Ending Type 2 Diabetes One Exercise, Nutrition, and Gardening Class at a Time

Not Giving Up, Even After 4 No-Shows

In Intensive Lifestyle Intervention - General on February 22, 2011 at 2:46 PM

I couldn’t figure out why all the intake equipment was set up in the conference room. It was a typical day in the Diabetes Prevention Program; soup being served that raises funds for the garden, administrators talking to Yale about the joint child-obesity program, patients calling throughout. Intakes usually take place before the start of a new Intensive Lifestyle Intervention, when the program needs to be filled with those whose results from OGTT screenings placed them in the category called prediabetic. We were six weeks into our twelve-week program, however. Hardly the time to begin filling the next program.

Mari flies in the office door, her scrubs swishing against a busting notebook. She mumbles to herself, ‘She’s not here!’

I couldn’t help but ask.

‘It’s the intake I had scheduled. This patient isn’t here…again.’

‘Again?’

‘She’s been scheduled four times.’

Mari picked up the phone with resolve. She plays with the patient, in a stern voice informing her of the missed appointment, and then laughing with compassion as the patient realizes her folly on the other end of the line. When they get off the phone, I ask how they decided to resolve the patient’s continued absence.

‘I’m going over to her house to do the intake.’ Mari exclaims proudly, like a woman who’s taken fate by the horns.

I couldn’t help wondering why – with 15,000 patients at FHCHC, how has this particular patient instigated a home visit? And what is Mari’s motivation for persisting?

‘It’s hard.’ She explained. ‘Weather, wrong numbers, messages left without call-backs. It’s difficult to generate participation. So when someone is interested and simply can’t get here, I’ll take an extra step.’

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