REPLICATION OF A NEW, EVIDENCE-BASED PREVENTATIVE HEALTH TRAINER SERVICE FOR PEOPLE AT RISK OF DEVELOPING TYPE 2 DIABETES

Objectives: Randomised controlled trials have shown that type 2 diabetes is preventable by lifestyle modification in patients with impaired glucose tolerance (IGT). The NIHR Collaboration for Leadership in Applied Health Research andCare for Greater Manchester (GM CLAHRC) worked with NHS Bolton to translate this evidence into practice. Following the success of the service in one locality, the GM CLAHRC supported and evaluated the replication of this service model to another health locality to see whether the model could achieve the same patient outcomes.Methods: Working with NHS Bolton’s commissioners, GP surgeries and patients, a face-to-face service model was chosen to offer intensive and personalised lifestyle and behaviour change support, delivered by the existing, primary carebased Health Trainer (HT) service. The service was diversified to offer support to people with IGT. It was piloted and gradually adapted and spread to GP surgeries across Bolton. Feedback from patients and staff was used to continuously improve the service. After embedding the service in Bolton, the same model was implemented in Ashton, Leigh & Wigan (ALW) utilising theexisting HT service and learnings from the first study; which meant that GM CLAHRC also worked with surgeries in validating IGT registers and identifying IGT patients. Both HT services are structured similarly with HTs working withinand mainly receiving referrals from GP surgeries. Differences exist in the ethnic mix of the populations of Bolton and ALW and also in the training of HTs with Bolton’s HTs trained to take bloods and measure a patient’s blood pressure. In order to evaluate the outcomes of both services, patients’ weight, body mass index (BMI) and waist circumference (WC) were measured at baseline and at the end of the HT intervention, making use of data routinely collected in primary care.Results: In Bolton, the first pilot study, a total of 80 participants were included in the initial evaluation with a mean baseline BMI of 31.0kg/m2, mean weight of 87.0kg and mean WC of 105.3cm. After the six month intervention participantsexperienced a mean weight loss of 2.9kg (SD 4.5) (p