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Study endpoints are composed of a) the status of participating village doctors, who are categorized as either “pre-diabetic specialist”, “diabetes specialist”, or “non-diabetes specialist”, as well as the rate of participation of pre-diabetics in different levels of prevention service; b) changes in the level of blood glucose, blood pressure and body mass index (BMI) of all pre-diabetics within the villages of the same block; and c) changes in village doctors’ compliance with prevention service delivery etc.
Study endpoints are assessed mainly from eCROPS qualitative and quantitative data collection tools, i.e., the full-length interview, the questionnaires, the blood sample taken during the post-intervention follow up. Study endpoints mainly include, a) quality of life measured by the Chinese version of the WHOQOL-BREF (WHOQOL-BREF-C) [62]; b) metabolic parameters including HbA1c, fasting plasma glucose (FPG), fasting serum insulin, and lipid profile; c) blood pressure (SBP/DBP) and BMI; and d) compliance indicators e.g., attendance rate of diabetes prevention counseling sessions, proportion of missed blood tests, proportion of missed bi-annual follow up, and proportion of non-compliant village doctors.
Trust-based incentives (T) are implemented via communication of the project results, dissemination of the key eCROPS findings via talks and papers and presentations etc. Firstly, for those participating in eCROPS as village doctors, their village name and eCROPS ID would be shown to the villagers and village doctors on the eCROPS web site indicating that the doctors are part of the research team and participate in the project. Secondly, the village doctors are invited to present the project results at various community-based activities including annual diabetes prevention campaign, semiannual community health day, and village doctor meetings etc. Thirdly, project teams communicate with the village doctors through telephone, email and text message, inviting them to attend eCROPS workshops, training courses and monthly webinars for diabetes prevention issues etc.
The above-mentioned performance-based incentives are validated by researchers via rounds of performance reviews. The validity of the others including honor awarding and ISP membership, is validated by the official participating local health authority and further peer reviews and inspections at county and prefecture and province levels.
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