{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T21:32:47Z","timestamp":1792445567624,"version":"4.5.0"},"reference-count":63,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/501100012349","name":"NIHR School for Public Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012349","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,11,13]]},"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Evaluation of the demonstrator phase and first wave roll-out of the National Health Service (NHS) Diabetes Prevention Programme (DPP) in England. To examine: (1) intervention design, provision and fidelity assessment procedures; (2) risk assessment and recruitment pathways and (3) data collection for monitoring and evaluation. To provide recommendations informing decision makers on programme quality, improvements and future evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We reviewed programme documents, mapping against the NHS DPP specification and National Institute for Health and Care Excellence (NICE) public health guideline: Type 2 diabetes (T2D) prevention in people at high risk (PH38), conducted qualitative research using individual interviews and focus group discussions with stakeholders and examined recruitment, fidelity and data collection procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Seven NHS DPP demonstrator sites and, subsequently, 27 first wave areas across England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Intensive behavioural intervention with weight loss, diet and physical activity goals. The national programme specifies at least 13 sessions over 9\u2009months, delivered face to face to groups of 15\u201320 adults with non-diabetic hyperglycaemia, mainly recruited from primary care and NHS Health Checks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Participants for qualitative research were purposively sampled to provide a spread of stakeholder experience. Documents for review were provided via the NHS DPP Management Group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>The NHS DPP specification reflected current evidence with a clear framework for service provision. Providers, with national capacity to deliver, supplied intervention plans compliant with this framework. Stakeholders highlighted limitations in fidelity assessment and recruitment and retention challenges, especially in reach and equity, that could adversely impact on implementation. Risk assessment for first wave eligibility differed from NICE guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The NHS DPP provides an evidence-based behavioural intervention for prevention of T2D in adults at high risk, with capacity to deliver nationally. Framework specification allows for balance between consistency and contextual variation in intervention delivery, with session details devolved to providers. Limitations in fidelity assurance, data collection procedures and recruitment issues could adversely impact on intervention effectiveness and restrict evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019467","type":"journal-article","created":{"date-parts":[[2018,2,21]],"date-time":"2018-02-21T09:15:42Z","timestamp":1519204542000},"page":"e019467","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":57,"title":["NHS Diabetes Prevention Programme in England: formative evaluation of the programme in early phase implementation"],"prefix":"10.1136","volume":"8","author":[{"given":"Linda","family":"Penn","sequence":"first","affiliation":[{"name":"Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK"},{"name":"Fuse: UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK"},{"name":"Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK"},{"name":"Fuse: UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Haste","sequence":"additional","affiliation":[{"name":"Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK"},{"name":"Fuse: UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK"},{"name":"Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta M","family":"Marques","sequence":"additional","affiliation":[{"name":"Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK"},{"name":"Fuse: UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Budig","sequence":"additional","affiliation":[{"name":"Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK"},{"name":"Fuse: UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirby","family":"Sainsbury","sequence":"additional","affiliation":[{"name":"Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK"},{"name":"Fuse: UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Bell","sequence":"additional","affiliation":[{"name":"Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Ara\u00fajo-Soares","sequence":"additional","affiliation":[{"name":"Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK"},{"name":"Fuse: UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"White","sequence":"additional","affiliation":[{"name":"Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK"},{"name":"MRC Epidemiology Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Summerbell","sequence":"additional","affiliation":[{"name":"Fuse: UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK"},{"name":"School of Applied Social Sciences, Durham University, Durham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Goyder","sequence":"additional","affiliation":[{"name":"School of Health & Related Research, University of Sheffield, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Brennan","sequence":"additional","affiliation":[{"name":"School of Health & Related Research, University of Sheffield, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley J","family":"Adamson","sequence":"additional","affiliation":[{"name":"Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK"},{"name":"Fuse: UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK"},{"name":"Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falko F","family":"Sniehotta","sequence":"additional","affiliation":[{"name":"Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK"},{"name":"Fuse: UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,2,21]]},"reference":[{"key":"2025121400470064000_8.2.e019467.1","unstructured":"NHS England. NHS diabetes prevention programme (NHS DPP). 2017 https:\/\/www.england.nhs.uk\/ourwork\/qual-clin-lead\/diabetes-prevention\/2017 (accessed 11 Apr 2017)."},{"key":"2025121400470064000_8.2.e019467.2","unstructured":"NHS England,\u00a0Public Health England,\u00a0Monitor. NHS five year forward view, 2014."},{"key":"2025121400470064000_8.2.e019467.3","unstructured":"National Cardiovascular Intelligence Network. Diabetes prevalence model for local authorities and CCGs. 2017. updated 27 Oct 2016 http:\/\/www.yhpho.org.uk\/resource\/view.aspx?RID=154049 (accessed 19 Apr 2017)."},{"key":"2025121400470064000_8.2.e019467.4","doi-asserted-by":"publisher","DOI":"10.1136\/jech.54.3.173"},{"key":"2025121400470064000_8.2.e019467.5","unstructured":"International Diabetes Federation. IDF Diabetes Atlas. 6th edn. Brussels: International Diabetes Federation, 2014. (2014 update)."},{"key":"2025121400470064000_8.2.e019467.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200105033441801"},{"key":"2025121400470064000_8.2.e019467.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012512"},{"key":"2025121400470064000_8.2.e019467.8","unstructured":"World Health Organization. 2006. Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia. Geneva: World Health Org. Report of a WHO\/IDF Consultation."},{"key":"2025121400470064000_8.2.e019467.9","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-9-342"},{"key":"2025121400470064000_8.2.e019467.10","unstructured":"NICE NIfHaCE. PH 38 Preventing type 2 diabetes - risk identification and interventions for individuals at high risk. 2012 http:\/\/guidance.nice.org.uk\/PH38 (accessed 26 Jul 2012)."},{"key":"2025121400470064000_8.2.e019467.11","unstructured":"Public Health England. A systematic review and metaanalysis assessing the effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes mellitus in routine practice. 2015 https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/456147\/PHE_Evidence_Review_of_diabetes_prevention_programmes-_FINAL.pdf (accessed 31 May 2016)."},{"key":"2025121400470064000_8.2.e019467.12","unstructured":"MRC (Medical Research Council UK). Developing and evaluating complex interventions: new guidance. 2008 http:\/\/www.mrc.ac.uk\/Utilities\/Documentrecord\/index.htm?d=MRC004871. www.mrc.ac.uk\/complexinterventionsguidance."},{"key":"2025121400470064000_8.2.e019467.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h1258"},{"key":"2025121400470064000_8.2.e019467.14","doi-asserted-by":"crossref","unstructured":"Ritchie J , Spencer L . Analyzing qualitative data. In: B A , Burgess RG , eds. Qualitative data analysis for applied policy research. London: Routledge, 1993:173\u201394.","DOI":"10.4324\/9780203413081_chapter_9"},{"key":"2025121400470064000_8.2.e019467.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68490-0"},{"key":"2025121400470064000_8.2.e019467.16","doi-asserted-by":"crossref","unstructured":"Welch V , Tugwell P , Petticrew M , et al . How effects on health equity are assessed in systematic reviews of interventions. Cochrane Database Syst Rev 2010:MR000028.doi:10.1002\/14651858.MR000028.pub2","DOI":"10.1002\/14651858.MR000028.pub2"},{"key":"2025121400470064000_8.2.e019467.17","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1002\/nur.20373","article-title":"Implementation fidelity in community-based interventions","volume":"33","author":"Breitenstein","year":"2010","journal-title":"Res Nurs Health"},{"key":"2025121400470064000_8.2.e019467.18","unstructured":"Ritchie J , Lewis J , eds. Qualitative research practice: a guide for social science students and researchers. London: Sage Publications, 2003."},{"key":"2025121400470064000_8.2.e019467.19","doi-asserted-by":"crossref","unstructured":"Moore G , S A , Mary Barker LB . MRC guidance process evaluation of complex interventions: UK Medical Research Council (MRC) guidance, 2015.","DOI":"10.1136\/bmj.h1258"},{"key":"2025121400470064000_8.2.e019467.20","unstructured":"NVivo 10. http:\/\/www.qsrinternational.com\/upgrade-from-nvivo-10.aspx 2015."},{"key":"2025121400470064000_8.2.e019467.21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b880"},{"key":"2025121400470064000_8.2.e019467.22","doi-asserted-by":"publisher","DOI":"10.3310\/hta17370"},{"key":"2025121400470064000_8.2.e019467.23","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.3.725"},{"key":"2025121400470064000_8.2.e019467.24","doi-asserted-by":"crossref","unstructured":"Barron E , Clark R , Hewings R , et al . Progress of Healthier You: NHS diabetes prevention programme: referral numbers, percentage uptake, attendee characteristics and factors associated with attendance. Diabetic Medicine. In Press;2017.","DOI":"10.1111\/dme.13562"},{"key":"2025121400470064000_8.2.e019467.25","unstructured":"NHS. NHS Choices. 2017 http:\/\/www.nhs.uk\/livewell\/Pages\/Livewellhub.aspx2017."},{"key":"2025121400470064000_8.2.e019467.26","unstructured":"Slimming World. Slimming World, touching hearts, changing lives. 2017 http:\/\/www.slimmingworld.co.uk\/joining-online\/what-to-expect.aspx2017."},{"key":"2025121400470064000_8.2.e019467.27","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61385-3"},{"key":"2025121400470064000_8.2.e019467.28","unstructured":"National Health Service UK. NHS health checks London: department of health. 2012 http:\/\/www.nhs.uk\/planners\/nhshealthcheck\/Pages\/Overview.aspx2012."},{"key":"2025121400470064000_8.2.e019467.29","doi-asserted-by":"publisher","DOI":"10.1126\/science.1191181"},{"key":"2025121400470064000_8.2.e019467.30","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d6386"},{"key":"2025121400470064000_8.2.e019467.31","unstructured":"England PH . Eligibility changes relating to the NHS diabetes prevention programme: revised guidance, 2017."},{"key":"2025121400470064000_8.2.e019467.32","unstructured":"NHS England. The use of POCT HbA1c devices in the NHS diabetes prevention programme: recommendations from an expert working group commissioned by NHS England, 2017."},{"key":"2025121400470064000_8.2.e019467.33","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s13142-015-0341-0","article-title":"A review of diabetes prevention program translations: use of cultural adaptation and implementation research","volume":"5","author":"Tabak","year":"2015","journal-title":"Transl Behav Med"},{"key":"2025121400470064000_8.2.e019467.34","doi-asserted-by":"crossref","unstructured":"Donabedian A . An introduction to quality assurance in health care: Oxford University Press, 2002.","DOI":"10.1093\/oso\/9780195158090.001.0001"},{"key":"2025121400470064000_8.2.e019467.35","unstructured":"Oppe M , Devlin NJ , Szende A . EQ-5D value sets: inventory, comparative review and user guide: Springer, 2007."},{"key":"2025121400470064000_8.2.e019467.36","first-page":"4","article-title":"The national diabetes prevention program: from research to reality","volume":"33","author":"Albright","year":"2012","journal-title":"Diabetes Care Educ Newsl"},{"key":"2025121400470064000_8.2.e019467.37","unstructured":"Hastings G . Social Marketing: why should the devil have all the best tunes? Oxford: Elsevier Ltd, 2007."},{"key":"2025121400470064000_8.2.e019467.38","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-0410"},{"key":"2025121400470064000_8.2.e019467.39","doi-asserted-by":"publisher","DOI":"10.1177\/003335490712200216"},{"key":"2025121400470064000_8.2.e019467.40","doi-asserted-by":"publisher","DOI":"10.1177\/1359105304036103"},{"key":"2025121400470064000_8.2.e019467.41","unstructured":"Dixon D , Johnston M . 2010. Health behaviour change competency framework: competences to deliver interventions to change lifestyle behaviours that affect health. Scotland."},{"key":"2025121400470064000_8.2.e019467.42","doi-asserted-by":"publisher","DOI":"10.3132\/dvdr.2007.064"},{"key":"2025121400470064000_8.2.e019467.43","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-0039"},{"key":"2025121400470064000_8.2.e019467.44","first-page":"1","article-title":"Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors","volume":"57","author":"Schwarzer","year":"2008","journal-title":"Appl Psychol"},{"key":"2025121400470064000_8.2.e019467.45","doi-asserted-by":"publisher","DOI":"10.1002\/ejsp.258"},{"key":"2025121400470064000_8.2.e019467.46","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-7-249","article-title":"Prevention of type 2 diabetes by lifestyle intervention in an Australian primary health care setting: Greater Green Triangle (GGT) diabetes prevention project","volume":"7","author":"Laatikainen","year":"2007","journal-title":"BMC Public Health"},{"key":"2025121400470064000_8.2.e019467.47","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-13-152"},{"key":"2025121400470064000_8.2.e019467.48","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-2647"},{"key":"2025121400470064000_8.2.e019467.49","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-1"},{"key":"2025121400470064000_8.2.e019467.50","unstructured":"Rollnick S , Mason P , Butler C . Health behaviour change. Edinburgh: Churchill livingstone, 1999."},{"key":"2025121400470064000_8.2.e019467.51","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.1.36"},{"key":"2025121400470064000_8.2.e019467.52","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-5-200503010-00007"},{"key":"2025121400470064000_8.2.e019467.53","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/S0140-6736(04)17670-8","article-title":"External validity of randomised controlled trials: \u201cTo whom do the results of this trial apply?\u201d","volume":"365","author":"Rothwell","year":"2005","journal-title":"The Lancet"},{"key":"2025121400470064000_8.2.e019467.54","doi-asserted-by":"publisher","DOI":"10.1093\/her\/cyg113"},{"key":"2025121400470064000_8.2.e019467.55","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0057143","article-title":"Importance of weight loss maintenance and risk prediction in the prevention of type 2 diabetes: analysis of European Diabetes Prevention Study RCT","volume":"8","author":"Penn","year":"2013","journal-title":"PLoS One"},{"key":"2025121400470064000_8.2.e019467.56","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.275"},{"key":"2025121400470064000_8.2.e019467.57","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h4717"},{"key":"2025121400470064000_8.2.e019467.58","unstructured":"Group NW , Blackshaw J , Montel S , et al . Joined up clinical pathways for obesity: report of the working group: NHS England Publications Gateway Reference\u00a001004, 2014."},{"key":"2025121400470064000_8.2.e019467.59","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002080","article-title":"Population approaches to prevention of type 2 diabetes","volume":"13","author":"White","year":"2016","journal-title":"PLoS Med"},{"key":"2025121400470064000_8.2.e019467.60","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2013-002949","article-title":"Participants\u2019 perspectives on making and maintaining behavioural changes in a lifestyle intervention for type 2 diabetes prevention: a qualitative study using the theory domain framework","volume":"3","author":"Penn","year":"2013","journal-title":"BMJ Open"},{"key":"2025121400470064000_8.2.e019467.61","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2013-004530","article-title":"Perspectives of UK Pakistani women on their behaviour change to prevent type 2 diabetes: qualitative study using the theory domain framework","volume":"4","author":"Penn","year":"2014","journal-title":"BMJ Open"},{"key":"2025121400470064000_8.2.e019467.62","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-350"},{"key":"2025121400470064000_8.2.e019467.63","unstructured":"Sutton M . Evaluating the NHS Diabetes Prevention Programme (NHS DPP): the DIPLOMA research programme (Diabetes Prevention Long term Multimethod Assessment). https:\/\/www.journalslibrary.nihr.ac.uk\/programmes\/hsdr\/164807\/#\/2017"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-019467","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:47:12Z","timestamp":1765702032000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-019467"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2]]},"references-count":63,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,2,21]]},"published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1136\/bmjopen-2017-019467"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-019467","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2]]}}}