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Program information Chapa de Indian Health Program, Inc. Diabetes Prevention Program. Jamie Sweet, MSN, RN Who is this new person? What is this program?. The Ojibwe Stealing the Sun Rabbett Before-Horses Strickland. Evidence: Flowers do grow in Wisconsin.
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Program information • Chapa de Indian Health Program, Inc. Diabetes Prevention Program Jamie Sweet, MSN, RN Who is this new person? What is this program?
The Ojibwe Stealing the Sun Rabbett Before-Horses Strickland
The Diabetes Prevention Program (DPP) What the program is: Intensive 16 week classes over 16-24 weeks for AI persons at risk for type 2 diabetes. The focus is on sustained lifestyle balance: healthy food and activity choices in a supportive group setting. Why we’re doing it: The CDC estimates 16% of AI adults are diabetic, and 2-3 X more risk for DM than other groups Prevention works: Research shows that lifestyle modification works better than placebo or Metformin to stop conversion to DM Prevention is more cost-effective than becoming diabetic
DPP CORE CONCEPTS Recruitment-How we find people Screening & Eligibility-How we find the right people DPP Curriculum-who and what we’ll be teaching Retention-how we keep people involved
Recruitment Recruitment Goals = 48 new participants each year Recruitment Activities: Invitation to participate based on eligibility requirements (AI, pre-diabetes, age 18 or older) Entry process – informed consent, talking points Settings for Recruitment: clinic, community events, pow-wows, clinic foyer (open to other ideas) Methods of Recruiting individuals to participate: (interoffice referrals, word of mouth, social-marketing, networking w/other programs) Materials for Recruitment: Incentives, Information on weight-loss & pre-diabetes information, offering screenings: ADA Risk Assessment, BS screening (possibly).
Screening and Eligibility Identify individuals at risk for diabetesage> 18 Screening and Diagnosis Settings-ADA Risk Assessment & DX of pre-diabetes: 1. Community 2. Clinic Diagnosis of pre-diabetes-(set by the grantors) 1. Fasting blood glucose 100-125 mg/dl (Impaired Fasting Glucose, IFG)OR 2. 2-hour glucose 140-199 mg/dl (Impaired Glucose Tolerance, IGT)OR 3. A1c > 5.7 and < 6.5 (note: this remains an area of controversy for the diabetes community. Our best evidence suggests this cut-off at this time.)
Screening and Eligibility Identify old cases for recall. Persons w/pre-existing diagnosis of pre-diabetes (registries in RPMS, EHR, Notifications of new cases) Follow-up w/high-risk persons screened during community events(referrals back to providers for additional screening-Health physical and blood work). Exclusion of Individuals (Non-native, diabetic, active substance abuser, GDM, under 18, end stage renal disease)
DPP Curriculum Diabetes Prevention Team 1. Who is the DPP Team: Diabetes Program Manager, Data Coordinator, Lifestyle Coach, RD, BH, and other celebrity guest star speakers (hint hint) 2. Team Meetings: DM, DPP, but we might ask to be involved with template meetings, medical staff, etc. for help with program development
DPP Curriculum DPP Curriculum 1. Teach 16 session curriculum over 16 – 24 weeks 2. Goal – 48 newly enrolled participants each year 3. Recommend 12 participants per group, 4 groups per year, 1-2 hours in length 4. Group education sessions (interactive) taught by a variety of disciplines in the Activities Center at Chapa-De in Auburn 5. Uses Specific DPP Curriculum/Lifestyle Core Classes as content
DPP Curriculum Other Services offered by DPP to participants: Individual Coaching Sessions-lifestyle, encouragement After Core Program-f/u quarterly after course completion Motivational Activities-calendar of events, opportunities for local activities, walking Tracking/Monitoring/Follow-up of Participants with Pre-diabetes for appointments, maintenance
Retention Retention Goal = 100% of your participants Retention Plan 1. Make it fun! Ideas: variety of presenters, cooking classes, cultural activities, make it accessible, flexible hours (most likely evenings once a week) 3. Incorporate social media (FB, Digital storytelling) 2. Continuous evaluation of barriers to participation-asking for feedback and improving the program continually Tracking of Participation 1. Intensive: involves data collection/tracking participants using registries, electronic health record & excel spreadsheets 2. Recovery Efforts – when participant misses appointments or classes-we make it up. 1:1
~INSPIRATION~ The underlying message of DPP is that sustained Behavior change is the solution to many health problems (like diabetes) AND people CAN DO IT They just have to BELIEVE they CAN!! And they need encouragement and support on their path to CHANGE. • Video: Dick Hoyt