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Table 2 Using Accordance, Discrepancies and Discontinuities (ADD-Fuse) to identify service specification recommendation

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

  Demonstrator site phase of NHS DPP Wave 1 phase of NHS DPP
Component of the programme Recommendation Component of the programme Recommendation
Accordance Format: Face-to-face group sessions were suggested for the format Format was being implemented as recommended Format, content and aims: Face-to-face group sessions were suggested for the format, with the core sessions/aims recommended to focus on weight loss, diet and PA The format and the three core goals of the programme were followed as recommended
Discrepancy Duration and intensity: Minimum of 9 months. At least 13 sessions, with minimum contact of 16; 1–2 h sessions Intensity and duration varied greatly between demonstrator sites with some not achieving the recommended intensity or duration. Systems for collecting data to assess intensity and duration, such as attendance and contact details, should be considered Duration and intensity: Standardised across providers Minimum of 9 months. At least 13 sessions, with minimum contact of 16; 1–2 h sessions Duration and intensity still remained varied, however only one provider reported less than the minimum specification recommendations. Further monitoring and development of programmes with providers is needed to improve specification achievement, which at present could impact on programme outcomes
Discontinuity BCT description: Include, but not limited to, goal setting and self-monitoring There was limited information about the use of behaviour change techniques (BCTs) in baseline documents from demonstrator sites. More specific information about the use of BCTs should be included in the NHS DPP specification, especially as there is currently a discrepancy between NICE PH38 guidance that recommends specific BCTs and the NHS DPP specification that provides limited guidance on the use of BCTs Additional contacts: For non-face-to-face contact, details on this should also be provided Detail of the additional contacts providers incorporated with patients was minimal. Greater detail on the aim and content of the non-face-to-face contact and materials used is needed. The service specification could develop a checklist to support providers