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March Partner Spotlight

Frederick County Health Department Utilizes NDEP’s Power to Prevent Curriculum in Diabetes Prevention Program

Participants graduate Diabetes Prevention Program

Background

In November 2009, the Frederick County Health Department launched Power to Prevent, a lifestyle diabetes prevention program that utilizes NDEP’s Power to Prevent: A Family Lifestyle Approach to Diabetes Prevention curriculum. The overall goal of this program is to reduce the burden of chronic disease by preventing or delaying the onset of type 2 diabetes and preventing or delaying health complications associated with type 2 diabetes. People with and at risk for type 2 diabetes are eligible to join the program. Funding for this initiative was made possible by a three-year grant received from the Office of Chronic Disease Prevention of the Maryland Department of Health and Mental Hygiene. To achieve the overall goal, the Power to Prevent program has two primary objectives:

  • Overweight participants lose 5 to 7 percent of their weight. Normal weight participants maintain their weight.
  • Participants are moderately physically active for at least 30 minutes a day, five days a week.

The program’s third and less central objective is to get participants to see their health care providers for follow-ups and for those who are without a medical home to get them connected with a health care provider.

Participants attend one two-hour class per week for 12 weeks. Thirty minutes of class are dedicated to doing low-impact physical activity. Groups are co-led by a community lay educator and registered dietician (RD). Each participant also receives two individual sessions with the RD and is contacted by the department’s health access coordinator to ensure all participants have seen their health care provider in the past year or are connected with a provider if they do not have one.

The Frederick County Diabetes Coalition serves as the Advisory Committee for this project. Support and in-kind services are provided by at least 10 different community organizations/groups:

  • New Dimension Worship Center
  • Frederick County Extension Office
  • Frederick Memorial Hospital Stroke Program
  • Frederick Memorial Hospital Diabetes Program
  • The Y
  • If the Shoe Fits
  • Mission of Mercy
  • Hillcrest School Based Health Center
  • Menocal Family Practice
  • Centro Hispano

Lessons Learned

Some of the lessons learned and modifications made to NDEP’s Power to Prevent curriculum include:

  • Use of a co-leader model for the entire 12-week program. A RD and community lay educator share responsibility for teaching each class lesson. More technical and complicated subjects are assigned to the RD.
  • In addition to the 12 weeks of classes, participants are eligible for two individual nutrition counseling sessions with the RD.
  • Class lessons are augmented with additional handouts. All handouts are also available in Spanish and information on certain subjects of interest, such as whole grains and healthy fish choices, have been added.
  • Thirty minutes of each two-hour class are dedicated to doing a low-impact physical activity.
  • Based upon participant feedback concerning tracking physical activity and foods eaten, participants are now routinely provided with websites where they can track this information online. Program leaders are also in the process of developing a more user-friendly hard copy tracker. In their experience, participants have a more difficult time recording foods eaten verses physical activity, so they continue to offer encouragement, support, and improved tools and resources. They also offer incentives based on how well participants track these activities and complete their weekly pledge.
  • Participants have consistently given high marks for the grocery store tour, which they do for each 12-week cycle, the expert guest speakers, and the simple message of the program “Small steps lead to big rewards.”
  • Additionally, participants have stated how important it is that the program is offered for free. Many have stated they simply would not have taken the class if there was a fee. Participants have also reported that the group support and accountability (discussion of food and physical activity trackers) influenced their behavior in positive ways.

Evaluation Results

One of the program’s primary objectives is that overweight participants lose 5 to 7 percent of their weight, and normal weight participants maintain their weight. The RD measures change in participants’ weight based on data collected pre-program, post-program and three months post program.

Based upon results from the 57 graduates who have completed pre/post program weight measurements, 18 percent of graduates lost 5 percent or more of their weight or maintained a normal weight. Among those who lost weight, the average weight loss was 3.2 percent. The number of graduates who lost any amount of weight was 82 percent. Using their pre-session weight as a benchmark, 79 percent of the 33 graduates who completed the three-month follow-up, have maintained their weight loss.

A second primary objective is that participants are moderately physically active for at least 30 minutes a day, five days a week. Participants complete a pre/post survey, which measures time and level of physical activity. Participants use food and activity trackers to record what they eat and their daily level of activity.

Based upon results from the 68 graduates who completed pre/post surveys, participants who engaged in 30 minutes or more of moderate physical activity or 20 minutes or more of vigorous physical activity per day, at least five days per week improved from 35 percent pre-program to 57 percent post-program.

For more information about this program, contact Angela Blair at ablair@FrederickCountyMD.gov.


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