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Q-and-A: How the CDC encourages community-based diabetes prevention

4 min read


From 1995 to 2010, diabetes rates increased 50% or more in 42 states and 100% or more in 18 states, according to research by the Centers for Diseases Control and Prevention. Researchers say that until community programs are in place to reduce obesity and prevent diabetes, rates likely will keep going up. We spoke with Sue Shaw, public health adviser with the CDC’s Division of Diabetes Translation, about how the CDC is working to prevent diabetes and how its National Diabetes Prevention Program is bringing evidence-based lifestyle change programs to communities around the U.S.

What is the National DPP’s role in establishing community-based programs to reduce diabetes rates?

The National DPP has established the National Diabetes Prevention Recognition Program, which was launched in early 2012. The purpose of DPRP is to recognize organizations that have demonstrated their ability to effectively deliver a proven, type 2 diabetes prevention lifestyle intervention. As of November, more than 200 organizations have applied for pending recognition. Six organizations were funded on Sept. 30 to implement the four components of the National DPP and work with their existing networks and affiliates to establish lifestyle change programs for populations at high risk for type 2 diabetes. The result will be the establishment of a sustainable network of organizations delivering an evidence-based lifestyle change program (based on part of the Diabetes Prevention Program study) that has proven to prevent and/or delay the onset of type 2 diabetes by almost 60%.

How are programs funded?

Previously, the Division of Diabetes Translation provided funding to the Y-USA through the Pioneering Healthier Communities [program]. As a result of the funding, 9,000 persons with prediabetes participated in the Y lifestyle change program in 29 states and over 900 lifestyle coaches have been trained to deliver the program. Initial funding for the Pioneering Healthier Communities was through a cooperative agreement with CDC. In the future, we anticipate that lifestyle change programs that have received CDC recognition will be sustained by third-party payers based on a pay-for-performance model of reimbursement.

Where are new programs being planned?

The new programs are expected to be established in approximately 25 states. Grantees are working with the National DPP to finalize the locations. To date, 9,383 participants in communities across the U.S. are enrolled in or have completed the core sessions of the lifestyle change program. The mean weight loss achieved for those attending nine or more of the 16 core sessions is 5.1%.

How can communities or the National DPP address cultural differences?

The Diabetes Prevention Program, the clinical research trial sponsored by [the National Institutes of Health] and supported by CDC, upon which the National DPP is based, was effective with both males and females and all ethnic groups. Lifestyle coaches who facilitate discussions based on the lifestyle curriculum are encouraged to use culturally specific examples and tools to emphasize lifestyle change. Both the lifestyle change curriculum and participant handouts have been translated into Spanish. Two Somali communities, in Minnesota and Washington State, have trained Hmong (Somali workers) to go out and lead the lessons in Somali with their individual Somali groups. They plan to develop visual and oral aids to complement the hands-on training, since the Somali are a very oral, visual group, we’re told.

What roles do nurses, dietitians and other health care professionals play?

The lifestyle change program can be implemented by trained health professionals and lay health workers. Nurses, dietitians and other health care professionals are key sources of referrals of people with prediabetes to the community-based lifestyle change program. These health care professionals can also serve as lifestyle coaches.

Are there any longer-term, 5- or 10-year goals for reducing diabetes and/or obesity?

Continued scaling and sustaining of the National DPP in communities across the country will increase access to the evidence-based lifestyle change program for people at high risk for type 2 diabetes. In addition to the National DPP, communities are encouraged to make environmental changes and create policies to support lifestyle change to make the healthy choice the easy choice.