Session
Diabetes Prevention Efforts
APHA 2022 Annual Meeting and Expo
Abstract
Lessons learned from transitioning from in-person to distance learning for diabetes prevention and management programs
APHA 2022 Annual Meeting and Expo
Background:
The National Diabetes Prevention Program (National DPP) and Diabetes Self-Management Education and Support (DSMES) programs are essential for helping community members prevent or manage diabetes and have historically been delivered in-person throughout Los Angeles County. In March 2020, the onset of the COVID-19 pandemic created a need to quickly transition programs from an in-person delivery model to a distance learning model (i.e., via Internet or telephone).
Methods:
The Los Angeles County Department of Public Health (DPH) and Ad Lucem Consulting conducted an assessment to understand the impact of this transition on program providers and program outcomes. The assessment consisted of a document review of DPH’s quarterly landscape surveys, literature review on telehealth and distance learning practices, and key informant interviews (n=35) of program providers and diabetes prevention and management programs subject matter experts.
Results:
Assessment results highlighted that outreach and recruitment for both programs were most impacted by the pandemic and necessitated the rapid adoption of creative strategies to enroll participants and keep them actively engaged in the programs. Additionally, technology literacy was identified as a key barrier for program participants. The switch to distance learning also presented new opportunities. For example, distance learning increased National DPP and DSMES access for individuals who could not participate in-person previously due to geographic distance and other factors.
Conclusion:
Lessons learned from this assessment provide practical, sustainable actions local public health departments and program partners can take to successfully deliver and increase access to National DPP and DSMES programs.
Abstract
Optimizing Care for Pre-diabetic and Diabetic Patients at a Federally Qualified Health Center
APHA 2022 Annual Meeting and Expo
Background: Northeast Valley Health Corporation (NEVHC) is a Federally Qualified Health Center (FQHC) in Los Angeles County providing comprehensive healthcare services to medically underserved residents. NEVHC seeks to increase access to quality care and reduce disparities for patients at risk for or diagnosed with diabetes. To support this effort, the Los Angeles County Department of Public Health and NEVHC conducted a two-month pilot to increase the number of patients referred to the National Diabetes Prevention Program (National DPP) and the Diabetes Self-Management Education and Support program (DSMES) and increase bi-directional communication among the patient navigator and clinical staff.
Methods: The team applied the Counting Chronic Conditions risk stratification model to identify high-risk pre-diabetic/diabetic patients and encourage their enrollment into preventive and self-management education. Identified patients were contacted by a patient navigator to provide health education, referring them into the National DPP or DSMES. The patient navigator then documented referrals to programs in the electronic health record (EHR) to inform the clinical team of targeted outreach outcome.
Results: Referrals to the National DPP increased by 66.5% and to DSMES by 100% for the project sample (35 referrals). Bi-directional communication across care team members via EHR increased by 100%.
Conclusion: A risk stratification model carried out by a patient navigator can be an effective way to help identify high-risk patients to connect them to diabetes prevention or management services. This model of practice can support other health systems seeking to increase enrollment into National DPP/DSMES programs among medically underserved patients.
Abstract
Building a Workforce of Diabetes Specialist to Support Technical Supportive Services to Expand Diabetes Programming
APHA 2022 Annual Meeting and Expo
The National Diabetes Prevention Program (National DPP) lifestyle change program (LCP) and diabetes self-management education and support services (DSMES) are effective in preventing type 2 diabetes and managing diabetes, respectively. Evidence suggests that improving access to and participation in these programs can help decrease type 2 diabetes risk and improve diabetes-related outcomes, including among communities disproportionately impacted by diabetes.
State health departments have been tasked with increasing participation in these programs by providing technical assistance to program providers. To facilitate and support technical assistance efforts, the National Association of Chronic Disease Directors, in partnership with the Centers for Disease Control and Prevention and other leaders in diabetes programming, developed and launched workforce training and development programs for state diabetes staff. These programs combine extensive training and peer networking, resulting in a diabetes workforce with the skills needed to provide technical assistance and support to program providers working to expand access to and participation in the National DPP LCP and DSMES.
Since the launch of these programs in 2021, 24 states have at least one trained diabetes specialist. Evaluation findings suggest: 1) an increase in competencies necessary to improve access to/participation in DSMES and the National DPP LCP among priority groups, and 2) an increase in access to resources and support needed to provide quality technical assistance.
This novel approach to workforce development presents an opportunity to build sustainable diabetes programming for individuals disproportionately impacted by diabetes.
Abstract
Addressing Health Equity through a collaboration between worksite wellness and a Health Department in a rural community during COVID-19 pandemic.
APHA 2022 Annual Meeting and Expo
Background
The COVID-19 pandemic led to a surge in teleworking, often resulting in longer hours, isolation, burnout, and diminished collaboration. Interagency collaboration between health departments and organizations can be leveraged to bring health promotion programs to employees. We describe the implementation of a Lifestyle Change Diabetes Prevention Program (DPP) during the COVID-19 pandemic. The goal of DPP is to achieve and maintain 5% weight loss and increase physical activity over 12 months. Our objective was to make DPP virtually accessible during work hours to employees who changed from in-person to telework.
Methods
DPP was implemented by the Yuma County Public Health Services District (YCPHSD) and Chicanos Por La Causa (CPLC), a non-profit organization that advocates for underserved communities. Participants included professional/technical employees (e.g., bus drivers) who reported a body mass index >25. YCPHSD staff offered DPP three times a week online in Spanish and English to accommodate employees’ schedules. All participants self-reported weight and physical activity.
Results
We observed an average decrease of 8.7 pounds and an average of 200 minutes/week of physical activity per participant (n=48). Participants stated that DPP provided healthy lifestyle tools, emotional resources, and social interaction during isolation. Offering DPP during work hours was key to participation.
Conclusion
Findings from this collaboration demonstrate that delivering health promotion programs online at work is feasible and beneficial. Health promotion programs conducted during work hours can address health equity by enhancing the accessibility of healthy lifestyle resources. Collaboration across public health organizations can support health promotion program sustainability.