A Solutions-Based Approach to Building Data-Sharing Partnerships.

INTRODUCTION: Although researchers recognize that sharing disparate data can improve population health, barriers (technical, motivational, economic, political, legal, and ethical) limit progress. In this paper, we aim to enhance the van Panhuis et al. framework of barriers to data sharing; we present a complementary solutions-based data-sharing process in order to encourage both emerging and established researchers, whether or not in academia, to engage in data-sharing partnerships. BRIEF DESCRIPTION OF MAJOR COMPONENTS: We enhance the van Panhuis et al. framework in three ways. First, we identify the appropriate stakeholder(s) within an organization (e.g., criminal justice agency) with whom to engage in addressing each category of barriers. Second, we provide a representative sample of specific challenges that we have faced in our data-sharing partnerships with criminal justice agencies, local clinical systems, and public health. Third, and most importantly, we suggest solutions we have found successful for each category of barriers. We grouped our solutions into five core areas that cut across the barriers as well as stakeholder groups: Preparation, Clear Communication, Funding/Support, Non-Monetary Benefits, and Regulatory Assurances.Our solutions-based process model is complementary to the enhanced framework. An important feature of the process model is the cyclical, iterative process that undergirds it. Usually, interactions with new data-sharing partner organizations begin with the leadership team and progress to both the data management and legal teams; however, the process is not always linear. CONCLUSIONS AND NEXT STEPS: Data sharing is a powerful tool in population health research, but significant barriers hinder such partnerships. Nevertheless, by aspiring to community-based participatory research principles, including partnership engagement, development, and maintenance, we have overcome barriers identified in the van Panhuis et al. framework and have achieved success with various data-sharing partnerships.In the future, systematically studying data-sharing partnerships to clarify which elements of a solutions-based approach are essential for successful partnerships may be helpful to academic and non-academic researchers. The organizational climate is certainly a factor worth studying also because it relates both to barriers and to the potential workability of solutions.

Long-term effects of a community-based lifestyle intervention to prevent type 2 diabetes: the DEPLOY extension pilot study.

OBJECTIVE: The US Diabetes Prevention Program (DPP) and other large trials internationally have shown that an intensive lifestyle intervention can reduce the development of type 2 diabetes. We evaluated long-term effects of a lower cost, group-based adaption of the DPP lifestyle intervention offered by the YMCA. METHODS: Participants were adults with BMI ≥24 kg/m(2) and random capillary blood glucose 6.1-11.1 mmol/L who had been previously enrolled in a cluster-randomized trial comparing a group-based DPP lifestyle intervention versus brief advice alone. Four to 12 months after completion of the initial trial, 72% of 92 participants enrolled in an extension study, and all were offered a group lifestyle maintenance program at the YMCA. Paired t-tests were used to assess within-group changes; ANCOVA with adjustment was used for between-group comparisons. RESULTS: At 28 months, after both arms were offered the same 8-month lifestyle maintenance intervention, both arms had statistically significant weight losses compared to baseline (brief advice controls: -3.6%; 95% CI: -5.8 to -1.4; intensive lifestyle: -6.0%; 95% CI: -8.8 to -3.2). Participants initially assigned to the DPP also experienced significant improvements in blood pressure and total cholesterol. DISCUSSION: The YMCA is a promising channel for dissemination of a low-cost model for lifestyle diabetes prevention. Future studies are needed to verify these findings.

Reduced 10-year risk of coronary heart disease in patients who participated in a community-based diabetes prevention program: the DEPLOY pilot study.

OBJECTIVE: We evaluated whether participation in a community-based group diabetes prevention program might lead to relative changes in composite 10-year coronary heart disease (CHD) risk for overweight adults with abnormal glucose metabolism. RESEARCH DESIGN AND METHODS: We used the UK Prospective Diabetes Study engine to estimate CHD risk for group-lifestyle and brief counseling (control) groups. Between-group risk changes after 4 and 12 months were compared using ANCOVA. RESULTS: Baseline 10-year risk was similar between treatment groups (P = 0.667). At 4 and 12 months, the intervention group experienced significant decreases in 10-year risk from baseline (-3.28%, P < 0.001; and -2.23%, P = 0.037) compared with control subjects (-0.78%, P = 0.339; and +1.88%, P = 0.073). Between-group differences were statistically significant and increased from the 4- to 12-month visits. CONCLUSIONS: Community-based delivery of the Diabetes Prevention Program lifestyle intervention could be a promising strategy to prevent both CHD and type 2 diabetes in adults with pre-diabetes.

The effect of soy protein and soy isoflavones on calcium metabolism in postmenopausal women: a randomized crossover study.

BACKGROUND: Evidence suggests that soy isoflavones act as estrogen agonists and have beneficial skeletal effects, but the effects on calcium metabolism in humans are not known. OBJECTIVE: This study tested whether soybean isoflavones, soy protein, or both alter calcium metabolism in postmenopausal women. DESIGN: Calcium metabolism in 15 postmenopausal women was studied by using metabolic balance and kinetic modeling in a randomized, crossover design of three 1-mo controlled dietary interventions: soy protein isolate enriched with isoflavones (soy-plus diet), soy protein isolate devoid of isoflavones (soy-minus diet), and a casein-whey protein isolate (control diet). RESULTS: There was no significant difference between the diets in net acid excretion (P = 0.12). Urinary calcium excretion was significantly (P < 0.01) less with consumption of either of the soy diets (soy-plus diet: 85 +/- 34 mg/d; soy-minus diet: 80 +/- 34 mg/d) than with consumption of the control diet (121 +/- 63 mg/d), but fractional calcium absorption was unaffected by treatment. Endogenous fecal calcium was significantly (P < 0.01) greater with consumption of the soy-minus diet than with consumption of the other diets. Total fecal calcium excretion, bone deposition and resorption, and calcium retention were not significantly affected by the dietary regimens. CONCLUSIONS: The lower urinary calcium seen with the consumption of an isolated soy protein than with that of an isolated milk protein was not associated with improved calcium retention. This finding reinforces the importance of evaluating all aspects of calcium metabolism. Soy isoflavones did not significantly affect calcium metabolism.