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If diabetes is a public health problem, why not treat it as one? A population-based approach to chronic illness

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  • Published:
Annals of Behavioral Medicine

Abstract

It is increasingly acknowledged that diabetes and other chronic illnesses are major public health problems. Medicare and many managed health care organizations have recognized the enormous personal and societal costs of uncontrolled diabetes in terms of complications, patient quality of life, and health care system resources. However, the current system of reactive acute-episode focused disease care practiced in many settings does not adequately address this public health problem. An alternative proactive, population-based approach to chronic illnesses such as diabetes is proposed and illustrated. This multilevel systems approach addresses supportive and inhibitory social-environmental factors at multiple levels (personal, family, health care team, work, neighborhood, community). Key disciplines contributing to a population-based approach to diabetes include epidemiology, behavioral science, health care services, public health, health economics, and quality of life professions. Current and potential contributions of each of these disciplines are illustrated and an integrative, population-based systems approach to diabetes management and prevention of complications is proposed. This approach is also seen as applicable to other chronic illnesses.

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References

  1. Lamm R, Caldwell R:Hard Choices: The Center for Public Policy and Contemporary Issues. Denver, CO: University of Denver, 1991.

    Google Scholar 

  2. Vinicor F: Is diabetes a public-health disorder?Diabetes Care. 1994,17:22–27.

    PubMed  Google Scholar 

  3. National Diabetes Data Group.Diabetes in America. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, NIH Publication No. 95-1468. Bethesda, MD: National Institutes of Health, 1995.

    Google Scholar 

  4. Centers for Disease Control and Prevention:National Diabetes Fact Sheet: National Estimates and Information on Diabetes in the United States. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Division of Diabetes Translation, 1997.

    Google Scholar 

  5. American Diabetes Association: Economic consequences of diabetes mellitus in the U.S. in 1997.Diabetes Care. 1998,21: 296–309.

    Article  Google Scholar 

  6. American Diabetes Association: Standards of medical care for patients with diabetes mellitus.Diabetes Care. 1997,20(Suppl.):S5-S13.

    Google Scholar 

  7. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report on the expert committee on the diagnosis and classification of diabetes mellitus.Diabetes Care. 1997,20:1183–1197.

    Google Scholar 

  8. Harris M, Flegal K, Cowie C, et al: Prevalence of diabetes, impaired fasting glucose and impaired glucose tolerance in U.S. adults: The third national health and nutrition examination survey, 1988–1994.Diabetes Care. 1998,21(4):518–524.

    Article  PubMed  Google Scholar 

  9. Aubert R: Trends in the global burden of diabetes.Diabetes. 1997,46:139A.

    Google Scholar 

  10. Martensen R, Jones D: Diabetes mellitus as a “disease of civilization.”Journal of the American Medical Association. 1997,278: 345.

    Google Scholar 

  11. Murray C, Lopez A: Alternative projections of mortality and disability by cause 1990–2020: Global burden of disease study.Lancet. 1997,349:1498–1504.

    Article  PubMed  Google Scholar 

  12. Eastman RC, Javitt JC, Herman WH, Dasbach EJ, Harris M: Prevention strategies for non-insulin dependent diabetes mellitus: An economic perspective. In Le Roith D, Taylor S, Olefsky J (eds),Diabetes Mellitus Philadelphia, PA: Lippincott-Raven, 1996, 621–630.

    Google Scholar 

  13. Kaplan RM: Measuring health outcome for resource allocation. In Glueckauf RL, Frank R, Bond GR, McGrew JH (eds),Psychological Practice in a Changing Health Care System: Issues and Directions. New York: Springer, 1996.

    Google Scholar 

  14. Bodenheimer TS, Grumbach KE:Understanding Health Policy: A Clinical Approach. Stamford, CT: Appleton & Lange, 1995.

    Google Scholar 

  15. Etzwiler DD: Chronic care: A need in search of a system.Diabetes Educator. 1997,23:569–573.

    Article  PubMed  Google Scholar 

  16. Kaplan RM:The Hippocratic Predicament: Affordability, Access, and Accountability in American Health Care. San Diego, CA: Academic Press, 1993.

    Google Scholar 

  17. Kleinman A:The Illness Narratives. New York: Basic Books, 1988.

    Google Scholar 

  18. Hampson SE, Glasgow RE, Foster L: Personal models of diabetes among older adults: Relation to self-management and other variables.Diabetes Educator. 1995,21:300–307.

    Article  PubMed  Google Scholar 

  19. Vogt TM, Hollis JF, Lichtenstein E, et al: The medical care system and prevention: The need for a new paradigm.HMO Practice. 1998,12:6–14.

    Google Scholar 

  20. Strauss AL:Chronic Illness and the Quality of Life. St. Louis, MO: The C.V. Mosby Company, 1975.

    Google Scholar 

  21. Wagner EH, Austin B, Von Korff M: Improving outcomes in chronic illness.Managed Care Quarterly. 1996,4:12–25.

    PubMed  Google Scholar 

  22. Califano Jr. JA:Radical Surgery: What's Next for America's Health Care. New York: Random House, 1994.

    Google Scholar 

  23. Glasgow RE, Eakin EG: Dealing with diabetes self-management. In Anderson BJ, Rubin RR (eds),Practical Psychology for Diabetes Clinicians. Alexandria, VA: American Diabetes Association, Inc., 1996, 53–62.

    Google Scholar 

  24. Glasgow RE, Anderson BJ: Future directions for research on pediatric chronic disease management: Lessons from diabetes.Journal of Pediatric Psychology. 1995,20:389–402.

    Article  PubMed  Google Scholar 

  25. Marks DF: Health psychology in context.Journal of Health Psychology. 1996,1:7–21.

    Article  Google Scholar 

  26. Wagner EH: Population-based management of diabetes care.Patient Education and Counseling. 1995,26:225–230.

    Article  PubMed  Google Scholar 

  27. Anderson LA, Jenkins CM: Educational innovations in diabetes: Where are we now?Diabetes Spectrum. 1994,7:89–124.

    Google Scholar 

  28. Glasgow RE: A practical model of diabetes management and education.Diabetes Care. 1995,18:117–126.

    Article  PubMed  Google Scholar 

  29. Jenkins CD: An integrated behavioral medicine approach to improving care of patients with diabetes mellitus.Behavioral Medicine. 1995,21:53–65.

    PubMed  Google Scholar 

  30. Mazze RS: A systems approach to diabetes care.Diabetes Care. 1994,17:5–11.

    PubMed  Google Scholar 

  31. Harris MI, Eastman RC, Siebert C: The DCCT and medical care for diabetes in the U.S..Diabetes Care. 1994,17:761–764.

    PubMed  Google Scholar 

  32. Marrero DG: Current effectiveness of diabetes health care in the U.S.Diabetes Review. 1994,2:292–309.

    Google Scholar 

  33. Marrero DG, Vandagriff JL, Kronz K, et al: Using telecommunication technology to manage children with diabetes: The Computer-Linked Outpatient Clinic (CLOC) Study.Diabetes Educator. 1995,21:313–319.

    Article  PubMed  Google Scholar 

  34. Naisbitt J:Global Paradox. New York: William Morrow & Company, 1994.

    Google Scholar 

  35. Negroponte N:Being Digital. New York: Random House, 1995.

    Google Scholar 

  36. Glasgow RE, McKay HG, Boles SM, Vogt TV: Interactive technology, behavioral science, and health care: Progress, pitfalls, and promise.Journal of Family Practice (in press. 1999).

  37. Baker EL, Melton RJ, Stange PV, et al: Health reform and the health of the public. Forging community health partnerships.Journal of the American Medical Association. 1994,272:1276–1282.

    Article  PubMed  Google Scholar 

  38. Quickel KE: Diabetes in a managed care system.Annals of Internal Medicine. 1996,124:160–163.

    PubMed  Google Scholar 

  39. Brownson RC, Remington PL, Davis JR:Chronic Disease Epidemiology and Control. Baltimore, MD: Port City Press, 1993.

    Google Scholar 

  40. Harris MI: Medical care for patients with diabetes: Epidemiologic aspects.Annals of Internal Medicine. 1996,124: 117–122.

    PubMed  Google Scholar 

  41. Janes GR: Ambulatory medical care for diabetes. InDiabetes in America. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 1995, 541–552.

    Google Scholar 

  42. Kottke TE, Brekke ML, Solberg LI: Making “time” for preventive services.Mayo Clinical Procedures. 1993,68:785–791.

    Google Scholar 

  43. Greenlick MR: Educating physicians for population-based clinical practice.Journal of the American Medical Association. 1992,267:1645–1648.

    Article  PubMed  Google Scholar 

  44. Vogt TM: Paradigms and prevention.American Journal of Public Health. 1993,83:795–796.

    PubMed  Google Scholar 

  45. Hiss RG, Anderson RM, Hess GE, Stepien CJ, Davis WK: Community diabetes care: A 10-year perspective.Diabetes Care. 1994,17:1124–1134.

    Article  PubMed  Google Scholar 

  46. DCCT Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.New England Journal of Medicine. 1993,329:977–986.

    Article  Google Scholar 

  47. Fisher Jr. EB, Arfken CL, Heins JM, et al: Acceptance of diabetes in adults. In Gochman DS (ed),Handbook of Health Behavior Research II: Provider Determinants. New York: Plenum Press, 1997, 189–212.

    Google Scholar 

  48. Von Korff M, Gruman J, Schaefer J, Curry S, Wagner EH: Collaborative management of chronic illness.Annals of Internal Medicine. 1997,19:1097–1102.

    Google Scholar 

  49. McCulloch DK, Glasgow RE, Hampson SE, Wagner E: A systematic approach to diabetes management in the post-DCCT era.Diabetes Care. 1994,17:765–769.

    PubMed  Google Scholar 

  50. Rubin RR, Peyrot M: Implications of the DCCT: Looking beyond tight control.Diabetes Care. 1994,17:235–236.

    PubMed  Google Scholar 

  51. Mazze RS, Etzwiler DD, Strock E, et al: Staged diabetes management.Diabetes Care. 1994,17:56–66.

    PubMed  Google Scholar 

  52. Lichtenstein E, Glasgow RE, Lando HA, Ossip-Klein DJ, Boles SM: Telephone counseling for smoking cessation: Rationales and review of evidence.Health Education Research. 1996,11:243–257.

    Article  PubMed  Google Scholar 

  53. Weinberger M, Kirkman MS, Samsa GP, et al: A nurse-coordinated intervention for primary care patients with non-insulin-dependent diabetes mellitus: Impact on glycemic control and health-related quality of life.Journal of General Internal Medicine. 1995,10:59–66.

    Article  PubMed  Google Scholar 

  54. DCCT Research Group: Lifetime benefits and costs of intensive therapy as practiced in the Diabetes Control and Complications Trial.Journal of the American Medical Association. 1996,276: 1409–1415.

    Article  Google Scholar 

  55. Gochman DS: Personal and social determinants of health behavior: An integration. In Gochman DS (ed),Handbook of Health Behavior Research II. New York: Plenum Press, 1997, 381–400.

    Google Scholar 

  56. Stokols D: Establishing and maintaining healthy environments: Toward a social ecology of health promotion.American Psychologist. 1992,47:6–22.

    Article  PubMed  Google Scholar 

  57. Stokols D: Translating social ecological theory into guidelines for community health promotion.American Journal of Health Promotion. 1996,10:282–298.

    PubMed  Google Scholar 

  58. Glasgow RE, Eakin EG: Issues in diabetes self-management. In Shumaker SA, Schron EB, Ockene JK, McBee WL (eds),The Handbook of Health Behavior Change. New York: Springer Publishing Company, 1998.

    Google Scholar 

  59. Green LW, Kreuter MW:Health Promotion Planning: An Education and Environmental Approach. Mountain View, CA: Mayfield, 1991.

    Google Scholar 

  60. Speers MA, Schmid TL: Policy and environmental interventions for the prevention and control of cardiovascular diseases.Health Education Quarterly. 1995,22:476–477.

    PubMed  Google Scholar 

  61. Anderson BJ, Rubin RRE:Practical Psychology for Diabetes Clinicians: How to Deal with the Key Behavioral Issues Faced by Patients and Health Care Teams. Alexandria, VA: American Diabetes Association, Inc., 1996.

    Google Scholar 

  62. Cox DJ, Gonder-Frederick L: Major developments in behavioral diabetes research.Journal of Consulting and Clinical Psychology. 1992,60:628–638.

    Article  PubMed  Google Scholar 

  63. Eakin EG, Glasgow RE: The physician's role in diabetes self-management: Helping patients to help themselves.The Endocrinologist. 1996,6:1–10.

    Article  Google Scholar 

  64. Glasgow RE, Fisher E, Anderson BJ, et al: Behavioral science in diabetes: Contributions and opportunities.Diabetes Care. 1999,22:832–843.

    Article  PubMed  Google Scholar 

  65. Lorig KR, Mazonson PD, Holman HR: Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs.Arthritis and Rheumatism. 1993,36:439–446.

    Article  PubMed  Google Scholar 

  66. Anderson RM, Funnell MM, Butler PM et al: Patient empowerment. Results of a randomized controlled trial.Diabetes Care. 1995,18:943–949.

    Article  PubMed  Google Scholar 

  67. Miller WR, Rollnick S:Motivational Interviewing: Preparing People to Change Addictive Behavior. New York: Guilford Press, 1991.

    Google Scholar 

  68. Ruggiero L, Prochaska JO: Introduction: Readiness for change: Application of the transtheoretical model to diabetes.Diabetes Spectrum. 1993,6:22–24.

    Google Scholar 

  69. Anderson BJ, Wolf FM, Burkhart MT, Cornell RG, Bacon GE: Effects of peer-group intervention on metabolic control of adolescents with IDDM: Randomized outpatient study.Diabetes Care. 1989,12:179–183.

    Article  PubMed  Google Scholar 

  70. Beresford SAA, Farmer EMZ, Feingold L, et al: Evaluation of a self-help dietary intervention in a primary care setting.American Journal of Public Health. 1992,82:79–84.

    PubMed  Google Scholar 

  71. Campbell MK, DeVellis BM, Strecher VJ, et al: Improving dietary behavior: The effectiveness of tailored messages in primary care settings.American Journal of Public Health. 1994,84:783–787.

    PubMed  Google Scholar 

  72. Litzelman DK, Slemenda CW, Langefeld CD, et al: Reduction of lower extremity clinical abnormalities in patients with non-insulin-dependent diabetes mellitus: A randomized, controlled trial.Annals of Internal Medicine. 1993,119:36–41.

    PubMed  Google Scholar 

  73. Glasgow RE, Toobert DJ, Hampson SE: Effects of a brief office-based intervention to facilitate diabetes dietary self-management.Diabetes Care. 1996,19:835–842.

    Article  PubMed  Google Scholar 

  74. Glasgow RE, La Chance P, Toobert DJ, et al: Long-term effects and costs of brief behavioral dietary intervention for patients with diabetes delivered from the medical office.Patient Education and Counseling. 1997,32:175–184.

    Article  PubMed  Google Scholar 

  75. Franz MJ, Monk A, Barry B, et al: Effectiveness of medical nutrition therapy provided by dietitians in the management of non-insulin-dependent diabetes mellitus: A randomized, controlled clinical trial.Journal of the American Dietetic Association. 1995,95:1009–1017.

    Article  PubMed  Google Scholar 

  76. Franz MJ, Splett PL, Monk A, et al: Cost-effectiveness of medical nutrition therapy provided by dietitians for persons with non-insulin-dependent diabetes mellitus.Journal of the American Dietetic Association. 1995,95:1018–1024.

    Article  PubMed  Google Scholar 

  77. Greenfield S, Kaplan SH, Ware JE, Yano EM, Frank H: Patients' participation in medical care: Effects on blood sugar control and quality of life in diabetes.Journal of General and Internal Medicine. 1988,3:448–457.

    Article  Google Scholar 

  78. Anderson RM, Funnell MM: The role of the physician in patient education.Practical Diabetology. 1990, 10–12.

  79. Anderson RM: The personal meaning of having diabetes: Implications for patient behaviour and education or kicking the bucket theory.Diabetic Medicine. 1986,3:85–89.

    PubMed  Google Scholar 

  80. Glasgow RE: Social-environmental factors in diabetes: Barriers to diabetes self-care. In Bradley C (ed),Handbook of Psychology and Diabetes Research and Practice. Berkshire, England: Hardwood Academic, 1994, 335–349.

    Google Scholar 

  81. Pichert JW, Smeltzer C, Snyder GM, et al: Traditional vs anchored instruction for diabetes-related nutritional knowledge, skills, and behavior.Diabetes Educator 1994,20:45–48.

    Article  PubMed  Google Scholar 

  82. Glasgow RE, Toobert DJ, Hampson SE, Noell JW: A brief office-based intervention to facilitate diabetes self-management.Health Education Research Theory and Practice. 1995,10: 467–478.

    Google Scholar 

  83. Kirkman MS, Weinberger M, Landsman PB, et al: A telephone-delivered intervention for patients with NIDDM. Effect on coronary risk factors.Diabetes Care. 1994,17: 840–846.

    Article  PubMed  Google Scholar 

  84. Wasson J, Gaudette C, Whaley F, et al: Telephone care as a substitute for routine clinic follow-up.Journal of the American Medical Association. 1992,267: 1788–1793.

    Article  PubMed  Google Scholar 

  85. Glasgow RE: Compliance to diabetes regimens: Conceptualization, complexity, and determinants. In Cramer JA, Spilker B (eds),Patient Compliance in Medical Practice and Clinical Trials. New York: Raven Press, 1991, 209–221.

    Google Scholar 

  86. Johnson SB: Methodological issues in diabetes research: Measuring adherence.Diabetes Care. 1992,15(Suppl. 4): 1658–1667.

    Article  PubMed  Google Scholar 

  87. Clement S: Diabetes self-management education.Diabetes Care. 1995,18: 1204–1214.

    PubMed  Google Scholar 

  88. Noell J: Changing health-related behaviors: New directions for interactive media.Medical Education and Technology. 1994,4: 4–8.

    Google Scholar 

  89. Ferguson T:Health Online. Reading, MA: Addison-Wesley Publishing Company, 1996.

    Google Scholar 

  90. Street Jr. RL, Gold WR, Manning TE:Health Promotion and Interactive Technology: Theoretical Applications and Future Directions. London: Lawrence Erlbaum Associates, 1997.

    Google Scholar 

  91. LaPorte RE, Akazawa S, Hellmonds P, et al: Global public health and the information superhighway.British Medical Journal. 1994,308: 1651–1652.

    PubMed  Google Scholar 

  92. Roberts SL: Waltzing through the diabetes web.Diabetes Forecast. 1996, 31–34.

  93. McKay HG, Feil EG, Glasgow RE, Brown JE: Feasibility and use of an internet support service for diabetes self-management.Diabetes Educator. 1997,24: 174–179.

    Google Scholar 

  94. Glasgow RE, Barrera Jr. M, McKay HG, Boles SM: Social support, health behaviors, and quality of life among participants in an internet-based diabetes support program: A multi-dimensional investigation (submitted, 1998).

  95. Health Plan Employer Data and Information Set (HEDIS): National Committee for Quality Assurance. Washington, DC: 1993.

  96. Diabetes Guidelines Advisory Group:Measuring Quality of Care in Health Systems: Population-Based Guidelines for iabetes Mellitus. Portland, OR: Oregon Health Division, 1997.

    Google Scholar 

  97. Joyner L, McNeeley S, Kahn R: ADA's provider recognition program.HMO Practice. 1997,11: 168–170.

    PubMed  Google Scholar 

  98. Institute of Medicine:Committee for the Study of the Future of Public Health. The Future of Public Health. Washington, DC: National Academy of Sciences, 1988.

    Google Scholar 

  99. Washington State Diabetes Control Program:An Assessment of Diabetes in Washington State. Olympia, WA: Washington State Department of Health, 1995.

    Google Scholar 

  100. Amick III BC, Levine S, Tarlov AR, Chapman-Walsh D:Society and Health. New York: Oxford University Press, 1995.

    Google Scholar 

  101. Levetan C, Ratner R: The economic bottom line on preventive diabetes care.Practical Diabetology. 1995, 10–16.

  102. Centers for Disease Control and Prevention:1994 Behavioral Risk Factor Surveillance Summary Prevalence Report. Atlanta, GA: 1994.

  103. Biglan A, Glasgow RE: The social unit: An important facet in the design of cancer control research.Preventive Medicine. 1991,20: 292–305.

    Article  PubMed  Google Scholar 

  104. U.S. Department of Health and Human Services:Healthy People 2000: National Health Promotion and Disease Prevention Objectives, DHHS Publication No. (PHS) 91-50212. Washington, DC: U.S. Government Printing Office, 1990.

    Google Scholar 

  105. Public Health Improvement Plan Steering Committee:Public Health Improvement Plan. Olympia, WA: Washington State Department of Health, 1994.

    Google Scholar 

  106. Nelson DE, Fleming DW, Grant-Worley J, Houchen T: Outcome-based management and public health: The Oregon benchmarks experience.Journal of Public Health Management Practice. 1995,1: 8–17.

    Google Scholar 

  107. Kaplan RM: Behavior as the central outcome in health care.American Psychologist. 1990,45: 1211–1220.

    Article  PubMed  Google Scholar 

  108. Spilker B:Quality of Life and Pharmacoeconomics in Clinical Trials. New York: Raven, 1996.

    Google Scholar 

  109. Oregon Diabetes Project:Measuring Quality of Care in Health Systems: Population-Based Guidelines for Diabetes Mellitus. Portland, OR: State of Oregon, 1997.

  110. Vinicor F: Primary prevention of Type 2 diabetes mellitus. In Dyck P (ed),Diabetes Mellitus and Neurology. 1998.

  111. Hardin G:Living Within Limits: Ecology, Economics, and Population Taboos. New York: Oxford University Press, 1993.

    Google Scholar 

  112. Schneiderman LJ, Kaplan RM, Pearlman RA, Teetzel H: Do physicians' own preferences for life-sustaining treatment influence their perceptions of patients' preferences?Journal of Clinical Ethics. 1993,4: 28–33.

    PubMed  Google Scholar 

  113. Kilo C, Miller JP, Williamson JR: The Achilles heel of the University Group Diabetes Program.Journal of the American Medical Association. 1980,243: 450–457.

    Article  PubMed  Google Scholar 

  114. Kaplan RM, Ganiats TG: Trade-offs in treatment alternatives for non-insulin dependent diabetes mellitus.Journal of General Internal Medicine. 1989,4: 167–171.

    Article  PubMed  Google Scholar 

  115. Spilker B:Quality of Life in Clinical Trials. New York: Raven, 1990.

    Google Scholar 

  116. Gold MR, Siegel JE, Russell LB, Weinstein MC:Cost-Effectiveness in Health and Medicine. New York: Oxford University Press, Inc., 1996.

    Google Scholar 

  117. Kaplan RM: The Ziggy theorem: Towards an outcomes focused health psychology.Health Psychology. 1994,13: 451–460.

    Article  PubMed  Google Scholar 

  118. Kaplan RM, Rosen P: The Quality of Well-Being Scale: Overview and applications. In Aydin C (ed),Patient-Focused Care in the Hospital. Washington, DC: Faulkner & Gray, 1995, 363–385.

    Google Scholar 

  119. Keen H: Management of non-insulin-dependent diabetes mellitus. The United Kingdom experience.Annals of Internal Medicine. 1996,124: 156–159.

    PubMed  Google Scholar 

  120. Young MJ, Boulton AJ, Macleod AF, Williams DR, Sonksen PH: A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population.Diabetologia. 1993,36: 150–154.

    Article  PubMed  Google Scholar 

  121. Eastman RC, Javitt JC, Herman WH, et al: Model of complications of NIDDM II: Analysis of the health benefits and cost-effectiveness of treating NIDDM with the goal of normoglycemia.Diabetes Care. 1997,20: 735–744.

    Article  PubMed  Google Scholar 

  122. Meinert CL:Clinical Trials: Design, Conduct and Analysis. New York: Oxford University Press, 1986.

    Google Scholar 

  123. Flay BR: Efficacy and effectiveness trials (and other phases of research) in the development of health promotion programs.Preventive Medicine. 1986,15: 451–474.

    Article  PubMed  Google Scholar 

  124. Sidman M:Tactics of Scientific Research: Evaluating Experimental Data in Psychology. New York: Basic Books, Inc., 1960.

    Google Scholar 

  125. Solberg LI, Kottke TE, Brekke ML, et al: Using continuous quality improvement to increase preventive services in clinical practice—Going beyond guidelines.Preventive Medicine. 1996,25: 259–267.

    Article  PubMed  Google Scholar 

  126. Glasgow RE, Osteen VL: Evaluating diabetes education: Are we measuring the most important outcomes?Diabetes Care. 1992,15: 1423–1432.

    Article  PubMed  Google Scholar 

  127. Glasgow RE, Vogt TM, Boles SM: Evaluating the public health impact of health promotion interventions: The RE-AIM framework.American Journal of Public Health (in press, 1999).

  128. Anderson B, Auslander WF, Epstein M, et al: The importance of social context in diabetes management. In Mazze RS (ed),Professional Education in Diabetes Management: Proceedings of the Diabetes Research and Training Centers Conference. Washington, DC: 1980, 3–42.

  129. National Committee for Quality Assurance (NCQA):Health Plan Employer Data and Information Set 3.0. Washington, DC: National Committee for Quality Assurance, 1996.

    Google Scholar 

  130. Evans Jr. CA: 1995 presidential address: Public health: Vision and reality.American Journal of Public Health, 1996,86: 476–479.

    Article  PubMed  Google Scholar 

  131. World Health Organization:Prevention of Diabetes Mellitus: Report of a WHO Study Group. Geneva, Switzerland: World Health Organization, 1985.

    Google Scholar 

  132. Wallack L, Dorfman L, Jernigan D, Themba M:Media Advocacy and Public Health. Newbury Park, CA: Sage Publications, 1993.

    Google Scholar 

  133. McKinlay JB: A tale of three tails. “Prevention: Contributions from Basic and Applied Research” conference cosponsored by the Office of Behavioral and Social Sciences Research (OBSSR) of the National Institutes of Health and the Science Directorate of the American Psychological Association. Chicago: August, 1997.

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Authors and Affiliations

  1. AMC Cancer Research Center, 1600 Pierce Street, 80214, Denver, CO

    Russell E. Glasgow Ph.D.

  2. Group Health Cooperative of Puget Sound, Seattle, USA

    Edward H. Wagner M.D., M.P.H.

  3. University of California, San Diego, USA

    Robert M. Kaplan Ph.D.

  4. South Auckland Diabetes Project, Auchland, New Zealand

    Laurie Smith M.P.H., B.S.N.

  5. State of Washington Department of Health, Washington, USA

    Jan Norman R.D., C.D.E.

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  1. Russell E. Glasgow Ph.D.
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  3. Robert M. Kaplan Ph.D.
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  4. Frank Vinicor M.D., M.P.H.
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National Center for Chronic Disease Prevention and Health Promotion

Preparation of this manuscript was supported in part by grants NIDDK 3DK-R01-35524 from the National Institute of Diabetes, Digestive, and Kidney Diseases; #030103 from the Robert Wood Johnson Foundation; and Centers for Disease Control and Prevention, Division of Diabetes Translation Cooperative Agreement 424.

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Glasgow, R.E., Wagner, E.H., Kaplan, R.M. et al. If diabetes is a public health problem, why not treat it as one? A population-based approach to chronic illness. ann. behav. med. 21, 159–170 (1999). https://doi.org/10.1007/BF02908297

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