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N A R A D i abetes T r e a tmen t & P r e v ention P r o g ram

Presentation to NARA Board of Directors Portland (NARA) of the Northwest. N A R A D i abetes T r e a tmen t & P r e v ention P r o g ram. P r e s entation t o t h e N A R A B o a r d o f D i r ec tors

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N A R A D i abetes T r e a tmen t & P r e v ention P r o g ram

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  1. Presentation to NARA Board of Directors Portland(NARA) of the Northwest NARADiabetesTreatment& PreventionProgram PresentationtotheNARABoardofDirectors AlisonGoerlRD,LD-ProgramManager Patricia Foster-ProgramAssistant,JVN Technician PennySchumacherRN, CDE,MCHES-PublicHealth Nurse SheilaHeuschkelRD,LD,CDE- RegisteredDietitian

  2. Diabetesin AmericanIndiansand AlaskaNatives:FactsAt-a-Glance 16.1% Percent ofAI/ANadultsdiagnosedwith diabetes (comparedwith8.3% of non-Hispanicwhites) Percentincreaseindiagnoseddiabetesfrom 1990 to2009, inAI/ANyouthaged 15-19 yrs. Average medicalexpendituresfor peoplewith diabetes are 2.3 timeshigherthan for people without diabetes. 110% 2.3times

  3. Diabetesin AmericanIndiansand AlaskaNatives:FactsAt-a-Glance 2.3timeshigher LikelihoodofAI/ANadultstohave diabetes comparedwithnon-Hispanic whites LikelihoodofAI/ANyouthaged 10-19 tohave diagnosedType2 Diabetes compared with non-Hispanicwhites Death rateduetodiabetesforAI/AN compared to generalUSpopulation-2008 9timeshigher 1.6timeshigher

  4. s AlisonGoerlRD,LD-ProgramManager PatriciaFoster-ProgramAssistant/JVNTechnician(Hopi/Tewa) SheilaHeuschkelRD,LD,CDE-RegisteredDietitian(Aleut) PennySchumacherRN,CDE,MCHES-DiabetesCaseManagerAliciaDeasMSW-ProjectCoordinator/DataManager Christa OhlrichRD,LD-RegisteredDietitian JesseVanderHeideRN,BSN-DiabetesCaseManager

  5. NARADiabetesProgramOverview • Funding: IndianHealthServices(3grants),communitygrant fromKaiser. • Vision:“Workingtowardadiabetes-freefuture” • Target population:AI/AN livinginthegreaterPortland metropolitanarea • Program Purpose:Identifyandscreenthoseatriskfor diabetes, preventordelaytheonsetofdiabetesandmanage orpreventthecomplicationsassociated withdiabetesinour community • Howmanypatientsdoweserve?NARAactivelymanages • 475 patientswithdiabetesand550patientswithpre-diabetes. • NARA DiabetesTreatment&PreventionTeamwasawardedthe • IHSDirector’sRecognitionofExcellenceAwardinApril2012 • for ImprovingQuality&AccesstoCare

  6. NARA DiabetesProgramServices • NutritioncounselingwithaRegisteredDietitian • AppointmentswithaCertifiedDiabetesEducator • Intensive diabetescase-management • DiabetesScreening • SaturdayDiabetesClinics • DiabetesPreventionClasses • DiabetesSelf-ManagementClasses • DiabeticRetinopathyscreening viaJoslinVision • Network (JVN)RetinalCamera

  7. DiabetesScreening • RandomCBG,time sincelast eaten,BMI,andage collectedon every patient 10 yearsandolderatroutine clinicappointments(referredfor further • screeningifabnormal) • Totalof4800peoplescreenedsince • February 2005 • All new patients completea • DiabetesRiskAssessment

  8. DiabetesPreventionProgram(DPP) • Program startedin2005 • Usethe‘NativeLifestyle Balance’ curriculum • 18weekseriesof classes that • focusonhealthyeatingand • increasingphysicalactivity to promoteweightloss and prevent diabetesinhigh-riskindividuals(AI/AN diagnosedwithpre-diabetes). • Classesare heldonTuesday • eveningsat the NARA Clinic. • Monthly ‘aftercore’classesand datacollectioncontinueafter first18 weeksintheprogram

  9. NARADPP Successes 99 5 Participants graduated Patients convertedtodiabetesover 7 years Statisticsshowthat 44 of thesepeople wouldhaveconvertedwithoutany typeof intervention!

  10. DPPKeysto Success • Developingandmaintainingarelationshipandtrust • withparticipants. • Remindercalls/letters for classes • Birthday, holiday,sympathy cards • Includefamily and culture • Photomemory books • Reunionactivities • Acknowledgeachievements,goalsmet • “Halfway to a New You” gathering • “Graduation” at theendof curriculum • Framed certificates of completion • Writtenprogress reportson weightloss, labs, food journals, etc.

  11. DPPKeysto Success • Providetools/smallincentives • Measuringcups, CalorieKing • book • DPPBucks • Provide lightmeal/snacks- • includingtraditionalfoods • Bustickets/gascards • Makelearninginteractiveandfun • Chair aerobicsclasses, fooddemos • Physical activity competition, hulahoopcontest,fruit andvegetabletasting, relaxationsession

  12. Team NARA 2012 • Wewalkto raisemoneyfortheAmericanDiabetes Association(ADA)becausewesupporttheirmission: to preventandcurediabetesandto improvethelivesof all peopleaffectedby diabetes. • TeamNARAwasfoundedin2005 • Fundsraisedto date:over$22,600 • Portland’slargestteam2007-2012(175walkerslastyear!) • HonorableMentioninAdvocacy;ADAJohnPipeVoicesof • ChangeAwardin2010

  13. 11WorkingTowardA [:)iabetesFreeFuture11

  14. Resources • IndianHealthServices,DivisionofDiabetesTreatment&Prevention • www.ihs.gov/MedicalPrograms/Diabetes/index.cfm?module=resourcesFactSheets • UrbanIndianHealthProgramwebsite www.ihs.gov/NonMedicalPrograms/Urban/Overview.asp • UrbanIndianHealthOrganizationDiabetesCare&OutcomesAudit- • AggregateReport2000-2005 • www.uihi.org/wp-content/uploads/2007/07/urban-diabetes-report-2000-2005.pdf • DiabetesPreventionProgram(DPP)OutcomesStudyWebsite www.bsc.gwu.edu/dpp/aboutdpp.htmlvdoc • AmericanDiabetesAssociationwebsite • http://www.diabetes.org/diabetes-basics/prevention/pre-diabetes/pre-diabetes-faqs.html

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