Description of an integrated framework for building linkages among primary care clinics and community organizations for the prevention of type 2 diabetes: Emerging themes from the CC-Link study

Strong clinic-community linkages are pivotal for the success of preventive services that combine clinical and community resources. Unfortunately, there has been limited guidance for how clinical and community groups can partner to improve self-care and prevention for chronic conditions. This manuscript describes the development and implementation of an integrated framework to guide clinic-community linkages for the prevention of type 2 diabetes in an ongoing randomized effectiveness trial known as Clinical-Community Linkages to Prevent Diabetes (CC-Link) study. This study involves 10 primary care practices in a metropolitan area of the Midwest US. The study provided each practice location with technical assistance to select, implement, evaluate and refine different strategies to identify and address pre-diabetes using a clinic-community linkage. Sites were also randomized to receive either direct or indirect involvement by a community liaison/expert from the YMCA of Greater Indianapolis. Early implementation of the CC-Link Framework has underscored the importance of strong leadership and partnership synergy, and it uncovered several examples of how linkages can be designed to make the most of partner strengths. This success is promising, and an evaluation of the effectiveness of these efforts to improve lifestyle behaviours of adults with prediabetes is now underway.