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

Posts Tagged ‘Diabetes Prevention Research’

What is the SINGLE BEST THING WE CAN DO FOR OUR HEALTH?

In Fitness Class on January 25, 2012 at 4:47 PM

Dr. Camp’s Diabetes Prevention Research Featured on MDLinx

In Diabetes Prevention Resources on April 14, 2011 at 6:03 PM

The article ‘Quality improvement in community health centres: the role of microsystem characteristics in the implementation of a diabetes prevention initiative’ in Quality & Safety in Health Care was recently featured on MDLinx.com! MDLinx carries an index of health-related articles for medical professionals. Click here to read the article.

Intake Invitations: See How They’re Done

In Intensive Lifestyle Intervention - General on February 28, 2011 at 3:24 PM

At the Fair Haven Community Health Center, prediabetic patients are invited to participate in the Diabetes Prevention Program research study. If interested, they are randomized, and placed in one of two research tracks – delayed, which means they continue seeing their providers every three months and have a consultation with a nutritionist; or immediate, which means they join an intensive lifestyle intervention modeled after the National Institutes of Health’s Diabetes Prevention Program. Reaching out, explaining, inviting, and solidifying participation in the study is no small task.

This short video gives you an intimate view of the process, and provides the basic tools to be able to replicate the tenants of the invitations.

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.’

FHCHC’s DPP Intensive Lifestyle Intervention – An Overview

In Intensive Lifestyle Intervention - General on December 8, 2010 at 4:01 PM

ILI Overview & Intake Procedure

If a Hispanic woman between the ages of 18-55 has had a blood test in the past three months that has rendered her pre-diabetic, and she is a patient at the Fair Haven Community Health Center, she is eligible to participate in the Diabetes Prevention Program’s Intensive Lifestyle Intervention (DPP’s ILI). There are two study tracks: delayed and immediate. Those randomized to participate in the delayed group see their provider every three months for a year, as well as a nutritionist once during that time. Those in the immediate track participate in a 12-week exercise and nutrition program, seeing a provider weekly and having the opportunity to continue participating after the initial 12-weeks. At the end of one year, all delayed and immediate-track ILI participants have an OGTT screening to distinguish any changes in their physical wellbeing. Those in the delayed group can then enter into the immediate track if they choose. Those randomized to participate in the immediate study group begin their weekly nutrition and exercise classes immediately.

Prior to the randomization process, pre-diabetic patients are invited to the clinic for an intake (click here to see the Intake Checklist). There, their labs are confirmed, vitals taken, and they are given the opportunity to join the ILI study (click here to see intake checklist). These intakes are free, and are scheduled by the DPP staff, rendering most of the process outside the clinic’s traditional admission and billing processes. Typically, the appointment takes around 30 minutes, and is conducted by a trained DPP administrator.

The intention of the intake is to determine whether a pre-diabetic patient is interested in participating in the ILI study, and if so, collect all the essential study data to get them started. The consent form solidifies their participation, after which vitals and other medical-related data is collected, and physical activity and nutrition-related questionnaires are filled out. As part of the initial data collection, patients are also given pedometers and a pedometer tracking form, the data from which will indicate the amount of walking each patient does on a typical weekday or weekend. The DPP awards $10 gift certificates to Walmart if they return the pedometers and the pedometer tracking form after a complete week, a strategy that has fueled participation.

FHCHC DPP OGTT Screening Billing Flow

In OGTT Screening on December 8, 2010 at 1:06 PM

FHCHC’s Diabetes Prevention Program has strived to create a financially sustainable billing system. This is a month in the life of the OGTT billing process.

This document refers to several related documents:

Click here for a sample Encounter Form

Click here for sample coupons

Click here for a sample OGTT attendance, billing, and insulin data spreadsheet

FHCHC DPP OGTT Billing Spreadsheet

In OGTT Screening on December 8, 2010 at 1:06 PM

The FHCHC Diabete Prevention Program maintains spreadsheets for all data to ensure research accuracy. This spreadsheet chronicles the relevant patient, billing, and insulin numbers for all OGTT screening attendees.

For a look at the whole billing flow, click here.

FHCHC OGTT Execution Checklist

In OGTT Screening on December 8, 2010 at 1:03 PM

This checklist is meant to guide DPP staff in conducting a successful OGTT screening.

FHCHC DPP OGTT Billing Coupon System

In OGTT Screening on December 8, 2010 at 1:02 PM

These are the coupons that the DPP staff pastes on Encounter Forms after OGTT Screenings. By using a coupon system, the Billing Department can charge the DPP the amount that isn’t covered by the OGTT screening patients’ insurance.

Click here to see the whole OGTT billing process.

DPP Research Flow: OGTT -> Preventative Interventions -> OGTT

In About the Program on December 8, 2010 at 1:02 PM
%d bloggers like this: