Come Exercise with Us! FHCHC DPP’s Exercise Class Video!

Check out the FHCHC DPP’s latest video, and do the health-enhancing exercise video with us! No fancy equipment or space needed!

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

Bike Day!

In October 2011, the Fair Haven Community Health Center’s Diabetes Prevention Program (FHCHC DPP) expanded its exercise, nutrition, and gardening classes to engage in a one-time bicycle education program. Paul Hammer, local bicycle advocate and active member of the New Haven Bike Collective (http://www.newhavenbikecollective.com), volunteered his time to supply two DPP families with retrofitted bikes, helmets, and an educational ride down the Farmington Canal trail (http://www.farmingtoncanal.org).

On the sunny afternoon of October 16^th, the two participating DPP families met two FHCHC staff members, Hammer, and two volunteers from Farnam Neighborhood House, Liz Gambardella, Executive Director, and Frank Redente, Program Director, at the Winchester Avenue entrance to the canal trail. There, the participants were fitted with helmets while Paul demonstrated basic bicycle safety guidelines. Soon afterwards, the group of 14 adults and children set off on their adventure. Some walked their bikes, holding small sons and daughters at the same time and enjoying the beautiful trail and company. Some rode ahead and turned back to meet the group a couple of hours later. Paul took frequent opportunities to explain the historical plaques along the canal, and to provide bike coaching.

At the end of the day, satisfied with an afternoon of group exercise, all participants were given the bikes to take home with them as a gift from the New Haven Bike Collective. The helmets were provided and then donated to the participated DPP families by Elm City Cycling (http://elmcitycycling.org).

Paul Hammer teaching bicycle safety pre-ride

Paul Hammer instructing DPP staffer Mari Montosa on fitting helmets

DPP staffer Mari Montosa fitting helmets

FHCHC staffer Emily Swenson fitting DPP participant with Helmet

Helmet spray painted by local artist James Capuras

Brandon showing off his riding skills

DPP participants ready to ride!

The beautiful, donated New Haven Bike Collective bikes

January 9, 2011 Intensive Lifestyle Intervention Group – The Players

The FHCHC Diabetes Prevention Program has launched its latest Intensive Lifestlye Intervention! It’s a strong group, half of whom are returning to participate again from previous programs. Below are the players, adults and children, whom we will follow via video for the next 12 weeks. Whoo hoo!

FHCHC’s DPP Intensive Lifestyle Intervention – An Overview

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.

Diabetes Community Partnership Guide | NDEP

This diabetes prevention and education resource articulates many of the processes central to the success of our Diabetes Prevention Program. From statistics to strategies for preventing or controlling diabetes through physical activity and community organizing, the guide is in-depth and simple.

Download it here:

Diabetes Community Partnership Guide | NDEP.

Diabetes Prevention Program Video Overview

Watch this exciting video for an overview of the Fair Haven Community Health Center’s Diabetes Prevention Program:

You can also watch the video on our Youtube page here:

http://www.youtube.com/watch?v=96NbJR0p-2g

How to Introduce Food Diaries to Diabetes Prevention Program Participants

Elizabeth begins cultivating Diabetes Prevention Program participants’ investment in using Food Diaries from Session I.

“Not knowing exactly what you eat or how much you exercise every day is like trying to buy a bicycle without knowing how much money you have in the bank; you wouldn’t know how much to spend, save, or borrow! Being aware of what you ate yesterday, however, makes it possible for you to know what would be wise for you to eat today. Knowing how much you exercised yesterday makes it easy for you to decide how to exercise today.”

People’s interest is peaked at this point, but owning the Diary as their personal tool for healthy living is not yet present.

“What did you eat for breakfast yesterday, Lucy?”

“A piece of toast.”

Elizabeth nods solemnly. ” Thank you! A piece of toast. Anything else?”

“Um, a cup of coffee also.”

“Thank you!” Elizabeth smiles. ” Anything else?”

Elizabeth teaches Diabetes Prevention Program participants how to use Food Diaries

“No. I don’t think so.” Lucy responds quickly.

The whole group is now listening intently, suspicious of Elizabeth’s grin and apparent enthusiasm.

“Was there anything else you had for breakfast yesterday?” She asks.

Lucy, somewhat surprised, takes a moment to think. “Ah yes, I had a glass of orange juice. I think I also tasted my mom’s torta.”

Elizabeth turns to the rest of the group, and declares with compassion and intensity, “It is difficult to remember what we eat, isn’t it? For that reason, it is sometimes easy to fool ourselves when it comes to our own health. But you ladies are committed to living long and vital lives, no?” Everyone concurs. “I am going to therefore provide you with a tool to use for the next 12-weeks of the program and on an ongoing basis as well. It’s called the Food Diary.”

Elizabeth then gages one of the more important factors influencing the efficacy of the Food Diary tool: participant literacy rate. Although their ability to use the Food Diaries will become abundantly clear within the next few weeks, she likes to get a general sense of people’s comfort levels from the start. “Who here likes to read or write?” A few people raise their hands. Elizabeth, in true form, thanks them for their candor.

At this point everyone is given a Food Diary, and Elizabeth proceeds to describe how to fill it out. Because the assignment is so unfamiliar and often jarring for people in the beginning, Elizabeth requests that they simply document the contents of their meals and physical activities from day to day. She coaches them to ignore portions and nutrition facts for the time being.

Elizabeth closes that component of the class with a reminder that using the Food Diary is central to avoiding diabetes, and their participation is correlated closely with their success in the program.

Food Diaries – What are They and Why are They Important in Diabetes Prevention?

A food diary is a simple notebook that participants use to declare their short-term physical fitness and dietary goals, daily exercise regimen, and food and beverage intake. Distinct from the recall method, where subjects chronicle their activities on a weekly or even monthly basis, studies have shown that lifestyle interventions are more effective when subjects account for their performance on a daily basis.

It is important to note here that the Food Diary does not single handedly change dietary and physical fitness behavior; nor is it presented as such by the program administrators. Indeed it is one of a series of interventions, the combination of which make the Diabetes Prevention Program as successful as it is.

The following english version of a food diary comes directly from the NIH:

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Elizabeth explains how to use a Food Diary to DPP participants

From the Classroom to the Garden to the Plate: Using Greens

Approximately two weeks into planting, I quickly realized that as wonderful as it was to have program participants involved in the garden, the harvest would be futile unless they knew what to do with the goods!

In response, we created the ‘Veggie of the Week.’ Elizabeth explains the nutritional value of a given crop on the Monday night Nutrition and Exercise class, we harvest said vegetable on Tuesday, and hear their feedback on Friday.

Last and this week’s theme was Greens.  One participant named Mary (for the purpose of this blog) said she loved the chard. She ate it raw like I recommended, in a sandwich. At the mention of kale, however, Mary’s nose scrunched up like she was smelling something stinky. ‘Too bitter’ she said. When I recommended honey, SHE explained patiently to ME that they were not supposed to eat a lot of sugar.  I revised my suggestion, obediently; ‘Garlic!’ I exclaimed. ‘Try it with garlic and a tad olive oil and salt.’  With slightly less conviction she said they weren’t supposed to eat a lot of salt, but quickly followed with a promise to try it.

View this document on Scribd

View this document on Scribd