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Summary

UGA Extension FACS Agents helped 98 Georgians lose almost 500 pounds and improve their health during the COVID-19 pandemic through the Diabetes Prevention Program.

Situation

One in three American adults (88 million) has prediabetes and more than 8 in 10 adults with prediabetes don’t know they have it(1). Prediabetes increases the risk for heart disease and stroke and developing type 2 diabetes (T2DM), a costly and life-altering disease and one that puts people at greater risk for severe disease from COVID-19. It is estimated that together, prediabetes and diabetes cost Georgia 9.9 billion annually (2), and those costs are likely higher in the wake of COVID-19. The evidence-based, CDC-recognized National Diabetes Prevention Program (DPP) has been shown to decrease the risk of developing T2DM among those with prediabetes by more than 50% through weight loss, improved nutrition, and increasing physical activity (3). 1. Centers for Disease Control and Prevention. About Prediabetes & Type 2 Diabetes. https://www.cdc.gov/diabetes/prevention/about-prediabetes.html. Accessed on Jul 27, 2020. 2. American Diabetes Association. The Burden of Diabetes in Georgia. http://main.diabetes.org/dorg/PDFs/Advocacy/burden-of-diabetes/georgia.pdf. Accessed on Jul 27, 2020. 3. Centers for Disease Control and Prevention. Research Behind the National DPP. https://www.cdc.gov/diabetes/prevention/research-behind-ndpp.htm. Accessed on Jul 27, 2020. 4. Nichols GA, Bell K, Kimes TM, O’Keeffe-Rosetti M. Medical Care Costs Associated With Long-term Weight Maintenance Versus Weight Gain Among Patients With Type 2 Diabetes (2016). Diabetes Care 2016 Nov; 39(11): 1981-1986.https://doi.org/10.2337/dc16-0933 5. American Medical Association. AMA DPP Cost Saving Calculator. https://ama-roi-calculator.appspot.com/. Accessed on Jul 27, 2020.

Response

: In the fall of 2019, UGA Extension began delivering the 12 month lifestyle change program in two counties and then expanded to 13 counties in Winter/Spring 2020. The program was planned for in-person classes, once per week for 16 weeks and then bimonthly or monthly for the remainder of the year-long program. In March 2020, COVID-19 put the country on hold, and challenged us to help our 102 participants maintain and even improve their health to resist against diabetes and COVID-19. On March 16, 2020, all programs pivoted to offering sessions in a virtual or conference call only format. FACS Extension agents held weekly sessions via Zoom and conference call with the 102 participants to discuss healthy eating, physical activity, problem solving, and stress management. FACS Agents delivered 158 virtual or conference call sessions to 98 participants for more than 15,000 educational contact hours. At each session, participants reported weight and physical activity and discussed problem solving, healthy eating, and active living during a pandemic.

Impact

Since the start of COVID-19, we have retained 96% of our participants. Our first cohort that began in August 2019 graduated 7 participants virtually in July 2020. We have 91 additional participants that remain active in the program. Participants lost a total of 429 pounds by the time COVID-19 suspended in-person programming in March 2020. Since programming transitioned to online and phone only, participants have persevered and lost an additional 496 pounds and logged 2,899 hours of physical activity. Forty-four participants (45%) have met or exceeded the 5% weight loss goal, and for many, they are only half way through the year-long program. Participants have been very pleased with the program and found it worthwhile for helping them set and achieve their health goals. One farmer noted, “I just came out of the hay filed. I probably still need to be out there, but I think enough of the program to come.” Since transitioning to virtual, many participants have found the program to be a bright spot in their week. One said, “[The Diabetes Prevention Program] has been an uplift for me. I live for Thursday mornings at 8 o’clock.” The health benefits of the Diabetes Prevention Program extend beyond the duration of the program. At least one study estimates for a person with type 2 diabetes, losing 5% of their body weight and keeping it off saves $400 per year in medical costs(4). Thus, the potential value of the first 44 participants meeting their weight loss goals is approximately $17,600. Moreover, using the American Medical Association DPP Cost Savings Calculator(5), we estimate that the potential return on investment for this program over three years is $28,666 given our program costs and prevalence of prediabetes in our initial group. Thus, UGA Extension is helping people live healthier and saving Georgia money even in the face of COVID-19. 1. Centers for Disease Control and Prevention. About Prediabetes & Type 2 Diabetes. https://www.cdc.gov/diabetes/prevention/about-prediabetes.html. Accessed on Jul 27, 2020. 2. American Diabetes Association. The Burden of Diabetes in Georgia. http://main.diabetes.org/dorg/PDFs/Advocacy/burden-of-diabetes/georgia.pdf. Accessed on Jul 27, 2020. 3. Centers for Disease Control and Prevention. Research Behind the National DPP. https://www.cdc.gov/diabetes/prevention/research-behind-ndpp.htm. Accessed on Jul 27, 2020. 4. Nichols GA, Bell K, Kimes TM, O’Keeffe-Rosetti M. Medical Care Costs Associated With Long-term Weight Maintenance Versus Weight Gain Among Patients With Type 2 Diabetes (2016). Diabetes Care 2016 Nov; 39(11): 1981-1986.https://doi.org/10.2337/dc16-0933 5. American Medical Association. AMA DPP Cost Saving Calculator. https://ama-roi-calculator.appspot.com/. Accessed on Jul 27, 2020.

State Issue

Health & Nutrition

Details

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

Author

  • Berg, Alison C.

Collaborator(s)

CAES Collaborator(s)

  • Averill, Bradley
  • Campbell, Christa Anderson
  • Cook, Georgeanne L.
  • Dallas, Jacqueline H
  • Koonce, Joan
  • Moore, Jessica Elizabeth
  • Moore, Susan L
  • Roberts, Alexis
  • Soltanmammedova, Zohregul
  • Stackhouse, Rebecca
  • Sweda, Cynthia
  • Thomas, Rebecca B.
  • Tucker, Candace
  • Worley, Barbara

Non-CAES Collaborator(s)

  • Ellen Evans, Professor, Associate Dean for Research and Graduate Education, UGA College of Education, Department of Kinesiology
  • Ewan Williams, Graduate Student, UGA College of Education, Department of Kinesiology
  • Hannah Wilson, Graduate Student, Project Coordinator, College of Family and Consumer Sciences, Department of Foods and Nutrition
  • Isaura M. Castillo-Hernández, Graduate Student, UGA College of Education, Department of Kinesiology
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