1. Piecing the puzzle together: The National Diabetes Prevention Program
Jamie Francis, RN, ADN, BSW
Morgan County, KY Diabetes Coalition

2. Pieces of the puzzle: Decide to offer the National DPP
Secure funding source
Recruit trained lifestyle coach
Advertise cohort meeting details
Screen and select participants
Initiate National DPP cohort
The decision can be made by individual, but there is strength in numbers, so if multiple individuals make the decision to begin DPP there is momentum for your cohort. Funding can be secured through grants, local health departments, private pay, and some insurance companies. A trained lifestyle coach is needed to facilitate the cohort. Training is usually 2 days and can range from $50-$750. The trained coach does not have to be a licensed person (RN, RD, etc.) This past year, the Kentucky Diabetes Prevention and Control Program (Program within the Kentucky Department of Public Health) was able to receive a grant which allowed for DPP coach trainers to come to Kentucky. Trainers were located at various regions throughout our state on 3 different dates and an online training was offered as well. Due to the grant received by KY. Individuals were able to apply for and attend a coaches training for $50 per person. This afforded 3 more individuals in Morgan County to be trained as a lifestyle coach. Advertisement is essential to attract participants to your cohort. Look for ways to advertise for free in your community’s local media outlets. Develop a screening tool to collect basic demographic/program relevant data. If individuals do not meet CDC criteria for blood glucose/A1C/GDM, then a CDC risk assessment tool may be used to identify if the individual has positive risk factors. Use caution though, at least 50% of your cohort participants must be eligible based on either blood test indicating prediabetes or a history of GDM. Once all of the above are completed, a location, time, and date(s) for the cohort must be determined. Now you are ready to begin your DPP cohort.

3. Decision to offer DPP:
A “no-brainer” to offer DPP in Morgan, County, KY because. . .
No existing DPP cohorts offered in Morgan County, as of January 2016
Only 1 trained lifestyle coach available to Morgan County
Morgan County is part of the “Diabetes Belt” identified by CDC
Estimates concur 1 in 3 Americans have prediabetes
90% of adults with prediabetes don’t know they have it and/or have not been diagnosed
According to the CDC, 15-30% with prediabetes will develop Type 2 diabetes within 5 years without any intervention.
Often, individuals don’t know they have prediabetes because there are no symptoms. Latest data shows that approximately 86 million American adults have prediabetes. These individuals are also at increased risk for heart disease and stroke.

4. Funding:
Morgan County Diabetes Coalition applied for a grant through Marshall University to offer DPP.
Application accepted-grant awarded.
Collaboration with local entities sharing established resources
Utilize grant funds to: train additional lifestyle coaches, purchase curriculum materials, and continue of DPP offerings in Morgan County, KY.
Grant: Appalachian Diabetes Control and Translation Project Strengthening Grant through Marshall University Center for Rural Health.
Collaboration: Lifestyle coach, meeting space, curriculum materials, etc.

5. Lifestyle Coach:
No initial cost to Morgan County Diabetes Coalition for a DPP Lifestyle Coach.
Diabetes Nurse from the local health department is a member of diabetes coalition and had previously been trained as a Lifestyle Coach
Morgan County now has 3 more trained DPP lifestyle coaches!!!
3 new individuals in Morgan County, KY, all representing different community entities, have been trained as DPP lifestyle coaches, since April 2016.

6. Advertise!!!!
The DPP cohort must be advertised in as many media outlets as possible to reach the public.
Utilize as many community resources as possible
Morgan County Diabetes Coalition advertised via: local newspaper, Cooperative Extension Service newsletters/FaceBook/website, radio PSA, local t.v. station, and posted community flyers at local businesses. Additional avenues might include: church bulletins, bank marquees, etc

7. Select Participants:
Interested individuals inquiring about the DPP cohort, should be selected based on established CDC criteria or a positive risk assessment
It is at the discretion of the lifestyle coach, the number of participants to include in the cohort.
Usually keep each cohort at participants. Some will drop from the cohort for various reasons, so you still want to allow for enough to collect data for reporting purposes, if you entity is seeking CDC recognition for their DPP.

8. Missing Pieces:
If one or more pieces of your puzzle are missing, it will be hard to complete the project.
If no lifestyle coach available to launch a DPP cohort, individuals don’t have access to this lifestyle intervention program. If no funding, it’s hard to get a program launched. If no advertising, your DPP program may not have many participants. So all components fit together, just as a puzzle, to create a desired outcome.

9. Ready, Set, Go!!!!
Once group members have been identified and enrolled, it is time to launch your DPP cohort.
Reach out to others for support, once you launch your DPP. You may seek support from your local coalition, local health department, local providers for referrals, other lifestyle coaches, and CDC technical assistance support providers.

10. Looking Forward…
Although the decision to initiate DPP can be overwhelming, remember with diligent planning and preparation, we will impact prediabetes, one puzzle piece at a time, in each of our communities.

11. Success:
Commitment and support from each individual member of your diabetes coalition and local community is key!!!!!
Thoughts, questions, comments…..

12. Questions, Thoughts, Comments?????

13. Thank You!!! Morgan County, KY Diabetes Coalition
Jamie Francis, RN, ADN, BSW