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Table 1—

Key diabetes translational issues in real-world settings

Descriptions and prior lessons learned 
 · Translation occurs in two continuous phases. The first is “bench to bedside,” from laboratory research to clinical research. The second phase goes beyond the clinical research bedside to the community at large. 
 · Many barriers to adoption of new science into clinical care at the community level exist. 
 · Diabetes translational issues are diverse and complicated, involving quality of care, outcomes, access to care, and costs across the multiple intervention levels of patients, including children and older individuals, providers, centers, health care systems, and society. 
 · Behavior is influenced by a combination of multilevel forces: predisposing, enabling, and reinforcing factors. 
 · No single best practice is appropriate for all patients and practitioners. Tailoring to patients and customizing to settings is necessary. 
 · Real-world translation requires flexibility to deal with pragmatic issues such as provider time constraints, reimbursement, and system problems. 
 · Rigorous nonrandomized study designs including quasi-experimental, time-series, and observational studies are frequently most appropriate. 
Priority areas for much-needed diabetes translation 
 · External validity issues and applicability of programs and results to different settings. 
 · Identifying and understanding barriers and facilitators to translating research into practice. 
 · Moving from an acute-care paradigm to a multifaceted chronic-care model that is population-based as well as patient-centered. 
 · Vulnerable, understudied populations—older persons, minority populations, children/adolescents, and people at risk for diabetes, including the overweight and obese. 
 · Diabetes translational interventions. 
 · Sustainability of organizational interventions. 
 · Community-based participatory translational efforts involving researchers, community members, and governmental/private agencies. 
 · Economic studies of translation, including cost-effectiveness analysis. 
 · Public health and public policy efforts. 
Descriptions and prior lessons learned 
 · Translation occurs in two continuous phases. The first is “bench to bedside,” from laboratory research to clinical research. The second phase goes beyond the clinical research bedside to the community at large. 
 · Many barriers to adoption of new science into clinical care at the community level exist. 
 · Diabetes translational issues are diverse and complicated, involving quality of care, outcomes, access to care, and costs across the multiple intervention levels of patients, including children and older individuals, providers, centers, health care systems, and society. 
 · Behavior is influenced by a combination of multilevel forces: predisposing, enabling, and reinforcing factors. 
 · No single best practice is appropriate for all patients and practitioners. Tailoring to patients and customizing to settings is necessary. 
 · Real-world translation requires flexibility to deal with pragmatic issues such as provider time constraints, reimbursement, and system problems. 
 · Rigorous nonrandomized study designs including quasi-experimental, time-series, and observational studies are frequently most appropriate. 
Priority areas for much-needed diabetes translation 
 · External validity issues and applicability of programs and results to different settings. 
 · Identifying and understanding barriers and facilitators to translating research into practice. 
 · Moving from an acute-care paradigm to a multifaceted chronic-care model that is population-based as well as patient-centered. 
 · Vulnerable, understudied populations—older persons, minority populations, children/adolescents, and people at risk for diabetes, including the overweight and obese. 
 · Diabetes translational interventions. 
 · Sustainability of organizational interventions. 
 · Community-based participatory translational efforts involving researchers, community members, and governmental/private agencies. 
 · Economic studies of translation, including cost-effectiveness analysis. 
 · Public health and public policy efforts. 
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