• Kunthea Nhim, Tamkeen Khan, Stephanie M Gruss, Gregory Wozniak, Kate Kirley, Patricia Schumacher, Elizabeth T Luman, and Ann Albright.
• Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: knhim@cdc.gov.
• Am J Prev Med. 2018 Aug 1; 55 (2): e39-e47.

IntroductionIntensive behavioral counseling is effective in preventing type 2 diabetes, and insurance coverage for such interventions is increasing. Although primary care provider referrals are not required for entry to the Centers for Disease Control and Prevention (CDC)-recognized National Diabetes Prevention Program lifestyle change program, referral rates remain suboptimal. This study aims to assess the association between primary care provider behaviors regarding prediabetes screening, testing, and referral and awareness of the CDC-recognized lifestyle change program and the Prevent Diabetes STAT: Screen, Test, and Act Today™ toolkit. Awareness of the lifestyle change program and the STAT toolkit, use of electronic health records, and the ratio of lifestyle change program classes to primary care physicians were hypothesized to be positively associated with primary care provider prediabetes screening, testing, and referral behaviors.MethodsResponses from primary care providers (n=1,256) who completed the 2016 DocStyles cross-sectional web-based survey were analyzed in 2017 to measure self-reported prediabetes screening, testing, and referral behaviors. Multivariate logistic regression was used to estimate the effects of primary care provider awareness and practice characteristics on these behaviors, controlling for provider characteristics.ResultsOverall, 38% of primary care providers were aware of the CDC-recognized lifestyle change program, and 19% were aware of the STAT toolkit; 27% screened patients for prediabetes using a risk test; 97% ordered recommended blood tests; and 23% made referrals. Awareness of the lifestyle change program and the STAT toolkit was positively associated with screening and referring patients. Primary care providers who used electronic health records were more likely to screen, test, and refer. Referring was more likely in areas with more lifestyle change program classes.ConclusionsThis study highlights the importance of increasing primary care provider awareness of and referrals to the CDC-recognized lifestyle change program.Published by Elsevier Inc.

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