Abstract
Scaling the National Diabetes Prevention Program in a large metropolitan area: 0pportunities, challenges, and recommendations
Jennifer Mosst, PhD, MScPH, MSSW1, Noel Barragan, MPH, MBA2, Liz Schwarte, MPH3, Lisa Craypo, MPH RD4 and Tony Kuo, MD, MSHS5
(1)Los Angeles County Department of Public Health, Los Angeles, CA, (2)Los Angeles, CA, (3)Ad Lucem Consulting, San Francisco, CA, (4)Ad Lucem Consulting, Kensington, CA, (5)University of California, Los Angeles, Los Angeles, CA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Introduction: An evidence base exists describing the effectiveness of the National Diabetes Prevention Program (NDPP), however little evidence is available to guide NDPP scaling and implementation. The Los Angeles County Department of Public Health (DPH) partnered with Ad Lucem Consulting to understand the opportunities and challenges for scaling NDPP and to develop actionable steps for increasing the reach and accessibility of the NDPP.
Methods:Four components informed the development of an NDPP action plan for Los Angeles: (1) literature review (2) 33 key informant interviews with diabetes prevention experts (3) facilitated discussions with a multi-sector coalition and (4) coalition network analysis.
Results: Several recommendations emerged for increasing the reach and effectiveness of the NDPP: (1) expand the network of CDC-recognized NDPP providers (2) increase feedback loops between health care and NDPP providers and promote use of electronic medical records (3) educate clinical providers on prediabetes screening and the NDPP (4) increase knowledge and awareness of prediabetes among at-risk populations (5) ensure NDPP cultural relevance (6) create financial and quality measures/incentives for addressing prediabetes, and (7) conduct NDPP implementation evaluation.
Administer health education strategies, interventions and programs Chronic disease management and prevention Planning of health education strategies, interventions, and programs Public health or related research
Abstract
Emerging efforts to scale the National Diabetes Prevention Program in Los Angeles County, 2014-present
Laura Baetscher, MPH, MA, Jennifer Torres, PhD, MSW, MPH and Tony Kuo, MD, MSHS
Los Angeles County Department of Public Health, Los Angeles, CA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Project Background:
This presentation describes planned activities and tools that were used to increase linkages between Los Angeles County (LAC) residents with prediabetes and the National Diabetes Prevention Program (DPP) during 2014-15. In LAC, the prevalence of diabetes (~10%) and prediabetes (~19%) were not trivial during this period.
Methods:
In collaboration with the local diabetes prevention coalition, the Los Angeles County Department of Public Health facilitated three key activities to increase prediabetes screenings and referrals to the DPP. First, the group developed a local DPP provider database, which allows healthcare providers access to program information about the various DPPs (e.g., time, location, cost, eligibility requirements, language, and contact information); a web-based community resource portal is currently under construction. Second, the group convened a community health fair, offering different types of chronic disease screenings and tools such as diabetes-risk-assessments, healthy living kits, and DPP referrals. Third, the group initiated the development of an evidence-based curriculum to train primary care providers on prediabetes identification and management.
Results:
The database portal and health fair(s) helped promote public awareness and expanded the reach of prediabetes screenings and increased the identification of this precondition in LAC. Referrals to CDC-recognized DPPs in the community, for example, totaled 233 in 2015.
Conclusion:
Program findings showed an increase in referrals to DPP in LAC. Efforts such as the community resource portal, health fair, and provider training appear to be important drivers of local DPP activities; albeit, program sustainability will still require obtaining health plan coverage in the long-term.
Administer health education strategies, interventions and programs Chronic disease management and prevention Implementation of health education strategies, interventions and programs Public health or related research
Abstract
Cross-Site Evaluation of the Together on Diabetes initiative's Efforts to Improve Diabetes Self-Management
Jerry A. Schultz, PhD1, Stephen Fawcett, PhD1, Charles Sepers Jr., B.S.1, Ithar Hassaballa, MPH, PhD2 and Vincent Francisco, Ph.D1
(1)University of Kansas, Lawrence, KS, (2)University of Kansas, Lawrence, KS, KS
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background: The Together on Diabetes (TOD) has engaged nearly 30 innovative approaches to improving diabetes self-management (DSME) in high risk communities. The projects implemented a variety of approaches to enhancing outreach and referral, quality of care, DSME and support, and community/system changes. A participatory evaluation approach was used. This cross-site evaluation of the development and delivery of community and clinical approaches to improving diabetes self-management sought to identify best practices and their impact on high-risk individuals.
Methods: The aims of the evaluation were to: a) understand what is being accomplished within and across projects, b) improve performance, and c) assess the impacts of the initiative. This required engaging grantees in development of a logic model and key evaluation questions, systematically documenting the program and the impact of the intervention, and utilizing data for program improvement and decision making. Key informant interviews, document review, ongoing monitoring of new programs, policies and practices and services provided by the project, clinical and behavioral indicators across nearly 30 projects were collected and reviewed. Case studies of each project were collaboratively developed with each grantee. Using an inductive analytic approach, facilitating and inhibiting factors, organizational and contextual, affecting implementation were identified
Results: Over 40,000 participants received services, most of whom were disproportionately affected by diabetes. Components and elements of innovative approaches to delivering DSME will be provided. Key findings related to the influence of factors and contexts will be presented. Preliminary results show that many of these innovative approaches reduced levels of A1c and proportion of clients at high-risk.
Chronic disease management and prevention Conduct evaluation related to programs, research, and other areas of practice
Abstract
Together on Diabetes Initiative: A Foundation's Ambitions and Lessons learned
Patricia Doykos, PhD1 and Vincent Francisco, Ph.D2
(1)Bristol-Myers Squibb Foundation, New York, NY, (2)University of Kansas, Lawrence, KS
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
The Together on Diabetes initiative, supported by the Bristol-Myers Squibb Foundation, was developed to address the type 2 diabetes epidemic. Its goal was to improve the health outcomes of people living with type 2 diabetes in the United States by strengthening patient self-management education, community-based supportive services, quality of care and broad-based community mobilization. The Foundation launched Together on Diabetes in November 2010, applying lessons learned from decades of experience implementing national and international initiatives such as the HIV-focused Secure the Future initiative. The Together on Diabetes initiative supported projects that focused on:
• Helping adults living with type 2 diabetes improve self-management and navigate care with sustained and relevant support for the course of their disease.
• Helping communities to build, integrate, and coordinate medical, community, and policy efforts; and expand the base of community organizations actively involved in applying their experience, reach, influence, and assets to bare against type 2 diabetes.
• Rethinking and testing new ideas about how diabetes control efforts are approached, designed, implemented, and measured given the current and future scale of the epidemic and the long duration of the disease trajectory.
This paper will present: 1) The aims and ambitions of the initiative; 2) How the Foundation designed and implemented the nearly 30-project effort that focused on multiple objectives, such as improving diabetes self-management and support, quality care improvement, access to services, and community interventions; 3) The challenges and adjustments to the project during the 5-year initiative; and 4) lessons learned about Foundation approaches to improving health outcomes.
Chronic disease management and prevention Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs