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

Overall Objectives

To rigorously evaluate health policies and interventions coming from health care systems, businesses, communities, and health care legislation that may reduce diabetes risk, its complications, and health inequalities across broad segments of the U.S. population.

Funding Agencies

This cooperative agreement 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.

Project Period

The NEXT-D Study is a 5-year research project that started in September 2010.

Study Outcomes

The NEXT-D study aims to understand how population-targeted policies affect preventive behaviors and diabetes outcomes, quantity and quality of care used, morbidity, costs, and unintended consequences. Find out more ... Evaluating Diabetes Health Policies Using Natural Experiments. [PDF - 544KB]

List of Grantees, Investigators, and Focus Areas

1.  Harvard Pilgrim Health Care Institute and Harvard Medical School, Department of Population Medicine, Boston, MA
Dennis Ross-Degnan, ScD, Associate Professor (Department of Population Medicine), Director of Research of Harvard Pilgrim Health Care Institute; Frank Wharam, MBBCh, BAO, MPH, General internist; Assistant Professor (Department of Population Medicine)

The Impact of Emerging Health Insurance Designs on Diabetes Outcomes and Disparities [PDF-502KB] project evaluates the impact of an employer-mandated switch to high deductible health plans on diabetes outcomes and disparities over a 12 year follow-up period, using a nationwide database. The population of interest includes adults with diabetes. Read more...[PDF-502KB]

2.  Kaiser Permanente Northern California, Division of Research, Oakland, CA
Julie A. Schmittdiel, PhD, Research Scientist, Division of Research, Kaiser Permanente, Northern California

The Health-Plan and Employer-Based Wellness Programs to Reduce Diabetes Risk [PDF-523KB] project evaluates the effectiveness of employer-based detection, outreach, and incentives for primary prevention of diabetes and of 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. Read more...[PDF-523KB]

3.  Northwestern University, Feinberg School of Medicine, Division of General Internal Medicine & Geriatrics, Chicago, IL
Ronald T. Ackermann, MD, MPH, Associate Professor of Medicine

The Effectiveness of a National Health Care Community Partnership to Prevent Diabetes [PDF-502KB] project evaluates health plan coverage of diabetes prevention programs delivered by YMCAs in diverse communities throughout the United States. The study will assess key drivers of reach, adoption, implementation, effectiveness, and maintenance of diabetes prevention programs. The population of interest includes adults with prediabetes. Read more...[PDF-508KB]

Summary Articles:

• Evaluating Diabetes Health Policies Using Natural Experiments: The Natural Experiments for Translation in Diabetes Study [PDF-544 KB]

4.  St. Luke's-Roosevelt Hospital Center, New York, NY
Jeanine Albu, MD, Associate Professor of Clinical Medicine, Columbia University College of Physicians and Surgeons

The Management and Education for Diabetes in New York City: The Expansion of Electronic Medical Record-Based Screening, Management and Prevention of Diabetes in NYC (MED-NYC) [PDF-511KB] project evaluates the use of electronic medical records with decision support for diabetes risk detection, prevention, and adoption of diabetes prevention interventions in community health centers and other outpatient clinics. The study population includes adults with prediabetes and newly diagnosed diabetes. Read more...[PDF-511KB]

5.  University of California, Los Angeles, Los Angeles, CA
Carol M. Mangione, MD, MSPH, Professor of Medicine and Public Health; O. Kenrik Duru, MD, MSHS, Associate Professor of Medicine

The Diabetes Health Plan: A System Level Intervention to Prevent and Treat Diabetes [PDF-541KB] project evaluates the effects of a health plan designed to reduce out-of-pocket costs and improve outreach and communication to patients with prediabetes and diabetes. Study outcomes include incidence of diabetes, control of risk factors, medication adherence, and costs. The population of interest includes adults with prediabetes and diabetes. Read more...[PDF-541KB]

Summary Articles:

• Optimizing Enrollment in Employer Health Programs: a Comparison of Enrollment Strategies in the Diabetes Health Plan [PDF-222KB].
• Adherence to Metformin, Statins, and ACE/ARBs Within the Diabetes Health Plan (DHP) [PDF-716KB]
• Metformin Prescription for Insured Adults With Prediabetes From 2010 to 2012: A Retrospective Cohort Study [PDF-405KB]

Participating Federal Agencies:

Division of Diabetes Translation, Centers for Disease Control and Prevention (CDC) and the National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)

CDC and NIDDK, agencies with a history of work related to translating diabetes prevention and control, are 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 scientific consultant: Edward Gregg, PhD, CDC
Project administrator: Bernice A. Moore, MBA, CDC
Collaborating Consultant: Christine Hunter, PhD, ABPP; CAPT USPHS, NIDDK