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Table 2 Examining rigor and relevance of the VA-DPP implementation study [3]

From: Practical partnered research to improve weight loss among overweight/obese veterans: lessons from the trenches

  Characteristic VA-DPP
Systems perspective
1 Context is critical VA-DPP intervention is clearly focused on preventing diabetes among Veterans with pre-diabetes within an integrated health system
2 Multilevel complexity Diabetes prevention involves multi-component, comprehensive lifestyle interventions; the VA-DPP coaches deliver personalized treatment
3 Focus on systems characteristics VA health system leaders supported the program and efforts were made to gain buy-in from VA site leaders and staff; implementation and delivery were tailored to sites
Robust, practical goals
4 Representativeness and reach Minimal eligibility criteria to reach wider population of Veterans in need
5 Generalizability Designed to assess generalizability of the DPP’s results for the largely male Veteran population
6 Pragmatic and practical Showed VA leaders the feasibility of implementing this program in the VA; it also showed the potential effectiveness of VA-DPP for Veterans
7 Scalability and sustainability The VA-DPP was piloted at three sites in order to determine feasibility across all VA sites nationally designed to utilize existing clinical processes when possible in order to promote sustainability, although existing clinical processes limited recruitment
Research methods to enhance relevance
8 Rigorous The VA-DPP maintained scientific rigor by using systematic assignment to intervention arms, but also focused on replicability by integrating the study into existing clinical processes as much as possible
9 Rapid VA health system leaders decided to make systemic changes based on early findings (at 6 months) indicating greater weight loss with the VA-DPP
10 Adaptive This research partnership was based on previous collaborations on similar weight loss interventions for Veterans
11 Integration of methods; triangulation Quantitative data (patient weights, HbA1cs, questionnaires, fidelity checklists) and qualitative data (patient and staff interviews) were integrated to assess VA-DPP implementation and effectiveness
12 Relevance The VA-DPP was a high priority for senior leaders
13 Multiplicity The partnership between researchers and health system leaders brought different viewpoints with how to implement the VA-DPP
14 Respect for diverse approaches; humility The researchers and health system leaders collaboratively decided on the best approach for conducting the VA-DPP evaluation