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DIABETES PREVENTION AT THE STREET LEVEL DIABETES PREVENTION PROGRAM YMCA OF GREATER LOUISVILLE APRIL 14, 2011. Steve Tarver, President/CEO Erin Brown, Association Wellness Coordinator. 14.6 million diagnosed with diabetes. 6.2 million with un-diagnosed diabetes.
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DIABETES PREVENTION AT THE STREET LEVELDIABETES PREVENTION PROGRAMYMCA OF GREATER LOUISVILLE APRIL 14, 2011 Steve Tarver, President/CEO Erin Brown, Association Wellness Coordinator
14.6 million diagnosed with diabetes 6.2 million with un-diagnosed diabetes 54 millionwith pre-diabetes
THE PROGRAM 1. The Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6);393-403 2. Ackermann, R., Finch, E., Brizendine, E., Zhou, H. & Marrero, D. 2008. Translating the Diabetes Prevention Program into the Community: The DEPLOY Pilot Study. American Journal of Preventive Medicine. 35(4); 357-363.
YDPP • 16 – week program • 1 hour per week sessions • Participants track intake and fat grams • Participants weigh in weekly • Sessions focus on • Diet • Exercise • Behavior Modification • Primary Goals • Reduce body weight by 7% • Participation in 150 minutes of PA per week • Maintenance classes • Similar structure to core classes • Meet 1 per month
CLASSES • First groups began in July 2009 • Greater Louisville has now had 41 groups • Sites include • Downtown, Northeast, Southeast, Oldham County and Bullitt County Family YMCAs • Family Health Center-Portland • University of Louisville • University Hospital • Norton Hospital • Total of over 260 Participants enrolled
MEASURING SUCCESS • Attendance • Weight Reduction • Evaluation Surveys • Done at Week 8 & week 16
QUALITATIVEEVALUATIONS • Most important thing they have learned • “ Portion control”, “ Daily exercise is very important” , “To keep trying” • Changes made • “Eating more fruits and veggies ”, “ Plan out lunches” , “ Portion control” • Challenges • “Time”, “ Self”, “eating out” • Benefits to being in the program • “Lost weight”, “ More energy” , “Access to YMCA” , “Eliminated a lot of muscle/joint pain”
QUALIFICATIONS Participants must be at a high risk of developing type 2 diabetes. This is determined by the following qualifications.
IT’S ALL ABOUT THE REFERRALS! OPTIONS: Physician fills out with patient and sends directly to the YMCA Physician gives to patient to either… Fill out and send directly to the YMCA Or, use contact information to contact program coordinator
METHODOLOGY • Each session topic-focused • Participant driven • 20% facilitator • 80% participant • Open dialogue • Goal setting & tracking • i.e., fat grams vs. calories, carbs
CHALLENGES • “My weight has been the same for years.” (but, not my body comp. . . I can float now.) • “My blood levels elevated, but not increasing.” (well, stick around. Other risk factors?) • “Everyone around me looks the same as I do.” (Is the bar set high enough?)
CHALLENGESMale vs. Female • Speculate: Support-Group environment not attractive to men • I’ll do it myself. • Ignore the stress – even though it aggravates the condition, especially over time. • No symptoms, therefore no problem.
CHALLENGES • Methodology is too benign. • Give me the answer, pill, shot. . . • Not “medical enough” • You mean it’s my responsibility to change?!