included a digital component in their programmes For non-face-to-face contact, details on this should also be provided One provider used additional telephone support (number of sessions or frequency not specified). Another provider used remote support (text messages, email, telephone, and social media) and another incorporated individual in-person sessions
Duration At least over a period of 9–18 months; Follow up sessions every 3 months for at least 2 years Across 9 months minimum Varied greatly with some being only 6 weeks and others lasting up to 12 months. Only three demonstrator sites were compliant with the recommended duration Standardised across providers Minimum of 9 months Duration varied between the providers, ranging from 6 months up to 12 months (with 6 months follow up). Only one provider did not comply with the 9 months minimum duration recommendation
Intensity At least 8 sessions (minimum of 16 h); weekly or fortnight sessions; reduce intensity over time Series of sessions At least 13 sessions, with minimum contact of 16; 1–2 h sessions The intensity of interventions differed greatly between sites. The intensity of sessions across the DPP programmes varied from six sessions to 52 sessions, with some sessions being held twice a week and others monthly Standardized across providers At least 13 sessions with a minimum total of 16 h contact time; 1–2 h session Brief interventions can be classified as session delivered if above 13 sessions of 1–1 h (or for e.g. 13 1–2 h with 4 brief interventions in addition, totalling 17 sessions) Final session counts as toward intervention hours (not the assessment session) The intensity of interventions differed between sites. The number of sessions varied between 11 and 18, with one provider not meeting the recommended number of sessions. Length of individual sessions ranged from 60 to 90 min in line with the recommendations
BCTs Information provision Motivational interviewing Goal setting Action planning Coping plans Relapse prevention Self-regulation techniques (e.g. self-monitoring) Include, but not limited to, goal setting and self-monitoring There was limited information about use of behaviour change techniques (BCTs) in baseline documents from demonstrator sites. Two sites mentioned using information provision, motivational interviewing, action planning, coping planning, relapse prevention, self-regulation techniques; goal setting; four sites described the use of goal setting and both motivational interviewing and action planning in their programme; and social support was reported in one site Use of BCTs standardized across providers Provider must be explicit re the techniques (BCTs) used, as well as the expected mechanism of action Framework must be used to detail this info Include, but not limited to, goal setting and self-monitoring For non-face-to-face contact, details on this should also be provided All sites used the BCT Taxonomy V1 [14] and theory-driven techniques and linked these techniques with the expected mechanisms of action. In addition, all sites used the recommended BCTs, and most used additional evidence-based techniques for sustained behaviour change
  1. BCTs behaviour change techniques