About one in three adults has prediabetes, yet 90 percent are unaware that they have the condition and are at risk for type 2 diabetes. Participation in evidence-based lifestyle change programs can help patients with prediabetes make healthy behavior changes and lose weight to reduce their risk of type 2 diabetes.
To improve access to lifestyle-change programs, the Pennsylvania Association of Community Health Centers (PACHC) offered an online learning series for its health centers that gave insight on implementing these National Diabetes Prevention Program (DPP) lifestyle-change programs for patients.
The AMA’s Diabetes Prevention Guide supports health care organizations and clinical care teams in defining and implementing diabetes prevention strategies. This comprehensive and customized approach helps clinical practices and health care organizations identify and manage patients with prediabetes, including referring eligible patients to a National DPP lifestyle-change program.
PACHC hosted the first webinar of the series—focusing on how organizations can prepare to implement a lifestyle change program—a month after its health centers completed the National DPP training. Nearly all the health centers had representation at the webinar.
Health centers then received guidance on implementation through an online learning series developed by the AMA. Outside of scheduled modules, additional support was also provided by the AMA through email check-ins and one-on-one phone calls.
“We partnered with the AMA on a learning series where there were five modules and those modules were really to provide the health centers with one-on-one technical assistance around a variety of things,” said Serina Gaston, former director of strategic initiatives and corporate compliance at PACHC. “The main goal of the learning series was to assist health centers with implementation of the DPP—how to get it started, how to recruit and how to retain.”
The National DPP demonstrates that people who are at high risk for type 2 diabetes can prevent or delay the disease by losing a modest amount of weight through lifestyle changes—dietary changes and increased physical activity.
These are the five modules used by PACHC to help health care teams implement a lifestyle-change program to prevent type 2 diabetes.
Clinic processes. The first module provided health centers with information on how to assess methods to identify, document and refer eligible patients with prediabetes to a lifestyle-change program. It also focused on determining patient communication methods and establishing workflows within the organization.
Standing up the National DPP lifestyle-change program. Health centers attended this module to learn about the key tasks to effectively implement the National DPP lifestyle-change program. After completion, health centers could:
- Identify a process to establish a feedback loop for physicians to monitor patient progress.
- Describe methods for broad patient outreach and recruitment.
- Utilize patient recruitment strategies, resources and support from the Centers for Disease Control and Prevention (CDC).
- Complete administrative and logistical tasks to implement a National DPP lifestyle-change program.
Physician and care team awareness and education. Clinical champions play an important role in a diabetes prevention strategy. This module shared AMA resources to support physician and care team awareness and engagement in diabetes prevention.
“They focused on physician awareness and education because the physician has to be on board and willing to support the referrals to the program,” said Gaston.
Program recognition. After understanding the clinic’s processes, how to start the program and how to get physicians involved, health centers learned about the CDC requirements and recognition processes for National DPP lifestyle-change programs. In this module, the CDC presented on operating procedures and standards for data collection and reporting for programs.
Post-implementation. The last module involved the entire group. Together, teams discussed and shared their experience, as well as lessons learned from program implementation. Following the learning series, the AMA offered one-on-one support and continues to support all organizations’ efforts to expand and/or sustain their programs.
“One of the health centers that completed the training adopted a hybrid approach and took what they learned from the lifestyle coach training and worked with their dietitian and their health-and-wellness coordinator to develop their own diabetes prevention program,” said Gaston.
To date, one health center has received CDC recognition and two others have launched their programs, with three more set to start this year.
Essential Tools & Resources
Managing Type 2 Diabetes: A Team-Based Approach
AMA Doc Talk podcast series
Visit AMA’s Diabetes Prevention Guide