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Summary

In an effort to decrease the number of adults who are diagnosed with Type 2 Diabetes, the agent was trained as a Lifestyle Coach through the Centers for Disease and Prevention and Emory University, marketed, recruited participants and delivered the National Diabetes Prevention Program. These adults had received a medical diagnosis of pre-diabetes, or were considered high risk due to age, weight, race and/or ethnic background and family history. The goal of the year long program is to reverse the diagnosis of Type 2 diabetes through a series of behavioral changes, specifically moderate weight loss and increased physical activity.

Situation

In Athens-Clarke County, approximately 26% of the adult population is obese with an additional 27% considered overweight. Obesity and overweight contribute to the development of chronic diseases, such as cardiovascular disease, the number one cause of death in Athens-Clarke County. According to the Centers for Disease Control and Prevention, 339 people die each year in Athens-Clarke County from cardiovascular disease. Obesity and overweight also contribute to hypertension, diabetes and cancer. In Athens-Clarke County, visits to the emergency room due to diabetes have risen by 62% while visits to the ER due to high blood pressure have increased by 116% (St. Mary’s Health Care System 2016 Community Health Needs Assessment). Complications from diabetes and high blood pressure are among the top six leading causes of death in Athens-Clarke County.

Response

The Diabetes Prevention Program (DPP) External was a major multicenter clinical research study. The intervention involved a lifestyle change program focusing on calorie reduction and increasing physical activity to at least 150 minutes per week. Results from the study showed that this structured lifestyle change program, in which participants achieved weight loss of 5 to 7 percent of their body weight (10 to 14 pounds for a person weighing 200 pounds), reduced the risk of developing type 2 diabetes by 58 percent in adults at high risk for the disease. A 10-year follow-up study, The Diabetes Prevention Program Outcomes Study External, showed that participants were still one-third less likely to develop type 2 diabetes a decade later than individuals who took a placebo. Those who did develop type 2 diabetes delayed the onset of the disease by about 4 years. (https://www.cdc.gov/diabetes/prevention/research-behind-ndpp.htm) The agent received a three-day, 20-hour training to satisfy the requirements to become a Certified Lifestyle Coach in order to offer the National Diabetes Prevention Program (DPP), through the Centers for Disease Control and Prevention. The agent was selected to lead the initial pilot group of participants for the University System of Georgia pilot for the program. The long-range plan is for the University System Wellbeing program to offer the DPP opportunity on each of the 26 system schools main and satellite campuses. Two cohorts, one from employees from the Athens-Clarke County employees and one from University of Georgia faculty and staff, began the year long DPP program in August and September 2019. The first half of the program is 16 one hour weekly sessions, utilizing curriculum provided by the CDC. After the first 16 weekly sessions, groups met twice a month for three months and then once a month for the remaining five months. The DPP is concerned with three metrics: having attendees meet the attendance requirement of 60% of sessions, achieving a 5-7% weight loss and reporting moderate physical activity minutes each week. The first two groups concluded in August and September 2020. Having led two complete cohorts, the agent was then selected to join the team of state-wide agents delivering the DPP sessions to a third cohort of Athens-Clarke County employees, utilizing a physical ability research component. This cohort began in January 2020. As a result of Covid-19, this cohort switched from face to face delivery to an all virtual delivery beginning in April 2020. The agent was also selected to pilot the DPP program for the University System of Georgia utilizing an all virtual format, creating a pilot within a pilot program. Two cohorts were added to University of Georgia faculty and staff and University of North Georgia faculty and staff. Faculty and staff from UGA and UNG were recruited through a variety of methods included utilizing both the UGA and the UNG Wellbeing Program Coordinators. One additional cohort offered to Athens-Clarke County employees, with the assistance of the Athens-Clarke County Wellness Coordinator. Zaxby’s employees were also offered the change to join the group. The agent leveraged previous opportunities working with the Zaxby’s Wellness Coordinator assisted with recruitment by attending an interest session and subsequently sharing the opportunity to employees. After initial delays due to Covid-19, these two cohorts are being delivered in an all virtual format, beginning August 2020. The agent also offered nutrition and health education classes through the Athens-Clarke County Employee Wellness Program, and the University of Georgia faculty and staff, Zaxby’s Corporate Headquarters and Athens Community Council on Aging and the Barrow County Hospital Diabetes Support Group

Impact

The focus of programming was delivery of the yearlong Diabetes Prevention Program. Over the course of the year, five cohorts have been delivered with various start and end dates. As a Certified Health Education Specialist and due to the agent’s consistent delivery of the Walk A Weigh series, the agent was chosen to attend training through The Diabetes Training and Technical Assistance Center (DTTAC) at Emory University. Now a trained Lifestyle Coach, the agent is fully capable to deliver the national curriculum for the Diabetes Prevention Program to local small groups and has also been chosen to lead the pilot program for the DPP utilizing the original face to face format and an all virtual format, through the University System of Georgia. Results for the first two cohorts, completed in August and September 2020 had the following results: August 2019 Community Cohort – 10 enrolled: Forty percent (40%) of participants reached their five percent (5%) weight loss goal and among all participants, averaged 119 physical activity minutes per week. Seventy percent (70%) met the attendance goal. September 2019 UGA Faculty and Staff, USG Pilot group #1 – seven (7) enrolled: Sixty-seven percent (67%) of participants reached their five percent (5%) weight loss goal and among all participants, averaged 137 physical activity minutes per week. Seventy-one percent (71%) met the attendance goal. Cohorts still in process are as follows: January 2020 – At-Large group, initially offered as face to face, then moved to all virtual in March 2020 – 9 enrolled August 2020 – UGA and UNG faculty and staff – USG pilot #2, as total virtual delivery – 33 enrolled August 2020 – Community group, including ACC employees, Zaxby’s employees, virtual delivery – 20 enrolled Total enrolled participants: 79 Cost-benefit: The health benefits of the Diabetes Prevention Program extend beyond the duration of the program. Using the American Medical Association DPP Cost Savings Calculator1, we estimate that the potential three-year net savings for this program for the 79 people enrolled so far is $14,891 given our program costs and prevalence of prediabetes in our initial group. This is about $7,358 for Clarke County community-based programs and $7,533 for USG Faculty Staff programs. The value is likely greater since all program costs have been supported by external grant funding thus far. Thus, UGA Extension is helping people live healthier and saving Georgia money even in the face of COVID-19. 1. American Medical Association. AMA DPP Cost Saving Calculator. https://ama-roi-calculator.appspot.com/. Accessed on October 12, 2020.

State Issue

Health & Nutrition

Details

  • Year: 2020
  • Geographic Scope: State
  • County: Clarke
  • Location: College Station, Athens
  • Program Areas:
    • Family and Consumer Sciences

Author

  • Dallas, Jacqueline H
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