Supporting and implementing evidence-based interventions for diabetes management at the local health department level could help control diabetes nationwide, according to a cross-sectional study published in BMJ Open Diabetes Research & Care.

Researchers distributed a survey to evaluate the patterns and correlates of evidence-based interventions for diabetes management at local health departments in the US. These local health departments were categorized based on population of the community they served. Small populations were less than 50,000, medium populations were between 50,000 and 199,999, and large populations were over 200,000. The practitioner survey included questions about demographics, experiences, and characteristics of health departments, such as support for evidence-based decision making. The survey also collected data about evidence-based programming initiatives offered to communities, including type of chronic disease prevention and whether they worked directly or collaboratively to provide these programs.

The 376 responders were 83% female, 73% were over the age of 40, and 72% had worked in public health for over 10 years. Of the evidence-based initiatives for diabetes management, 82% of the local health departments offered Diabetes Prevention Program, 81% offered diabetes self-management education, and 67% offered diabetes screening and referrals. Most evidence-based programs were offered collaboratively with other organizations, with only 3 to 11% offered directly from the local health department. Logistic regression models indicated that statewide diabetes prevalence was associated with the local health department offering the Diabetes Prevention Program (OR, 1.28; 95% CI, 1.02-1.62), diabetes self-management education (OR, 1.32; 95% CI, 1.04-1.67), and patient screening and referrals (OR, 1.27; 95% CI, 1.05-1.54). Models involving evidence-based decision making factors included a significant relationship between evaluation capacity and patient screening and referrals (OR, 1.54; 95% CI, 1.08-2.19).

The researchers recommended that future studies increase sample size to expand conclusions to other public health settings and to include other evidence-based interventions for potential associations with local health department offerings. Additionally, some bias was introduced to this study’s survey data because only one lead practitioner replied with self-reported answers for each local health department.

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While many characteristics cannot be modified (ie, demographic factors), improving evidence-based decision making capacity within local health departments “can lead to increased offering of [evidence-based interventions] by [local health departments], which is critical to addressing diabetes in the US and other countries,” concluded the researchers.


Tabak RG, Parks RG, Allen P, et al. Patterns and correlates of use of evidence-based interventions to control diabetes by local health departments across the USA. BMJ Open Diab Res Care. 2018;6(1):e000558.