July 2016 Partner Spotlight: Dr. Doron Schneider
Practice Transformation Resource Provides Health Care Teams with Tools to Improve Diabetes Care
For Dr. Doron Schneider, Internist and Chief Patient Safety and Quality Officer at Abington Health in Abington, PA, quality diabetes care is all about the journey. In his role as Chair of the National Diabetes Education Program’s (NDEP) Practice Transformation Task Group, Dr. Schneider worked to make Practice Transformation for Physicians and Health Care Teams a resource that can support the needs of health care practices of all sizes, and at various stages in their journey to redesign how diabetes care is coordinated and delivered. According to Dr. Schneider, “This journey requires a ‘transformation’ in practice.”
About Doron Schneider, MD, FACP:
- Chair of NDEP’s Practice Transformation Task Group
- Assistant Professor at Drexel University
- Deputy Program Director, Internal Medicine Residency at Abington Memorial Hospital
- Has served on the ACP Diabetes Initiative Advisory board and is Lead National Faculty for the ACP Quality Connect Programs
- Deputy Editor, Clinical Diabetes
To enhance the quality of care, Dr. Schneider believes diabetes care should transform from acute, physician-based care to patient-centered, team-based care that best promotes quality outcomes. “In a nutshell,” says Dr. Schneider, “practice transformation means moving to a team-based care model with the focus on everyone being aligned and thinking about the patient on their journey through life and how we can serve as a home for them in their lives."
One of the greatest strengths of the Practice Transformation site is its value and accessibility to all members of the health care team. Recognizing that every practice is unique, Dr. Schneider explains that many types of professionals in the health care setting can use Practice Transformation, from those just starting their journey in transformation, to those that are farther along and are searching for specific answers to their barriers. The site provides not only a theoretical view of change – but real solid tactics and approaches that
Dr. Schneider offers this advice to practices working to redesign how diabetes care is coordinated and delivered: “Employ a team-based approach and share a clear vision. All of the staff who are on that journey, not just the leader, can use the Practice Transformation site and accelerate their understanding of where they should be heading and their role in moving things forward.” He adds that “the goal of this site is really to optimize practices to provide the best possible diabetes care.” Dr. Schneider believes that practice transformation should result in four outcomes: 1) improved quality of care, 2) improved value of care, 3) improved patient experience, and 4) improved health care team experience.
“At this moment, we may not able to conquer diabetes,” he says, “but we can create a good battle plan if we follow some of the tenets that we have outlined in this resource.”
March 2016 Partner Spotlight
Doctor of Pharmacy’s Mission to Inspire Behavior Change
Dr. Danielle M. Gilliam is committed to keeping her community healthy. A doctor of pharmacy by training, Dr. Gilliam is also a certified diabetes educator. She incorporates her diabetes knowledge in her role as a health ministry leader at her church, Canaan Missionary Baptist Church in Mesa, Arizona.
About Danielle M. Gilliam, PharmD, CDE:
- Member of NDEP's Diabetes HealthSeanse Task Group
- Has 17+ years of experience in the field of diabetes, including clinical, research, and industry experience
- Obesity Medical Liaison with Novo Nordisk
- President of the Community Leadership Board, Board Chair of the Diversity Committee, and member of the National Adult Strategies Committee for the American Diabetes Association
- Health Committee Chair, East Vally Arizona NAACP
Because many members of Canaan Missionary Baptist Church—including the pastor—have type 2 diabetes, Dr. Gilliam lead “Diabetes Saturdays,” diabetes-specific education classes on the first Saturday of each month. Dr. Gilliam worked with fellow church members to help them learn how to eat healthy, be more active, cope with stress and emotions, and set goals to improve their health. Dr. Gilliam seeks to inspire positive health behavior change among her church community because she knows that managing and preventing type 2 diabetes is possible.
In her “Diabetes Saturdays” classes, Dr. Gilliam featured resources from the National Diabetes Education Program (NDEP), such as Small Steps. Big Rewards. Your GAME PLAN to Prevent Type 2 Diabetes: Information for Patients for people who are at high risk for type 2 diabetes and Diabetes HealthSense, a resource to provide information and support to help people understand how to make changes in their lifestyle to improve their health.
“The most effective way to manage or prevent type 2 diabetes is by tackling behavior change,” says Gilliam. “Many people know what they need to do to improve their health; but some people don’t understand how hard it is. It’s common for people to feel overwhelmed, when they are figuring out how to make these changes.”
By incorporating diabetes health classes in her classes, Dr. Gilliam hopes to instill the knowledge and support for healthy behavior changes within her church community.
For more patient education resources, visit the NDEP website
February 2016 Partner Spotlight
Florida Health Department Includes the Whole Community in Diabetes Education
The Florida Department of Health In Martin County (FL-DOH Martin) took NDEP’s 2015 National Diabetes Month theme “Diabetes Education and Support: Everyone Has a Role. What’s Yours?” to heart in November.
According to FL-DOH public information officer Renay Rouse, “Our health department believes that all of our staff has a role to play in getting the word out about diabetes education and support. Our mission is to promote, protect, and improve health in our community.”
FL-DOH Martin school health nurses, nurse program specialists and nutritionists help train and support students and families who are affected by diabetes. National Diabetes Month provided an additional opportunity to highlight the importance of education and outreach. NDEP’s Helping the Student with Diabetes Succeed: A Guide for School Personnel resource is one of those materials used to educate nurses and school personnel in Martin County. The health department also trains nurses and health assistants to conduct health screenings and body mass index (BMI) checks.
To help get important diabetes information into the community, Marybeth Peña, a certified diabetes educator and nurse program specialist for the Florida Department of Health, met residents in community centers, churches, and public libraries to provide information to help foster healthy relationships with food to help people maintain healthy lifestyles to manage and prevent diabetes-related health problems.
“We know it can be a challenge to change eating habits. We want our residents to know that we are there with them, and will help them fight this battle against diabetes,” says Peña. “We know it’s a huge life change that can seem impossible at times.”
Other activities to support National Diabetes Month, included posting the NDEP’s Diabetes Risk Test to the FL-DOH Martin website and issuing a news release announcing the NDEP’s National Diabetes Month campaign to its community partners and local media. The Stuart Fire and Rescue Squad saw the announcement and volunteered to distribute NDEP’s Small Steps. Big Rewards. Your GAME PLAN to Prevent Type 2 Diabetes: Information for Patients booklet to residents they assisted in the community.
January 2016 Partner Spotlight
Turning Theory into Practice: Public Health Researcher Dedicates Work to Empowering Patients to Take Their Medicine
“Why can’t I get my patients to do what I want them to do?” As a public health researcher, Dr. John G. Ryan has continuously heard health care providers’ common cry for help on how to get their patients to follow their treatment plans. This one statement from a physician set Dr. Ryan on the path of his entire career of studying and introducing medication adherence interventions for patients with diabetes.
While cost plays a significant role in preventing patients from taking their medications as prescribed, other key barriers to medication adherence include patients’ health beliefs, health literacy, and the complexity of their prescribed regimen. Because medication adherence is multi-factorial, Dr. Ryan believes there’s no magic bullet to address it. However, he says, “An important part of the answer is counseling and educating patients. Training physicians, nurses, social workers, pharmacists, clinical psychologists, and the patient’s entire health care team to encourage, motivate, reprogram, and manage patients’ cultural expectations can help further achieve the goal of increasing medication-taking behaviors.”
About John G. Ryan, Dr.P.H.:
- Professor of Family Medicine, University of Miami Miller School of Medicine Department of Family Medicine and Community Health
- Topic Editor, Endocrinology, Diabetes, and Other Endocrine Disorders, Clinical Therapeutics
- Author of over 50 journal articles, books, and monographs on family medicine and community health
- Member of NDEP’s Medication Adherence Task Group
Dr. Ryan and his team comprised of talented, allied health care providers are committed to helping patients by teaching and motivating them to change their behaviors, including by increasing their medication-taking behaviors. In an effort to train and support health care professionals in promoting medication adherence among their patients and within their teams, Dr. Ryan joined NDEP’s Medication Adherence Task Group to create the program’s Promoting Medication in Adherence in Diabetes web resource which contains a series of tools that health care professionals in various roles can use to help their patients take their medications as prescribed.
To provide the best diabetes care, Dr. Ryan says it takes a team. “NDEP’s Promoting Medication in Adherence in Diabetes web resource offers health care teams a collection of resources addressing a wide variety of medication adherence topics. If every member of a patient’s health care team is reading from the same script, they will enhance a diabetes patient’s understanding about his treatment plan and the importance of his medications. As a result, the patient will adhere to his medication as prescribed.”
For more information about medication adherence, a recording of NDEP’s Empowering Patients to Take Their Medicine: What Can We Do? webinar, which Dr. John G. Ryan co-presented, is available on NDEP’s website.
October 2015 Partner Spotlight
Diabetes Educator Links NDEP’s Diabetes HealthSense to Improved Patient Outcomes
As National Diabetes Month Approaches, Diabetes Educator Debbie Zlomek lives the National Diabetes Education Program’s (NDEP) 2015 campaign message—Diabetes Education and Support: Everyone Has a Role. What’s Yours?—through her work at Pottstown (Pa.) Medical Specialists Inc. (PMSI) with help from the NDEP’s Diabetes HealthSense.
About Deb Zlomek, RN, MSN, CDE, BC-ADM:
- A 26-year resident of Sanatoga, Pa., Zlomek earned her nursing degree from Montgomery County Community College.
- Earned her master’s degree in nursing from the University of Arizona
- Earned the level of BC-ADM (board certification in advanced diabetes management) from the American Association of Diabetes Educators in August 2015
- Was named the 2015 winner of the YWCA Tri-County Area Exceptional Woman Award in Science, Technology and Math
Each year PMSI identifies an area to improve patient outcomes. In the last year, this quality improvement project centered on increasing physical activity in patients and assessing the effect of that activity on A1C levels and weight.
“Chronic diseases need both pharmacological and lifestyle interventions to improve outcomes,” Zlomek says, adding that the benefit of Diabetes HealthSense is that it presents different exercise programs for patients. “They enjoy having the ability to customize their own educational package and change it as their needs and goals change,” Zlomek says.
“The number of people with diabetes is outpacing the number of diabetes educators,” Zlomek says. “Health insurance companies must consider education as preventive services and make it a covered service. What better way to promote health than to provide education?”
At the same time, Zlomek says, diabetes educators need to evaluate how their role has evolved in the current health care environment.
“I think diabetes educators need to rethink how they deliver education,” she says. “You need to bring education to the patient—not the patient to education.
September 2015 Partner Spotlight
The Road to Health Toolkit Hits the Border City of El Paso, Texas
The workshop welcomed more than 40 participants. The National Diabetes Education Program’s (NDEP) Road to Health Toolkit found its way this past summer to a workshop in El Paso, Texas, where diabetes is prevalent in this border city.
In June, a group in El Paso began their instruction to become “Promotoras de Salud,” or certified community health workers who are members of a target population that share many social, cultural, and economic characteristics. According to HHS’ Rural Assistance Center, “promotoras” provide culturally appropriate services and serve as patient advocates, educators, mentors, outreach workers and translators.
Role Playing: A family conversation with a community health worker after a diabetes diagnosis. Familias Triunfadoras is a women-led, community-based organization that certifies community health workers in El Paso and works to empower women and families along the United States-Mexico border who are victims and survivors of domestic and dating violence. Because diabetes is prevalent in this area, A community health worker shown taking the road to health. Familias Triunfadoras has worked with the NDEP to increase the capacity of Promotores de Salud in diabetes prevention to address this serious public health issue.
“Diabetes is a growing problem here in the border” said workshop trainer Rosalba Ruiz- Holguin, who explained that 7.3 percent of El Paso residents reported having diabetes, compared with the state prevalence statistic of 6.5 percent. Meanwhile, Ruiz-Holguin added that El Paso Hispanics have the highest prevalence at 8.1 percent, while non-Hispanics have a prevalence rate of 5.5 percent, and diabetes risk for families is significantly higher among Hispanic families.
“The Road to Health Toolkit is a way to teach promotoras an interactive, motivating series of steps with specific messages in order for the individual to start identifying diabetes risk factors, types of diabetes, and prevention measures against this deadly disease,” Covernali said.
For more information about Familias Triunfadoras, please visit our website at www.familiartriunfadoras.org, email Mary Covernali at email@example.com, visit us at 125000 Socorro Road, San Elizario, TX 79849, call us at 1 (915) 851-1622, or like us on Facebook.
July 2015 Partner Spotlight
NDEP Partner Elizabeth Venditti, Ph.D. Relies on NDEP Resources to Support Lifestyle Change
For the University of Pittsburgh’s Elizabeth Venditti, Ph.D. the National Diabetes Education Program (NDEP) has become an integral component of her work to help people change their lifestyles and manage their diabetes.
A clinical health psychologist, Venditti found her way to a career largely focused on diabetes prevention through her early work and research in obesity back in the mid-1990s with Rena Wing, PhD.
“I was always very interested not only in the idea of managing a disease that could cause problems, but doing so in a way that helps people feel good,” Venditti said. “I think that’s what has kept me in the field: what I’m really interested in is helping people not feel futile about having an impact on their lives—both physical and mental.”
And that’s where the work of the NDEP enters in.
About Elizabeth Venditti:
- Assistant Professor, Department of Epidemiology, University of Pittsburgh (since 2010)
- Assistant Professor, Department of Psychiatry, University of Pittsburgh (since 2005)
- Faculty, Diabetes Prevention Support Center, University of Pittsburgh (since 2005)
- NDEP partner since 2002
“I was on the first committee to take the DPP and say, ‘How do we communicate this to a primary care physician?’” Venditti explained. She referred to the Diabetes Prevention Program—the landmark study sponsored by the National Institutes of Health—that found people at increased risk for type 2 diabetes can prevent or delay the onset of the disease by losing 5 percent to 7 percent of their body weight through increased physical activity and a reduced-fat and lower-calorie diet. It was this research that led to the Small Steps. Big Rewards. Prevent Type 2 Diabetes. campaign, which Venditti cited as a prime example of how the NDEP applies research in a way that can help people make changes in their lifestyles and health. That’s especially useful today, as providers and payers emphasize evidence-based care to improve quality, enhance outcomes and lower costs.
“What NDEP does so well is taking these evidence-based interventions—whether it be in diabetes education or in behavior change—and putting them in materials, toolkits and one-pagers, and making them widely accessible to patients, providers and families,” Venditti said. As one example, she said the NDEP’s It’s Not Too Late to Prevent Diabetes resource is ideal for older adults (a focus of her current research) in the pre-diabetes phase because it provides a practical program they can follow—and see real results.
“Even if you have a really terrific drug that helps you keep your glucose in control, you really need to mind your lifestyle,” Venditti said. “Depending on how challenged you are—in terms of your work, family, social or economic stress—I think often one’s lifestyle takes a backburner,” she added. “We try to help people find manageable ways to make their lifestyle central.”
May 2015 Partner Spotlight
NDEP Resource Set to Hit ‘70s Song Helps Novant Health Educate Older Adults about Diabetes
Multiple Grammy winner Paul Simon might be surprised to learn one of his biggest solo hits influenced a diabetes presentation in North Carolina nearly four decades later after he released it.
That’s what happened when Marcy Shipwash, a registered nurse and wellness and disease navigator at Novant Health’s Thomasville (N.C.) Medical Center, used the song “50 Ways to Leave Your Lover” as the backdrop for her diabetes prevention presentation featuring the National Diabetes Education Program’s (NDEP) Choose More Than 50 Ways to Prevent Type 2 Diabetes.
Set to the strains of Simon’s late 1975 hit, Shipwash’s presentation—specifically for older adults—highlighted a range of topics, such as how to learn your risk for type 2 diabetes, ways to stay active, and tips about healthy foods and portion control.
“The participants loved the presentation” Shipwash said, adding that attendees tapped their toes and sung along as she presented. “It was helpful that the tip sheet is based on a song they already know. It made the information easier for them to remember.”
That’s especially important, given that 1 out of every 4 people over the age of 65 in the United States has diabetes. To help this population learn more about the disease, the NDEP’s Diabetes Resources for Older Adults web page offers older Americans—as well as caregivers and health care professionals of older adults—information that can help older adults learn how to manage their diabetes and take steps to prevent type 2 diabetes.
To learn more about the Novant Health Thomasville (N.C) Medical Center, or Shipwash’s presentation, please contact her directly at firstname.lastname@example.org.
NDEP’s Road to Health Toolkit a Valuable Resource for the Community Health Center of Lubbock
Outreach and Promotions
Looking for an effective way to start a conversation about preventing type 2 diabetes? Two community health programs in northwest Texas found the answer in the NDEP’s Road to Health Toolkit, a diabetes-prevention resource for health care providers.
For the Community Health Center of Lubbock (Texas) and the Northern Texas Community Health Worker Resource Coalition, the Road to Health Toolkit is the main resource featured in the continuing education programs that the two groups provide for community health workers, according to Claudia Bustos, an outreach coordinator and community health worker at the Community Health Center of Lubbock. Bustos also serves as a member of the Texas Community Health Worker Advisory Board.
“The toolkit is a wonderful way to introduce and spark conversation regarding the delay and prevention of type 2 diabetes,” said Bustos, a Certified Community Health Worker who teaches the training. In the trainings, participants discuss topics such as how to lose weight, make healthy food choices, and boost physical activity. The toolkit also has a section that highlights ideas and instructions about how to present a “train-the-trainer” workshop so participants can offer training in their own communities.
“The bilingual toolkit is wonderful because it gives the community health workers the ability to teach patients in Spanish,” Bustos said. “Also, the language is designed for the lay person, which makes it easier for patients to understand.”
And the toolkit is also helpful for newly certified community health workers, “I’ve had such great feedback from new health workers,” Bustos explained. “They get overwhelmed by the amount of information out there and say the toolkit is easy to understand and has the best practices in diabetes prevention.”
For more information about the Community Health Center of Lubbock, please contact Claudia Bustos at email@example.com.
March 2015 Partner Spotlight
Past NDEP Chair Marti Funnell Highlights the Emotional Aspects of Diabetes
As a trained diabetes educator and nurse, Marti Funnell understood the importance of patient-centered care long before it became a catch phrase in the era of health care reform.
Funnell, a national leader in diabetes education, was the first non-physician to serve as National Diabetes Education Program (NDEP) Chair from 2008 until 2011, and she has worked as an associate research scientist at the University of Michigan Medical School’s Department of Learning Health Sciences since 2012. Her range of experience in both research and practice—which includes working as a staff nurse at the Veterans Affairs Medical Center in Ann Arbor, Mich. early in her career—prepared her for what excites her most in her profession today: a greater focus on patient-centered care and the emotional side of diabetes.
As she explained, the NDEP spent many years developing and promoting messages on what patients should do, but that was not enough to help people change their lifestyles and improve their health.
About Marti Funnell:
- NDEP Chair, 2008-2011
- Member, Agency for Healthcare Research and Quality (AHRQ) Behavioral Health Programs for Diabetes Mellitus Technical Expert Panel, 2014
- Chair, Task Force to Revise the National Standards for Diabetes Self-management Education, American Diabetes Association, 2006-2007
- Director of Administration, Michigan Diabetes Research and Training Center at the University of Michigan, 1997-2006
- Outsanding Diabetes Educator of the Year, American Diabetes Association, 1999
“We gave a lot of messages that you need to exercise and eat better, but everybody kind of knows that,” Funnell said. What the NDEP had not done, she continued, was explain exactly how people can also make those lifestyle changes. “You don’t just change behavior based on knowledge. You have to understand the ‘why,’ and it’s also helping people figure out the ‘how.’”
Enter Diabetes HealthSense, the NDEP’s online library of resources for patients and health care professionals to help people with diabetes live well, meet their goals, and improve their health. According to Funnell, Diabetes HealthSense has been instrumental in the effort to assist patients in managing their diabetes.
“It goes beyond tips. It’s helping people put it all together,” she said of the NDEP’s purpose and mission. “We came to recognition that we needed to focus on helping patients change behavior, and Diabetes HealthSense was a big part of that effort.” Funnell considers this work—and the effects it has had on patients—as one of the NDEP’s important accomplishments to date.
And it is this effort that connects so well with what Funnell calls the “emotional side” of diabetes. That aspect is an additional factor that all patients, as well as their families, must live with and must manage each day.
“There’s this underlying sense that this is a tough disease to live with, so helping people address that component affects their behavior and metabolic outcomes,” Funnell said. The starting point for that conversation, she explained, is to help patients assess the hardest aspect of diabetes is for them, rather than launch into a spiel on diabetes.
Looking ahead, Funnell said she hopes both patients and health care professionals know about the valuable resources the NDEP has to offer.
“We have done a really good job,” she said, “creating materials that fit in the world of diabetes today.”
February 2015 Partner Spotlight
NDEP Materials Featured in the ADRC of Waukesha County Diabetes Management Workshops
Outreach and Promotions
In Waukesha County, Wisc., the NDEP has proven to be a useful source of content for the Healthy Living with Diabetes workshops that the Aging and Disability Center (ADRC) of Waukesha County offers area residents.
About the Aging and Disability Resource Center of Waukesha County:
- Federally sponsored program in Waukesha County, Wisc., home to more than 390,000 residents in 37 municipalities
- Provides information and education to improve the quality of life for older Americans
The six-week workshops, written and designed by Stanford University and implemented by the Wisconsin Institute for Healthy Aging, are funded through the Older Americans Act, and pair participants with volunteer trainers who offer instruction on diabetes self-management. NDEP’s content and resources play an essential role in the development process.
“I gather different resources from the NDEP website and love including them in the workshops,” says Lee Clay, Health Education Coordinator at the ADRC of Waukesha County.“ Know Your Blood Sugar Numbers fits in perfectly when explaining how people with diabetes should maintain a log of their blood glucose numbers and know the range the numbers should be in,” she added.
Other NDEP resources featured in the workshops include 4 Steps to Manage Your Diabetes for Life, Taking Care of Your Diabetes Means Taking Care of Your Heart, and the Take Care of Your Feet for a Lifetime booklet. The “Managing Diabetes, It’s Not Easy but it’s Worth It” posters also make an appearance at all of the trainings. “It helps reinforce the work the participants are doing to make lifestyle changes to have healthier lives,” Clay says. “They couldn’t be doing more important work.”
For more information about the Aging and Disability Resource Center in Waukesha Wisconsin, please contact Lee Clay at LClay@waukeshacounty.gov.
January 2015 Partner Spotlight
Leading Diabetes Educator Linda Siminerio Becomes New NDEP Chair
As a nurse, diabetes educator, and professor, Linda Siminerio has spent more than 40 years advancing diabetes education in the United States. Now she’s excited to continue those efforts on a national scale in her latest role: the leader of the National Diabetes Education Program (NDEP).
Siminerio, R.N., Ph.D, takes the helm of the NDEP this January when she succeeds John Buse, M.D., Ph.D. and begins her two-year term as NDEP Chair. A professor of medicine at the University of Pittsburgh in the Division of Endocrinology and Metabolism, Siminerio also serves as executive director of the University of Pittsburgh Diabetes Institute. Already active in the NDEP through her work with the NDEP’s Diabetes HealthSense Task Group and the NDEP’s Executive Committee, Siminerio recently reflected on the federal program’s core strengths and greatest opportunities.
“It seems like the NDEP and the folks who have been involved in it—including our partners—always seem to be one step ahead of where healthcare is going,” Siminerio said, adding that areas such as medication adherence and practice transformation are just the latest examples of this. “These are relatively new concepts in disease management and here we are in diabetes taking the lead on these programs.”
About Dr. Siminerio:
- Served as Chair of the International Diabetes Federation (IDF) World Congress
- Former President, Health Care & Education, American Diabetes Association
- Academic focus: translation research, diabetes quality improvement, self-management, community interventions and overcoming barriers to diabetes care in underserved populations
And it’s that innovation and foresight that makes NDEP stand out as a leading health education program, according to Siminerio.
“I do a lot of global work and I’m always so amazed that our country recognizes diabetes is a problem, and that education for patients, providers and the community is so important that we have a national diabetes education program,” she said.
As she prepares to lead the NDEP, Siminerio said she will focus on making sure people know and understand that NDEP’s resources are valuable tools in chronic-disease management.
"What kinds of strategies do we need to get folks ongoing support: is it through technology, community, peers? Those resources are available through the NDEP,” Siminerio said. For instance, the online library Diabetes HealthSense provides several resources for diabetes educators today, and the work of the NDEP’s Medication Adherence Task Group will provide additional resources in the near future.
To spread the word—and work—of the NDEP, Siminerio says she will focus on a primary goal of the NDEP Strategic Plan that kicked off in 2014: engaging partners.
“If there are partnerships that are working, what’s the secret?” she said. “We have to rely on our partners,” she added, “We all - in our organizations - have something to offer. I don’t care what specialty you go into—you are going to be working with someone with diabetes.”