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Natural Experiments for Translation in Diabetes (NEXT-D) Study

The NEXT-D Study is a 5-year research network designed to test the effectiveness and sustainability of population-targeted diabetes prevention and control policies emerging from health care systems, business and community organizations, and health care legislation. It includes large-scale natural experiments or effectiveness studies and rigorously designed prospective studies of ongoing or imminent diabetes prevention and control interventions. The studies quantify the impact of population-targeted policies on preventive behaviors, quality of care, morbidity, and intended and unintended intervention consequences. In addition, NEXT-D is developing innovative design and evaluation approaches to naturally-occurring population-based interventions.

This project is jointly funded by the Centers for Disease Control and Prevention (CDC) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) under CDC Funding Opportunity Announcement (FOA) Number: RFA- DP10-002, entitled Natural Experiments and Effectiveness Studies to Identify the Best Policy and System-Level Practices to Prevent Diabetes and Its Complications.

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Overall Objectives:

The research network is supporting a new and unique platform for rigorous diabetes health policy studies intended to influence and prioritize interventions that reduce diabetes risk, its complications, and health inequalities across broad population segments.

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Study Outcomes:

The study will assess the impact of population-targeted policies on preventive behaviors and outcomes, quantity and quality of care, morbidity, costs, and intended and unintended consequences.

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Network Sites and Collaborators:

Harvard Pilgrim Health Care Institute and Harvard Medical School, Department of Population Medicine, Boston, MA

Evaluates the impact of employer-mandated switch to high deductible health plans on diabetes outcomes and disparities during a 12-year follow-up period, using a nationwide database. The population of interest includes adults with prediabetes and diabetes.
- Co-PI: Dennis Ross-Degnan, ScD
  - Associate Professor (Department of Population Medicine)
  - Director of Research of Harvard Pilgrim Health Care Institute
- Co-PI: Frank Wharam, MBBCh, BAO
  - General internist; Assistant Professor (Department of Population Medicine)

Kaiser Permanente Northern California, Division of Research, Oakland, CA

Evaluates effectiveness of employer-based detection, outreach, and incentives for primary prevention of diabetes and post-partum glucose screening on future diabetes incidence and its severity. The study population includes adults with high risk for diabetes and women with gestational diabetes.
- PI: Julie A. Schmittdiel, PhD
  - Research Scientist, Division of Research, Kaiser Permanente, Northern California

Northwestern University, Feinberg School of Medicine, Division of General Internal Medicine & Geriatrics, Chicago, IL

Evaluates health plan coverage of diabetes prevention programs delivered by YMCAs in diverse communities throughout the United States. Main intervention objectives include assessing key drivers of reach, adoption, implementation, effectiveness, and maintenance. The population of interest includes adults with pre-diabetes.
- PI: Ronald T. Ackermann, MD, MPH
  - Associate Professor of Medicine
- Co-PI: Joyce W. Tang, MD
- Co-PI: Dustin D. French, PhD

St. Luke's-Roosevelt Hospital Center, Department of Medicine & Obesity Research Center, New York, NY

Evaluates effects of using electronic medical records with decision support on diabetes risk detection, prevention, and adoption of diabetes prevention interventions in community health centers and other outpatient clinics. The study population includes adults with pre-diabetes and newly diagnosed diabetes
- PI: Jeanine Albu, MD
  - Associate Professor of Clinical Medicine, Columbia University College of Physicians and Surgeons

University of California, Los Angeles, Department of Medicine, Los Angeles, CA

Evaluates the effects of a health plan designed to reduce out-of-pocket costs for patients with pre-diabetes and diabetes on primary and secondary prevention. Primary outcomes include incidence of diabetes, control of risk factors, medication adherence, and costs. The population of interest includes adults with pre-diabetes and diabetes.
- Co-PI: Carol M. Mangione, MD, MSPH
  - Professor of Medicine and Public Health
- Co-PI: O. Kenrik Duru, MD, MPH
  - Assistant Professor of Medicine

Division of Diabetes Translation, Centers for Disease Control and Prevention (CDC), Atlanta, GA

With a history of work related to translating diabetes prevention and control, this group is supporting each site to ensure high-quality scientific delivery, synergies between sites yielding cross-cutting metrics and methods, and multi-site deliverables such as policy frameworks, briefs, and analysis.
- Lead Project Consultant: Edward Gregg, PhD
- Project Administrator: Bernice A. Moore, MBA

National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK), Bethesda, MD

Collaborating Consultant: Sanford (Sandy) Garfield, PhD

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For Other Information

For public inquiries and more information about diabetes, please visit the Centers for Disease Control and Prevention Diabetes Web site or call 1-800-CDC-INFO (232-4636).

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