Research Priorities and Indicators for Lifestyle Programs to Address Cardiometabolic Conditions

Abstract

Background: Cardiometabolic conditions are a major and growing health burden in many countries. At least one-third of middle-aged adults with overweight and obesity develop various combinations of type 2 diabetes, hypertension, dyslipidemia, and other cardiometabolic conditions. Currently, all relevant clinical and community guidelines recommend lifestyle (e.g. diet and physical activity) interventions, yet current evidence suggests limited and variable uptake by either primary care or public health services. New implementation research in lifestyle interventions is needed in multiple jurisdictions. As part of this effort, some agreement within the research community on priorities and core measures and indicators across studies would improve comparability and drive progress. Members of a new volunteer network undertook a first Delphi process to determine initial consensus.Methods: Network members were invited by email to participate and completed two rounds of a modified Delphi process delivered through online questionnaire and teleconferences. Results were sent back to participants at the end of each round of the survey. High priority with consensus was defined as the median and 25-75%ile range within the 7 to 9 range on a 9-point scale. Results: Fifty-three people were invited and provided with a link to the first questionnaire. Twenty-five (47%) and 18 (34%) participants completed the round 1 and round 2 surveys, respectively. Of 22 possible research priorities, four were rated high priority with consensus, including: evaluating the efficacy and effectiveness of interventions in place, improving existing interventions for sustainability, and clinical and public health research to advance existing knowledge to develop new capacities. Of the 93 measures and indicators proposed, 15 achieved consensus with an additional nine measures having high medians, but greater variance.Conclusions: This first effort suggests a wide range of research priorities within the group, but also broad agreement on a few core implementation research priorities. There is currently limited agreement on core indicators/measures for implementation studies and additional work is needed. The results provide a starting point for further development of common measures for implementation research in lifestyle interventions for cardiometabolic conditions.