Background and theory

Previous clinical trials have shown the efficacy of lifestyle interventions in the prevention of type 2 diabetes in different populations [1, 2, 3, 4] and the sustainability of the beneficial effects for several years after the discontinuation of the intervention [5, 6].

The efficacy of such interventions depends strongly on the lifestyle changes adopted, which emphasizes successful health behavior change in the prevention of type 2 diabetes [5]. Importantly, sustainable and scalable models are needed to reach and identify individuals at increased risk of type 2 diabetes and to deliver personalized and effective lifestyle interventions.

The implementation of evidence-based approaches for reaching and identifying individuals at increased risk and preventing type 2 diabetes as permanent practices in the health care system and the society is still a challenge. Individuals at increased risk can be identified based on a history of non-diabetic dysglycaemia or gestational diabetes [7, 8] but also using validated risk screening tools, such as the Finnish Diabetes Risk Score (FINDRISC) [9]. However, such risk screening tools are not yet utilized systematically in the identification of individuals at increased risk of type 2 diabetes in the health care system and the society.

Many seminal lifestyle intervention studies, such as the Diabetes Prevention Study in Finland [1] and the Diabetes Prevention Program in the United States [2] as well as most of the implementation studies following these efficacy trials [10, 11] have been based on face-to-face counselling either individually or in groups.

However, individual counseling is resource-intensive and may not be feasible for most health care systems [10]. Group counseling demands less resources but requires special skills [12] which may limit its use in the health care system. Although digital interventions are more scalable than face-to-face interventions, adherence to digital interventions remains a challenge [13, 14].

Stop Diabetes – Knowledge-Based Solutions (StopDia): A Strategic Reseach Funding project

The Stop Diabetes (StopDia) study was set to create and implement evidence-based and digitally supported strategies for the prevention of type 2 diabetes at population level in three provinces in Finland.

The project received funding from the Strategic Recearch Council on June 2016. The Strategic Research Council (SRC) funds high-quality research that has great societal impact. The research should seek to find concrete solutions to grand challenges that require multidisciplinary approaches. An important element of such research is active collaboration between those who produce new knowledge and those who use it.

Importantly, the risk identification and the StopDia lifestyle interventions are fully integrated in the Finnish health care system to facilitate their long-term implementation.

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