August 11, 2015
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Increased capacity equals increased performance in diabetes education programs

NEW ORLEANS — Diabetes prevention is possible, proven and powerful — but it will not be possible on the local level without sufficient organizational capacity, according to a speaker here.

Effectively recruiting and retaining patients in the community is the key to success, said Betsy Rodriguez, MSN, CDE, deputy director of the CDC’s National Diabetes Education Program, and that is where community-based organizations come in.

“So many times [certified diabetes educators] put in all the effort — food, incentives, everything — going beyond the call ... and you have two people show up,” Rodriguez said during a presentation on promoting diabetes prevention capacity among Hispanic and Latino organizations. “So what is it that we need to do as diabetes educators?”

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Betsy Rodriguez

Rodriguez discussed a recent CDC pilot project that used the “Road to Health Toolkit,” implemented in several Hispanic/Latino community-based organizations in Texas, Florida and Washington, D.C. in an effort to increase capacity and improve outcomes. Participants were Hispanic adults aged 18 years or older at risk for type 2 diabetes (determined through the CDC prediabetes screening test), who were willing to participate in two consecutive rounds of 6-week interventions for lifestyle change and two follow-up sessions. Participants attended a minimum of 4, 60 to 90-minute group sessions with eight to 15 members each. Community health workers recorded participants’ weights and physical activity and the participants tracked their own eating habits and physical activity. Program goals included losing between 5% and 7% of body weight and increasing physical activity to reach 150 minutes per week, while learning healthy eating and exercise strategies.

CDC officials conducted in-depth interviews at baseline, between the two 6-week sessions and at the conclusion of the program with program managers and supervisors to assess any changes in participant recruitment and retention and to monitor adherence to the guidelines of the project.

Rodriguez said the pilot project revealed several lessons. Targeted outreach strategies that leverage existing relationships with partners are more effective, she said, and also save time and money. Those conducting the outreach must also be credible with the audience, Rodriguez said.

“They tend to follow the people they can trust,” Rodriguez said.

In addition, supervisors should conduct diabetes education sessions in places familiar to the participants, allow for make-up sessions and explain the time commitment clearly.

“They’re committing to 6 weeks ... what am I getting out of this?” Rodriguez said. “Many of them were asking that question.”

Most important, when everyone involved in the program, regardless of their role, feels they are a part of the program, they own it, Rodriguez said, and that impacts results.

“Community health workers are providers, too,” Rodriguez said. “We just need to remind ourselves, they are part of the team.” by Regina Schaffer

Reference:

Rodriguez, Betsy. T08. Presented at: The American Association of Diabetes Educators Annual Meeting 2015; August 5-8; New Orleans.

Disclosure: Rodriguez reports no relevant financial disclosures.