Quick Start Action Plan
Diabetes Prevention in Houston Area Action Plan
to Scale and Sustain the National Diabetes Prevention Program
Draft March 10, 2017
Diabetes Prevention Plan
toScale and Sustain the National Diabetes Prevention Program
in the Houston Area
2017– 2018
Introduction
The National Diabetes Prevention Program (National DPP) was launched in 2010 by the Centers for Disease Control and Prevention (CDC). Since then, significant resources have been invested in states to build momentum for a national movement to prevent type 2 diabetes based on sound scientific evidence. With support from the CDC, the Texas AHEC East – Greater Houston Region, Cities Changing Diabetes, the Houston Business Coalition on Health, the Texas Diabetes Council, and the Texas Department of State Health Services, collaborated with the National Association of Chronic Disease Directors (NACDD) to plan and implement a Houston-regional meeting focused on scaling and sustaining the National DPP in the Houston area. The plan also outlines key action steps that could be expanded and implemented statewide.
This meeting brought together a diverse group of organizations from across the Houston region and key statewide stakeholders to acknowledge current stakeholders for their diabetes prevention efforts and to engage new ones. All participants learned more about national efforts to promote the National DPP, and Houston’s successful evidence-based diabetes prevention efforts were prominently showcased. The meeting provided key partners an opportunity to provide input into the development of a stakeholder-driven action plan to prevent type 2 diabetes through scaling and sustaining the National DPP in Houston with potential to expand to other areas or statewide in Texas. The time is now to achieve a collective impact in Houston to prevent type 2 diabetes.
Together, we can make a huge difference to prevent type 2 diabetes.
Pillars
The following pillars are important for scaling and sustaining the National Diabetes Prevention Program.The italicized pillars were addressed during the Houston-regional meeting.
- Increase awareness of prediabetes;
- Increase coverage for the National DPP’s lifestyle change program;
- Increase clinical screening, testing, and referral to CDC-recognized lifestyle change programs under the National DPP; and
- Increase the availability of and enrollment in CDC-recognized lifestyle change programs.
All work in these pillars should be aimed at achieving an overarching diabetes prevention goal:
Decrease the new cases of diabetes among people with prediabetes and those at highest risk, by increasing enrollment in CDC-recognized lifestyle change programs by x percent (or from _____ to _____people enrolled).
Availability and Support of CDC-Recognized Lifestyle Change Programs
Currently, there are hundreds of publicly-available lifestyle change programs across the United States. These include in-person and online options, as well as programs that are a combination of both. The growing demand for CDC-recognized lifestyle change programs also needs to be addressed to ensure program availability meets program demand. This requires building an effectively trained workforce to implement the lifestyle change program ensuring program quality and standardized reporting.
Long term Priority:Short term Priority: By February 2018, establish five new, accessible and sustainable CDC-recognized Diabetes Prevention Programs (DPP) that are offered by diverse organizations reflecting the priority populations of the Greater Houston Area.
Start / End / Key actions to achieve priorities / Metrics / Resources / Lead organization
(bold organizations volunteered to lead action) / Progress
1 / Identify a workgroup to define and operationalize a plan. / Existing: CDC website for basic information about the DPP, the Prevent T2 curriculum, and DPRP requirements / Institute for Spirituality and Health, Cities Changing Diabetes, St. Joseph’s Medical Center, Texas AHEC East Greater Houston, City of Houston?, Harris County Public Health
2a / Identify process andcriteria to identify organizations that are interested in being one of five new DPP sites in Greater Houston. / St. Joseph’s Medical Center, Cities Changing Diabetes, Institute for Spirituality and Health, Windsor, TMF Health Institute, H.E.B.
2b / Identify and approach organizations that have the capacity to deliver and sustain a CDC-recognized diabetes prevention program (i.e. project managementskills, leadershipbuy-in, strong financial/billing infrastructure, ability to recruit participants) / TMF Health Institute, AADE
2c / Identify faith-based organizations to send invitation letter to containing key information about the need to increase availability of the DPP in Greater Houston.
- Collaborate with the City of Houston and Cities Changing Diabetes to identify a DPP leader/champion for each faith (Christian, Muslim, etc.)
2d / Compile accessibility report to include current availability of DPP in Houston/Harris County.
- Reach out to providers via umbrella group made up of key leaders to educate about the availability of DPP.
- Look for gaps in service areas.
2e / Assess payers (CMS and employers) to identify specific organizations that they would reimburse for delivery of the DPP. / Cities Changing Diabetes
3 / Convene a task force with state and local representatives in the Greater Houston Area to define priority populations based on available data. / Harris County Public Health
4a / Approach key organizations (i.e. YMCA, ADA, AHA, AADE, etc.) that may currently offer DSME and offer them support and training on how to reach their target populations with DPP.
- Increase awareness of prediabetes
- Reach out to community clinics and organizations
- Include HR managers in outreach
4b / Ensure there is a program coordinator within each organization to maintain and improve DPP. / St. Joseph’s Medical Center, Institute for Spirituality and Health, City of Houston?, H-E-B, Texas DSHS
5 / Provide orientation/DPP 101 to educate interested organizations about the program. / St Joseph’s Medical Center, Texas AHEC East Greater Houston, City of Houston?, Windsor, H-E-B
6 / Establish a Houston Area Network of DPP providers/coaches to share success stories and discuss issues and best practices. Identify regional DPP champions/providers. / None identified.
Statewide Actions / Develop an accessibility report for each region.
Group noted: All of the above action steps may be applicable statewide.
Clinical Screening, Testing, and Referral to CDC-Recognized Lifestyle Change Programs under the National DPP
Health care providers and delivery systems are overwhelmed by the growing number of patients with diabetes. Tools are available to help providers screen, test, and refer at-risk patients to lifestyle change programs to prevent their progression to type 2 diabetes. Referring patients to these evidence-based programs can help meet regulatory, state licensing, and board recertification requirements. The recognition requirements allow providers to confidently refer their patients from the clinic to community resources such as the CDC-recognized lifestyle change program.
Long term Priority:Increase all screenings for prediabetes and diabetes in Houston/Harris County by XX percent (tie goal to the Health People 2020 goal).Potential baseline measure:6.9 percent in region have self-reported that they have prediabetes.Short term Priority:By August 2016, establish a standardized system/approach for organizations (community-based organizations, faith-based organizations, health systems, health plans) to implement screening, testing, and referrals to CDC-recognized diabetes prevention programs.
Note: While the focus of this priority area was screening, testing, and referrals, the participants focused priorities and actions on increasing community awareness of prediabetes and CDC-recognized diabetes prevention programs. In refining the action plan, the focus of this section can be addressed.
Start / End / Key actions to achieve priorities / Metrics / Resources / Lead organization
(bold organizations volunteered to lead action) / Progress
1 / Review priorities and key actions from the other two pillar groups to determine where there is synergy to coordinate key actions / St. Joseph's Medical Center
2 / Identify accountability for key actions and organizational roles for this plan / NW Assistance Ministries?
3 / Partner/collaborate/coordinate with the eight CDC diabetes prevention programs in Houston/Harris County to:
- work on baseline data and create metrics to measure progress on referrals
- collaboratively create referral tool
- develop feedback loop to referring health care providers
- provide mechanisms for general information sharing among CDC DPPs and organizations
4 / Mobilize campaign with AHEC to take a CDC Diabetes Prevention Program road show to organizations
- Create standardized PowerPoint presentation
- Use the 5 steps (from AMA presentation and toolkit) to create a standardized process and utilize Diabetes Resource Center to house materials
- Identify the "ask" for each type of organization (community-based organizations, health systems, etc.)
- Describe what the diabetes prevention program is and the value/benefits for the members of organizations
- Market "road show":
- Option 1: DPP with letters standing for Diabetes impact, Program description, Participation
- Option 2: VALUE with letters standing for Value, Awareness, Lead screening event, Understand impact, and Empowerment
Statewide Actions /
- Statewide: Disseminate tools on Houston Diabetes Resource Center and TX Diabetes Council to create a prediabetes toolkit
Statewide Actions /
- Statewide: Establish a model screening, testing, and referral plan and use in other cities
Coverage of the National DPP’s Lifestyle Change Program by Employers and Insurance Plans
Prediabetes and type 2 diabetes are growing concerns for America’s workforce. These conditions affect the health and quality of life of millions of U.S. adults and cost employers and insurers billions of dollars each year in lost productivity and medical expenses. Evidence shows lifestyle change programs can cut a person’s risk of developing type 2 diabetes in half and reduce the risk of serious conditions associated with prediabetes. Obtaining insurance coverage for the National DPP’slifestyle change program for public and private employees as well as Medicaid beneficiaries is a critical driver for scaling and sustaining the program.
Long term Priority:Short term Priority: By February 2018,establish a diabetes prevention task force, focused on promotion and adoption of the CDC-Recognized Diabetes Prevention Program (DPP), that develops and launches six, 1-year demonstration programs in self-insured employers.
Start / End / Key actions to achieve priorities / Metrics / Resources / Lead organization
(bold organizations volunteered to lead action) / Progress
1 / Determine task force membership, including multiple sectors
- Recruit influencers to be on task force(advertisers, brokers, consultants, mayors)
2 / Outline a clear vision/implementation plan for demonstrations
- Determine work plan/time table/accountability for demonstrations
- Identify target list of employers by size (small, medium, large)
- Assure incentives for employers participating in demonstrations
- Identify other dollars to support demonstrations
2b / Tie the demonstrations to the Cities Changing Diabetes project / Harris Health
3 / Determine tools required to market DPP to employers, including contract language
- Customize/tailor tools
- Include corporate responsibility
- Identify employers with on-site clinics (i.e. HEB)
- Rally current DPP users as referrals for sales pitch
- Identify champions
3b / Build business case for employers to participate in demonstration
- Include brag sheet
- Include do-nothing strategy
4 / Identify DPP providers for demonstrations
- Vet a selection of providers that can perform
5 / Track how demonstrations are working and capture data the employers participating in demonstrations can use / Houston Business Coalition on Health, Texas DSHS
6 / Convene employer/broker/aggregate round tables / Houston Business Coalition on Health, Powell Industries, City of Houston, Rice University, Dow
Statewide Actions / Work with TX Business Group on Health
Expand work in Dallas area
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