D5.2. Country Implementations Plans. WP5 - CARE4DIABETES

EXECUTIVE SUMMARY
This document is the second deliverable of the work package 5 (WP5) “Preparatory Actions”. This deliverable integrates information related to task 5.2 “Development of country implementation plans” and task 5.4 “Recruitment strategies design”, developed between month M4 and M9 of the project, as described in the Grant Agreement (GA) of the Joint Action CARE4DIABETES (C4D JA).
The C4D JA supports 12 Member States in reducing the burden of type 2 diabetes (T2D) through effective lifestyle treatment programs. Partners will implement a Dutch evidence-based best practice (BP) “Reverse Diabetes 2 Now” (RD2N), developed by the non-governmental organisation Voeding Leeft (VL). The specific objectives of the pilot intervention phase are:
✓ To enhance lifestyle counselling knowledge and skills among healthcare professionals involved in the project pilots.
✓ To transfer, pilot, evaluate and adjust a lifestyle intervention model for T2D patients in each implementing country.
✓ To improve lifestyle, quality of life and levels of glycaemic control and reduction in use of glucose-lowering medication among T2D participants.
✓ To integrate the lifestyle intervention model for T2D patients into local/regional/national health care services.
The purpose of the document is to summarise the C4D the implementing partner’s plans in 12 different countries (Belgium, Bulgaria, Finland, Greece, Hungary, Italy, Malta, Poland, Portugal, Slovakia, Slovenia and Spain), and detail how they plan to deliver the VL BP in an integrated and sustainable way within each particular context.
The objective of this deliverable is to present an overview of the activities planned at national level for the intervention phase of the VL BP defining concrete actors (who), functions and roles (what), timeframe (when) and setting (where).
The intended audience are all members of the C4D consortium (competent authorities and affiliated entities), especially the WP leaders, C4D teams from implementing countries, and stakeholders involved in the pilot implementation and/or dissemination and scale-up of the VL BP.

The implementation methodology was developed based on proven techniques, specific procedures and recommendations oriented towards long lasting sustainability which were developed by the Joint Action on implementation of digitally enabled integrated person-centred care (JADECARE), as determined in the GA of the C4D JA. The methodology is based on the use of Plan-Do-Study-Act (PDSA) cycles (or Deming systematic process) for continuous tracking and improvement, the SQUIRE 2.0 framework for reporting new knowledge about how to improve healthcare, and the Consolidated Framework for Implementation Research (CFIR) for including elements that could influence on a positive or negative way the process of sustainability of the BP.
Other methods were included in the preparatory actions, such as the SCIROCCO self-assessment tool to understand RD2N, and the Strengths, Weaknesses, Opportunities, and Threats (SWOT) approach to analyse different contexts.
This document includes different stages: a set of preparatory actions already described in the deliverable D5.1 “In-depth review of BP and context analysis”, a stage of intervention, and a stage of post-intervention.

The present deliverable focuses on the practical preparation for the intervention stage and accounts for the information regarding ‘'implementation plans” to reproduce the BP at local level.
It addresses cross-sectional elements that will be further reflected upon on different deliverables during the project life, such as: communication and dissemination activities (D2.3); data collection and management (D3.2), development of a digital platform (D5.3) and sustainability oriented actions (D4.1).
Considering the early time in the project in which the information regarding implementation plans was collected and highlighting the fact that 8 out of the 12 participating countries (Belgium, Bulgaria, Greece, Hungary, Malta, Poland, Portugal and Slovakia) had not yet been trained on the BP by VL through the Training the Trainers, certain degree of change is foreseen on the implementation plans on the following months after this deliverable is submitted up to the start of the pilots.In conclusion, this document defines the intended development of activities to implement the VL BP in each particular context taking a basic common framework and compares and analyses the results at regional/country level aiming sustainability beyond the end of the JA.
Subsequent alterations to the plan will be reflected in upcoming deliverables, such as D6.2, Intensive care implementation on monitoring and reporting (Phase I) and D3.2, Interim and final evaluation reports.

Progress: All countries filled in the required information on the implementation plan templates with different degrees of detail, corresponding to the readiness to decide some of the specifics at such early stage and their different levels of knowledge of the BP. The preparation for this deliverable was set at the start of T5.2 and T5.4 (May, 2023 whilst the country-level information was collected on M7 and M8 (July and August, 2023) and compiled in this document by M9 (September, 2023).