Exploring the Implementation of a Diabetes Remission Program in Primary Care Using a Scalability Assessment: A Case Study

Abstract

Type 2 diabetes is a growing global health issue. Diabetes remission could offer an alternative approach to care by reversing the metabolic state with clinically meaningful benefits. However, research on effectively integrating remission programs into primary care practices remains limited. The aim of this thesis was to explore the contextual factors perceived by multidisciplinary team members within a Family Health Team regarding the implementation and scale-up of a diabetes remission program. This thesis used a qualitative single case study approach and leveraged the use of the Intervention Scalability Assessment Tool. Data generation included using an adapted version of the tool for one-to-one semi-structured virtual interviews with 11 participants. Data analysis involved multiple evidence sources being analyzed using the Framework Method. Three main themes were developed: (1) positioning the coaching role within primary care, (2) the readiness of the primary care site to adopt remission, and (3) positive health outcomes. The study found that a remission program was acceptable, attractive, and feasible for participants, contributing to a broader understanding of how to expand diabetes remission care across Ontario.