November 2014 Partner Spotlight
Outgoing Executive Committee Chair Reflects on NDEP’s Past Achievements, Future Possibilities
As he concludes his term as the National Diabetes Education Program’s (NDEP) Executive Committee Chair, Dr. John Buse says the federal program’s most important recent achievement is one that holds the greatest promise for its future: the NDEP Strategic Plan.
The five-year plan kicked off this year and is the result of work that NDEP’s Strategic Planning Task Group began in September 2012. NDEP’s Executive Committee, which Dr. Buse began chairing earlier that same year, challenged the task group to identify clear areas of focus for the next five years in areas where NDEP’s strengths could help make a significant difference in diabetes outcomes.
The Strategic Plan is most notable for shifting the NDEP’s primary focus from delivering health messages directly to the general public to improving the NDEP’s engagement with partner organizations representing health care professionals, including community health workers and community-based organizations. And Dr. Buse—who earned both his M.D. and Ph.D. at Duke University—says that shift has “turned the NDEP on its head.” Even so, he says the ambitious plan is “doable.” As he explains, NDEP’s budget and personnel are considerably smaller than the budgets and resources of the nation’s pharmaceutical companies and device-makers, and many U.S. health care systems are able to spend more on diabetes education and engagement than the NDEP. That’s why the Strategic Plan’s emphasis on engaging partners—which the Strategic Plan defines in a broad sense as any organization or institution interested in improving diabetes care for their constituents or members—is so important.
About Dr. Buse:
- Professor in the Division of Endocrinology, Department of Medicine, University of North Carolina School of Medicin, Chapel Hill, N.C.
- Practices at UNC Hihgate Specialty Center, Durham, N.C.
- Chairman of NDEP's Medication Adherence Task Group
- Began his term as NDEP Executive Committee Chairman in January 2012
“The NDEP in the past developed amazing materials, but my hope is in the future we will really serve much more of a role as a catalyst and curator,” Dr. Buse says. “If there are materials out there, we’ll find them. If there are not, we’ll make sure someone else helps us develop them—if we don’t develop them ourselves.”
In addition to leading the NDEP’s Executive Committee, Dr. Buse is also Chair of NDEP’s Medication Adherence Task Group, which will organize and consolidate information and tools to support health care professionals and community-based organizations in improving medication adherence among people with diabetes. According to Dr. Buse, the success of the Medication Adherence Task Group depends largely on shared decision-making in the patient-provider relationship. One of Dr. Buse’s most memorable examples of the importance of shared decision-making came in the late 1980s, when a patient chastised him after he lectured her on smoking. That made him realize not to tell the patient what to do, but rather to learn what the patient is already doing and then provide options and treatment strategies while developing a shared understanding of what the patient and provider can do together.
“Think coach, not drill sergeant,” Dr. Buse says. “It’s not the algorithms; it’s not the pamphlets; it’s not the drugs. It’s the relationship that’s most important.”
September 2014 Partner Spotlight
NDEP Materials a Valuable Tool in Alabama’s Schools, Senior Centers & Prisons
Ask anyone in the Alabama public health department’s Diabetes Prevention and Control Program (DPCP) and they’ll tell you the NDEP’s Road to Health toolkit has lived up to its name, serving as a map to help educate Alabamans about diabetes in schools, senior centers, and prisons throughout the state.
Intended especially for African Americans and Hispanics/Latinos at risk for type 2 diabetes, the Road to Heath toolkit provides materials for community health workers to develop an outreach program that emphasizes type 2 diabetes can be delayed or prevented. Debra Griffin, the DPCP’s diabetes nurse educator, says Road to Heath is most effective for its simple, three-pronged message about healthy food choices, exercise and weight loss.
In the last year and a half, DPCP staff members have hosted Road to Health sessions at 15 senior centers, where they educated about 355 residents. And they trained employees at the Alabama Office of Minority Health, who, in turn, led a Road to Health course at four prisons.
LaMont Pack, the DPCP’s community-clinical linkages manager, says he’s also visited “churches that you can’t get to with a GPS” to spread the word about how to prevent and manage diabetes.
“The things you do to prevent diabetes are the same things you do to prevent its complications: nutrition and physical activity,” Pack says.
Meanwhile, Pack and his staff have used other NDEP resources to educate the younger generation about diabetes and its effects. In March, Montgomery, Ala.-based Resurrection Catholic School implemented the Diabetes Ambassador Program, in which seven student ambassadors educated their peers, teachers, school staff members, and parents about diabetes prevention. The students wore Blue Circle pins from the International Diabetes Federation to promote the global symbol for diabetes, and on March 25—Diabetes Alert Day—the school’s principal allowed students to wear the color blue (instead of their required uniforms) to raise awareness about diabetes.
August 2014 Partner Spotlight
NDEP Resources Help Dentist Dr. Martin Gillis Urge People to Make the Oral Health-Diabetes Connection
As a dentist with type 1 diabetes, Dr. Martin Gillis not only brings first-hand experience of the disease to his role as a healthcare provider, he also understands that the best care for people with diabetes should come from a team of healthcare professionals who provide dental, podiatric, optometric and pharmacy (PPOD) services.
The National Diabetes Education Program’s (NDEP) resources have helped Dr. Gillis educate patients with diabetes and their healthcare providers around the world. Specifically, he has incorporated NDEP PPDOD information in his lectures on diabetes and oral health at the International Diabetes Foundation’s World Diabetes Congress and World Dental Federation’s World Dental Congress. Last year, Dr. Gillis received the Sir Alister McIntyre Distinguished Award for Integrative Medicine at the University Diabetes Outreach Program’s International Diabetes Conference in Jamaica, his achievements were profiled in the American Diabetes Association’s Diabetes Forecast
About Dr. Gillis:
- Member of the NDEP PPOD Stakeholder Gorup
- Chair of the NDEP PPOD Toolkit Update Task Group
- Diagnosed with type 1 diabetes while in dental school
- Past member of the International Diabetes Federation Consultative Section on Diabetes Education
“Oral disease needs to be related to the broad NCD (non-communicable disease) agenda by addressing how improvements in oral health will positively affect general well-being for a healthier society,” says Gillis, who serves as the registrar at the Provincial Dental Board of Nova Scotia in Halifax, Nova Scotia. “The connection between diabetes and oral disease does not exclusively reside in the relationship between periodontal disease and glycemic control, but extends to common modifiable risk factors such as poor nutrition, and the need to prevent and control diabetes and oral disease by building positive health behaviours through self-efficacy.”
Dr. Gillis will continue to lend his expertise to NDEP when he presents on team care and oral health and diabetes in the upcoming PPOD webinars, Working Together to Manage Diabetes: Tools and Strategies for Pharmacy, Podiatry, Optometry, and Dentistry. Click here for more information.
“To make positive change, we must foster partnerships among all stakeholders to reduce the social and economic burdens of oral disease and diabetes,” Gillis says. “I’m very thankful to have the opportunity to serve the National Diabetes Education Program in its valuable work to improve the lives of people with diabetes.”
July 2014 Partner Spotlight
NDEP Resources Help Primary Care Physician Dr. Kevin Peterson Deliver Patient-Centered Care
For primary care physician Dr. Kevin Peterson, the National Diabetes Education Program’s (NDEP) resources serve the dual purpose of helping him educate his patients and meeting health reform’s goal of patient-centered care.
And Peterson—who has worked with diabetes patients since 1991—says that’s an important message for other primary care providers, not just because these clinicians treat so many diabetes patients, but also because this patient population now has better access to information about how to manage their disease. By his estimate, there are about 220,000 primary care providers and only about 4,000 endocrinologists, and diabetes is one of the most common diseases that a primary care provider sees.
“NDEP has always been good at understanding the importance of both the patient and the extended health care team,” Peterson says. “I think that the importance of that extended team is only increasing and getting larger. As that happens, it’s essential for the care to remain patient-centered.”
About Dr. Peterson:
- Professor at University of Minnesota Medical School
- First became involved with NDEP at NIH as rep for AAFP in 2001
- Served on NDEP task group that last year updated the "Better Diabetes Care" resource
- Currently member of new Practice Transformation Group
Through the years, Peterson has used NDEP’s resources to develop a maintenance-of-certification module for the American Academy of Family Physicians. And currently he uses NDEP materials—particularly those translated into multiple languages—for the “After Your Visit” summary that he’s required to submit for the federal government’s electronic health records incentive program. He’s especially excited about the Practice Transformation group, which he sees as an opportunity to help primary care providers keep pace with the rapidly changing U.S. health care environment.
“The speed of transformation just continues to accelerate with the introduction of accountable care and the many different models that are being proposed for reimbursement,” Peterson says, adding that regardless of the political landscape, having health care providers share financial risk and understand who their patients are will serve as a support for diabetes and all chronic diseases. “The transformation of care will continue to happen. We will be focusing more on support of diabetes outside of the practice and providing people with the tools of self-management that we did in the olden days when we waited for them to show up outside our door.”
May 2014 Partner Spotlight
Diabetes Educator Linda Haas Incorporates NDEP Resources in Outreach Efforts
Linda Haas, Ph.C., R.N., C.D.E. is a former Washington State and National ADA Diabetes Educator of the Year who has written and lectured extensively about diabetes care. Ms. Haas served as an endocrinology clinical nurse specialist at the Seattle division of the VA Puget Sound Health Care System (formerly the Seattle VA when she started), where she helped veterans with diabetes manage their condition and served as a consultant to staff on diabetes management and self-management education. She is also a past president of the American Association of Diabetes Educators (AADE) and past president, Health Care and Education, for the American Diabetes Association (ADA). In 2013 she received AADE’s Living Legend Award.
Q. Where did you start your career in diabetes education and management, and what is the biggest difference you’ve seen in the field since then?
A. “I was a research nurse at the VA in Seattle (and) worked with endocrinologists. Meters had just come into being then, or the ability to test one’s blood sugar, and I really thought that was cool and allowed the person with diabetes to take over their management if they had appropriate education. And then I got more involved and went full time doing diabetes education and became an advanced practice nurse.”
Regarding the biggest changes in the field since then, Ms. Haas cited two:
“One is glucose monitoring, although it hasn’t fulfilled its promise because I don’t think people have been instructed what to do with the information. In fact, I gave a talk in ’86 that monitoring is a means to an end; not an end in and of itself, which is what I think a lot of people looked at it as, which was in error. The other big thing I think has happened is that providers are finally starting to realize that it’s really the patient who does everything and not the provider. And so helping people make changes in their behavior is probably one of the most important things providers can do. Because you can prescribe all you want, but if the patient doesn’t take it, it’s not going to work. I think providers are finally reaching a point to where they’re willing to turn over the management to the patient, but that’s been something educators have been preaching for a long, long time.”
Q. What do you think is the greatest challenge that diabetes educators face today, and what suggestions do you have on how they can address that challenge?
A. “I think the greatest challenge is responding to the changing healthcare system and figuring out where they fit in. My advice to them would be to get involved with primary care—make themselves known to primary care providers; let primary care providers know of their value.”
Follow-up: How could diabetes educators make themselves known to primary care providers?
“What I found very helpful was meeting with the nurses. Because particularly with medical homes, it’s really the nurses who are doing a lot of the work. And I mean RNs, not the Advanced Practice Nurses, although the latter are doing a lot, too. But they’re doing more management, and it’s the RNs who are doing the self-management education. So by working with the nurses and helping them, you can be a valuable resource.
Q. What was the most rewarding aspect of your work at the VA?
A. “Working with the patients. They’re just wonderful. And I truly believe that without them, we would not be here today because they’re the ones who preserved our freedom. They were just delightful to work with.”
From 2008-2012, Ms. Haas served as the Metabolic Syndrome/Diabetes Clinical Nurse Advisor in the Veterans Health Administration’s Office of Nursing Services, which she also cited as a highlight of her career.
“The other thing that I found very rewarding was when I took the position with National Nursing Services and got to help advise on policy that would help staff and people with diabetes.”
Q. Are there certain NDEP resources that you have found most useful in your diabetes-education initiatives?
A. “I like the Diabetes Health Sense web resource that focuses on behavior change. And I use the slides all the time. I download them and incorporate them into my lectures.”
Q. What area of diabetes education and management do you think deserves greater attention?
A. “I really think the role of the patient within the family deserves more attention. I think the patient is the key person because he or she is the person with diabetes and the family is hopefully supportive.”
Follow-Up: Should there be greater attention on what families should be doing, or how the patient needs to educate the family?
“Both. And it’s not so much what they should be doing, but what they can be doing, because you don’t want to turn family members into diabetes police.”
As an example, Ms. Haas suggested discussions patients and families can have around healthy eating. She emphasized that people with diabetes don’t need to have special foods, but rather an understanding about eating well.
“We’re much less compulsive about saying, ‘You can’t have this’ or “You can’t have that,’ because you really can, you just have to work it into your overall meal plan.”
Follow-Up: What is your suggestion for the patient to help the family?
“Learning all they can, and bringing family members to classes and clinic visits to include the family members in everything that is going on.”
Q. As part of its new strategic plan, the NDEP is working to enhance its relationship with partners in clinical and community settings. How can these partner organizations benefit the most from NDEP resources?
A. “The materials are great, and they’re really evidence-based. I’ve worked on a couple, and we really had to follow what the evidence said. I think that is a huge advantage to those. Authors of these materials work very hard at keeping current and making changes when they need to be made, even though sometimes they’re painful.”
Q. Final thoughts?
A “I think NDEP is just an incredible organization and one that I look up to very much.”
April 2014 Partner Spotlight
The SouthEast Alaska Regional Health Consortium Uses NDEP Resources to Raise Awareness of Diabetes in American Indians and Alaska Natives
The SouthEast Alaska Regional Health Consortium (SEARHC) is a non-profit tribal health consortium of 18 Native communities which serve the health interests of the Tlingit, Haida, Tsimshian, and other Native people of Southeast Alaska. SEARHC’s vision is to improve the health status of Native people in Southeast Alaska and other partners to the highest possible level. SEARHC is also a 2011 ADA John Pipe Voices for Change award recipient for its advocacy work for effective diabetes treatment and prevention services in American Indian and Alaska Native communities.
Outreach and Promotions
SEARHC, incorporates the National Diabetes Education Program’s (NDEP) diabetes education materials – such as Your Game Plan to Prevent Type 2 Diabetes, We Have the Power to Prevent Diabetes, and 4 Steps to Manage Your Diabetes for Life – in its “Know Your Numbers” campaign. The campaign targets health care professionals, people with diabetes, and people at risk for diabetes, with messages about understanding blood glucose, blood pressure and cholesterol levels to prevent and manage diabetes.
Maybelle Filler, Diabetes Grants Department Manager at SEARHC explained, “We look to the NDEP for information because the program provides content that is easy to use and understand and is tailored for our audiences. I don’t have to worry about the credibility of the information because it is up-to-date and research based.”
Campaign outreach involves inserting monthly columns in local newspapers using NDEP messages and content. The columns promote the “Know Your Numbers” tagline, information about target blood pressure, A1C and cholesterol goals, as well as tips for healthy eating and getting active.
Additionally, SEARHC inserts NDEP’s Diabetes Risk Test into local newspapers during key observances such as American Heart Month and National Diabetes Month. SEARHC adapted the Diabetes Risk Test to include an invitation to see a local doctor if readers have questions or concerns, healthy eating tips, and a link to the NDEP website.
Results and Lessons Learned
SEARHC’s diabetes outreach success is due to finding the right motivators that work in the community to get people involved in diabetes prevention and management. Pictures and narratives from local residents receive the biggest impact in the community and are the best motivators for action.
For more information about the SouthEast Alaska Regional Health Consortium contact Maybelle Filler at Maybelle.Filler@searhc.org or (907) 966-8739.
March 2014 Partner Spotlight
The National Kidney Disease Education Program Showcases NDEP Materials in its Annual Kidney Sundays Event
The National Kidney Disease Education Program (NKDEP) is a federally sponsored program that works to reduce the burden of chronic kidney disease (CKD) among communities most impacted by the disease. Established in 2000 by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NKDEP aims to raise awareness among people at risk for CKD about the need for testing and educate people with CKD about how to manage their disease.
Outreach and Promotions
NKDEP uses the National Diabetes Education Program’s (NDEP) messages and materials as part of its Kidney Sundays public awareness event, which was developed to educate African Americans about kidney disease and its key risk factors, like diabetes and high blood pressure. African Americans are a critical audience for kidney health messages because they are almost four times as likely as Caucasians to develop kidney failure.
Kidney Sundays leverages the growing tendency for African Americans to turn to places of worship to get accurate, useful information by bringing kidney health messages to the faith community. Because high rates of diabetes among African Americans contributes to their elevated kidney failure risk, messages about diabetes prevention and control are central to the Kidney Sundays program. Undiagnosed or untreated diabetes is a major cause of CKD. However, by managing diabetes, African Americans can lower their risk for CKD and other diabetes complications.
To help raise awareness of these diabetes messages, NKDEP distributes numerous NDEP materials, including 4 Steps to Manage Your Diabetes for Life, Choose More than 50 Ways to Prevent Type 2 Diabetes, Did You Have Gestational Diabetes When You Were Pregnant? What You Need to Know, and more, to more than 85 participating places of worship. Additionally, NKDEP and NDEP collaborate to promote the Kidney Sundays event through a variety of channels. NKDEP posts messages about the event and related partner materials, including NDEP’s, on the NIDDK Facebook page, Twitter feed, and the NIDDK Health Information News Eblast.
On March 2, 2014, in recognition of National Kidney Month, the National Kidney Disease Education program hosted its third annual Kidney Sundays event at more than 85 places of worship across the country.
Results and Lessons Learned
Kidney Sundays events in 2012 and 2013 engaged more than 420 African American faith communities across the country, reaching more than 335,000 congregants, to dedicate a day to talk about kidney health, diabetes, and high blood pressure. Over 6,000 blood pressure screenings were conducted and more than 200 people were referred to local area diabetes prevention and control programs for further evaluation. The Kidney Sundays events have supported the distribution of 130,000 kidney health-related materials from NKDEP and other NIDDK programs, including nearly 25,000 NDEP materials in 2013 alone.
For more information about the National Kidney Disease Education Program’s activities, contact Eileen Newman at firstname.lastname@example.org.
February 2014 Partner Spotlight
The Texas Diabetes Prevention and Control Program Incorporates NDEP Messages and Materials in its “Get Tested Today” Campaign
The Texas Diabetes Prevention and Control Program (DPCP) at the Texas Department of State Health Services administers grant-funded initiatives and contracted services to address current issues affecting people with diabetes and those at risk of getting diabetes. The Texas DPCP maintains a statewide system of quality education services for all people with diabetes and health care professionals who offer diabetes treatment and education. Programs and activities are made possible through state and federal funding and partnerships with other organizations across the state that share a vision of a Texas free of diabetes and its complications.
Outreach and Promotions
The Texas DPCP used the National Diabetes Education Program’s (NDEP) messages and materials as part of their public awareness campaign, “Get Tested Today,” developed to encourage Hispanic populations to get tested for diabetes.
The first step in developing the campaign was market research, specifically, targeted research on Hispanic and Latino populations in Texas. Research showed that getting tested to prevent the complications of diabetes – such as heart attack or stroke, nerve damage in hands and feet that can lead to amputations, and eye problems that can lead to blindness – was the message that resonated best with the target population. They also learned that Hispanics and Latinos are avid users of technology, including mobile phones, and go online using their mobile devices. This information was used to guide their campaign messages and outreach strategy, which featured television and radio public service announcements in English and Spanish, as well as online and mobile phone advertising. All outreach directed people to the diabetes prevention website, www.preventtype2.org.
The “Get Tested Today” campaign messages and website were based on language from the NDEP’s Small Steps. Big Rewards. Your GAME PLAN to Prevent Type 2 Diabetes toolkit and other diabetes prevention resources. For example, the website promoted NDEP’s Diabetes HealthSense online resource and behavior change videos from Diabetes HealthSense such as Managing Type 2 Diabetes: Sorcy’s Story. The site also included links to NDEP’s family health history information and resources.
Results and Lessons Learned
The campaign drove increased visits to www.preventtype2.org, which received more than 30,000 visits in December. Online advertising generated more than 47 million impressions resulting in 54,000 clicks during the month. A focus on online and mobile promotions showed immediate campaign results, so ads could be tailored as needed to drive even more people to the website. Additionally, the NDEP provided access to messages and materials that could be used and adapted for the campaign.
For more information about these activities, contact Richard Kropp at Richard.email@example.com.
January 2014 Partner Spotlight
The Diabetes Community Action Coalition of Fulton County Uses NDEP Resources to Create & Host a “Take One Step to Stop Diabetes” Workshop
The Diabetes Community Action Coalition (DCAC) of Fulton County was formed in March 2011 to increase the health, wellness, and function of Fulton County, Georgia residents at risk for, or affected by, diabetes. With over 90 local partner organizations, opportunities to educate and empower community members, health care providers, and employees of Fulton County are endless. In addition to promoting wellness through prevention, DCAC ‘s community outreach includes increasing access to health care for the low-income and uninsured, most recently by providing enrollment assistance in the Health Insurance Marketplace.
Outreach and Promotions
DCAC collaborated with a community partner, the Ruby A. Neeson Diabetes Awareness Foundation, Inc., to create and host a “Take One Step to Stop Diabetes” workshop in recognition of World Diabetes Day. The workshop targeted people at risk for type 2 diabetes, especially vulnerable populations, and took place at a local library.
DCAC used NDEP’s Choose More than 50 Ways to Prevent Type 2 Diabetes tip sheet as a guide for designing the workshop. For example, the workshop focused on three key messages highlighted in the tip sheet: “Take Care of Your Mind, Body, and Soul,” “Make Healthy Food Choices,” and “Move More Each Day.” All attendees received a free copy of the tip sheet.
The workshop began with an overview of diabetes, diabetes risk factors, and steps people can take to prevent or delay type 2 diabetes. Next, using the “Take Care of Your Mind, Body, and Soul,” message, DCAC partner and Nurse Diabetes Educator, Aliyah Barry, led attendees through a guided meditation, emphasizing the role stress, anxiety, and depression can play when it comes to good health. The next topic, “Make Healthy Food Choices,” focused on helping people better understand portion control and provided simple tips for healthy eating from NDEP, like “Drink water instead of sugary drinks” and “Keep a healthy snack with you, such as fresh fruit, a handful of nuts, and whole grain crackers.” Finally, DCAC used NDEP’s “Move More Each Day” message to promote the importance of increasing physical activity and tips from NDEP to get started. For example, the workshop’s final topic focused on NDEP’s “Dance it away, Faye” tip, and featured the story of a Native American woman who regained her health by dancing to Zumba. The workshop concluded with a free Zumba class led by a guest Zumba instructor.
Workshop attendees were also introduced to a variety of other helpful resources, such as NDEP’s Small Steps. Big Rewards. Your GAME PLAN to Prevent Type 2 Diabetestoolkit, NDEP’s Road to Health Toolkit, in addition to type 2 diabetes prevention books and Zumba DVDs available through the public library. Additionally, a Health Insurance Marketplace Certified Application Counselor was invited to the workshop to provide assistance to library patrons and workshop participants wanting to enroll in health insurance.
“We were thrilled that we could build an entire workshop around NDEP’s diabetes prevention messages and resources. This was DCAC’s first event focused entirely on type 2 diabetes prevention – we engaged people at risk for diabetes, and even formed some new partnerships along the way,” said Vicki Karnes, RN, MA, Diabetes Educator, Co-Chair of DCAC. For more information about DCAC’s activities, contact Ms. Karnes at firstname.lastname@example.org.