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Health Promotion International, Vol. 17, No. 4, 317-327, December 2002
© Oxford University Press 2002

A stage model for assessing a community-based diabetes prevention program in Sweden

Camilla M. Andersson, Gunilla E. M. Bjärås and Claes-Göran Östenson

Diabetes Prevention Unit, Karolinska Hospital, Stockholm, Sweden

Address for correspondence: Camilla M. Andersson Diabetes Prevention Unit Karolinska Hospital 171 76 Stockholm Sweden E-mail: camilla.m.andersson{at}ks.se

Type 2 diabetes is the most common type of diabetes, with a prevalence of at least 4% in Sweden. Aiming at primary prevention of the disease, the Stockholm Diabetes Prevention Program (SDPP) was developed as a joint program between the Departments of Endocrinology, Social Medicine and Epidemiology at the Karolinska Institute. The program was designed to include three stages, i.e. a combined baseline and aetiological study, a community-based intervention program and a follow-up study after 10 years. In 1995, the intervention program was initiated in Stockholm County with the aim of reducing the incidence of type 2 diabetes. The intervention has focused on the whole adult population in three intervention municipalities, where the local authorities have been involved in planning, initiating and implementing the program. Activities to prevent diabetes, aiming at risk factors such as obesity, low physical activity, dietary habits and tobacco use, have been initiated together with people from different fields and backgrounds, and with different ideas and approaches to health promotion and diabetes prevention. This paper provides a description and reflects upon the development and implementation process of SDPP as well as its interaction with the intervention communities. The stage model that was used for planning SDPP will be used for describing the various phases of the program. Over the period of the program, interest and responsibility has grown at the municipal authorities. The program has been a concern for the municipalities, as the program intermediate goals are also important for other health promotion issues.

Key words: process evaluation; stage model; Stockholm Diabetes Prevention Program; type 2 diabetes


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