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

Posts Tagged ‘Health’

FHCHC DPP Partners with Wholesome Wave and City Seed to Provide Farmer’s Market Vouchers to Patients!

In About the Program on March 28, 2012 at 3:07 PM

This summer, FHCHC’s Diabetes Prevention Program is partnering with City Seed and the Wholesome Wave Foundation to provide farmer’s market vouchers to our patients. The program is called the Fruit and Vegetable Prescription Program (FVRx), and aims to improve health through access to farmer’s markets.  Medical facilities across the country will be participating this year in the program, and measuring the effects on patient health through the 4-month market season.

Frederico Corazzini - Photographer

The FVRx program is perfectly aligned with our commitment to utilize innovative and practical strategies for improving the health of our patients. Obese children constitute the index patient – however, each of the index patients’ fellow household members receive $1/day each as well for use at the farmer’s markets. This feature of the program further supports the FHCHC DPP’s commitment to treating the entire household unit, and strays from traditional medical models that focus exclusively on the individual patient. Because diet-related chronic diseases often develop in the home, programs that include all household members tend to produce better results!

For more information on the FVRx Program, go to: http://wholesomewave.org/fvrx/

For more information on FHCHC’s farm-based activities, check out New Haven Farms: newhavenfarms.org

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Diabetes Prevention Program Nutrition Classes & Cooking Demonstrations

In Nutrition Class on February 17, 2012 at 5:56 PM

Since 2007, the Fair Haven Community Health Center’s Diabetes Prevention Program (FHCHC DPP) has offered 1-hour nutrition classes once per week for participants in the 12-week Intensive Lifestyle Intervention. The nutrition curriculum is based on the National Institutes of Health’s Diabetes Prevention Program curriculum, amended by the University of Pittsburgh to fit larger groups, and further translated to fit FHCHC’s particular low literate and predominantly Latino population. Classes are taught by FHCHC DPP clinicians, and are delivered in both English and Spanish. Bilingual PowerPoint presentations and handouts support participants in understanding the content of each session, while detailed facilitator scripts and facilitator guides support facilitators in addressing the widely diverse needs and experiences of participants. Cooking demonstrations and discussions are an experiential learning component of each class, and foods prepared each week reflect the ripe produce harvested that week from the program’s garden. Between 10-20 adults attend classes on a weekly basis, and often that same group stays the next hour for a professional trainer-led exercise class. Children attend their own exercise classes during the adult nutrition and exercise classes, while infants and toddlers attend onsite childcare. Aligned with the notion that diabetes is a family-oriented disease, when one patient is invited to attend nutrition classes, DPP staff invites members of the patient’s family to attend as well.

OGTT Sketch

In OGTT Screening on February 10, 2012 at 11:18 AM

Some drink the Glucola solemnly, obediently. It’s unclear whether they know the full extent to which we are testing their health status this morning. Others seem somewhat nervous, and still others chat away cheerfully until their name is called for the needle and flat orange sugar drink event.

The kids are restless, sucking on the backs of chairs as they watch the phlebotomy, or any sign of movement in the room.

The best is the tough guy with the mohawk. His name is called and he stays sitting, in a sheepish stand-off with the clinician’s assistant. And then, as he eventually pulls his tee shirt up over his tattooed forearm, he describes how much he hates needles.

Amazing how for style or nostalgia, an inked needle is welcome! And for an oral glucose tolerance test, it is so thoroughly resisted.

And yet resistant or not, bored or cheerful, nervous or curious, the 21 adults and their families present today will leave here with knowledge of diabetes, their risk, and some implementable-tools for improving the quality of their health. Cheers to them!

Tatoo!

OGTT!

Where have all the Registered Dietitians Gone?

In About the Program on February 6, 2012 at 4:55 PM

Interestingly, the Fair Haven Community Health Center has struggled to find a registered dietitian (RD) for our Diabetes Prevention Program vacancy. At the outset, we had no concerns about our ability to obtain qualified candidates. And yet, as search stretched from weeks to months, we discovered that we were sorely mistaken. It turns out that a “Bilingual (Spanish/English) Registered Dietician” is a rare commodity.

Why, we wondered, is it that bilingual dieticians are scarce?

Theory: the return on investment is too low.

Many folks coming from underprivileged backgrounds are interested in working in the health field. When they explore their options, two professions seem to fit their criteria: becoming a nurse and becoming a registered dietician. There is a demand in the market for both, the living is decent in either case, and in each profession provides an opportunity to make a difference in people’s health. So how do they choose?

They look at the cost and duration of each degree.

At Gateway Community College, located not far from the Fair Haven Community Health Center, a state resident can earn an associates nursing degree in 2 years, or 4 semesters, for a grand total of $6,192. This is one of many community, state, and private institutions that offer nursing degrees.

Now take a registered dietitian degree. First off, there is just one such program in Connecticut, located in Storrs at UCONN. In order to earn this degree, read the following passage taken from the program website:

To become an RD, a student must earn a four year degree and complete a didactic program in dietetics that is accredited by the Commission on Accreditation of Dietetic Education(CADE).  Upon completion, a verification statement that verifies you completed a didactic program in dietetics.  You are then eligible to apply to a supervised practice program, also called a dietetic internship that is accredited by CADE.  An internship typically lasts 9 months and consists of at least 1200 supervised practice hours in the field.   Upon completion of an internship, he/she is able to sit for the national registration examination administered by the Commission on Dietetic Registration (CDR). http://www.canr.uconn.edu/nutsci/nutsci/dietetics.html

Four years of study at $8,256 equals $33,024.

Now look again at your choices: two years to become a practicing nurse in the field for $6,192, OR a minimum of 4 years plus a 9-month internship to become a registered dietitian, at a minimum cost of $33,024.

You may be thinking yes, but I can make a lot more money as a registered dietitian once I have the degree! Think again. A registered nurse makes between $21-$45/hour. An RD earns between $15-$36/hour.

There may be many reasons that people become registered dietitians; but cost and duration of the degree are certainly not two of them. The result of these aggravating factors is a scarcity of registered dietitians. Those who are bilingual often come from economically disadvantaged conditions, and although they are precisely the kinds of job candidates we are searching for, they are the people who can scarcely afford the 4 years 9 months and $33,024 cost of becoming registered dietitions.

 

 

A Real Garden Tour Video Adventure!

In Community Garden, Intensive Lifestyle Intervention - General on January 13, 2012 at 6:00 PM

Watch the Fair Haven Community Health Center Diabetes Prevention Program Program Coordinator and Garden Manager give you a virtual tour of the program garden! It’s almost as awesome as being there physically.

http://youtu.be/IqVGRVhzAa0

Parade Magazine Features Dr. Anne Camp and the Diabetes Prevention Program!

In About the Program on May 16, 2011 at 11:06 AM

Check out the Diabetes Prevention Program and our health hero Dr. Anne Camp in Parade Magazine‘s most recent issue!

http://www.parade.com/health/stay-healthy/2011/05/15-health-hero-camp.html

With 7 million readers nation-wide, we hope the article brings awareness to the opportunity of preventing type 2 diabetes.

Photo Food Diaries

In Food Diaries, Nutrition Class on March 29, 2011 at 10:22 AM

The FHCHC Diabetes Prevention Program is testing the effectiveness of photo food diaries, and comparing the results with written food diaries. According to the NIH:

“All participants are asked to record their intake daily…because of the extensive evidence that self-monitoring is highly correlated with success in reaching dietary change goals. Numerous studies have shown a dose-response relationship between frequency of self-monitoring and level of success in losing weight and/or improving cardiovascular risk factors. Many experts consider self-monitoring the single most effective approach to changing dietary intake.” NIH DPP

For many FHCHC DPP participants, writing their daily food intake and the amounts of those foods they consume, occurs as very challenging. Indeed, it is rare that 100% of participants present their food diaries in any given week. Knowing the importance of self-monitoring, and the challenging nature of food diaries for our participants, we handed out disposable cameras with explicit directions on how to document their food consumption. Use the flash! Take a picture of everything you eat, even if it’s a snack or beverage. Bring it back next week.
Below are some examples of the photos women took in the first couple weeks of their participation in the FHCHC DPP program. In a week, participants will return their second set of disposable cameras, and the Lead Provider and nutritionist will analyze the results to see whether photo food diaries are a more effective self-monitoring strategy than written food diaries. They will look at rate of return, as well as glean any changes in food consumption that may have taken place since the first couple weeks of the program.

 

 

 

 

 

Diabetes Prevention Programs: Not a One-Hit-Wonder

In About the Program on December 21, 2010 at 5:06 PM

This morning, traditional irrigation was replaced by gardeners’ tears. It’s no secret that around these parts, people’s lives are tough. That their stories are not surprising, however, doesn’t make them any less disturbing. It seems as though the garden fosters candor rarely found outside the doctor’s office. Tearing out dead hot pepper plants, Mirabelle was through suppressing her tears; a son unjustly incarcerated, a mother crippled by diabetes, and a friends’ children wondering where their recently deceased father has gone.

Being the Communications Manager for the Diabetes Prevention Program, my attention was momentarily diverted when she expressed her dismay at the 4 year old’s weight. Her recently deceased friend left behind a wife, 4-year old boy, and 10-year old girl. At the funeral, the boy was hungry. Mirabelle’s funeral pictures revealed the grave, the family in mourning, and the boy at work on a monumental sandwich. ‘Solo come, Rebecca. Esta engordando mucho.’ He only eats, Rebecca. He’s gaining a lot of weight.

In other words, diabetes is complex. The disease is bred from the full spectrum of life’s challenges. Diabetes prevention, therefore, is equally complex. It does not – it cannot – stop at exercise, nutrition, or gardening classes.

Are You There? 2 Solutions for a Common OGTT Recruitment Breakdown

In OGTT Screening on November 9, 2010 at 4:23 PM

It’s been two weeks and Eva is making her third attempt to reach Sandra. Referred by her provider to get screened, Eva sits looking dejected in front of the referral note (click here for the OGTT recruitment write-up script).

Out of 20 referrals, Eva typically reaches five. The remaining 15 are unreachable – either not home or sporting a disconnected phone number. Eva leaves a message with those who have answering machines or someone capable of taking a message. Two or three will return her message. Now, what happens with the remaining 12 or 13 patients who were never spoken with after their provider wrote them an OGTT referral? Herein lies the rub.

A note is written on their referral form, and it is returned to the chart, filed away until the patients’ next scheduled PCP appointment. When is that appointment? Someday (indeed, elusive someday) in the future.

The problem with this scenario is not colossal: if the PCP has an urgent concern for the patient’s blood glucose level, they schedule an individual OGTT screening lab for that week as opposed to writing a group OGTT screening referral. An emergency, therefore, is not the problem. The main drawbacks of this system are as follows:

1) If the provider requests additional blood tests, like TSH, on that referral form, those requests are lost.

2) The elusive someday is truly elusive; for one reason or another the patient might not return to the clinic for years, by which time their prediabetes could easily have metamorphosed into type 2 diabetes.

A simple solution to this systems breakdown is to file the referral form into the referring providers’ folders after our Diabetes Prevention Program staff has finished with them, instead of into patients’ charts. Providers would then have the opportunity to see and, most importantly, react to the outcome of their referral request – whether that be to send a letter out themselves to those who were unreachable or note that the patient is scheduled for their screening.

Possible solution #2 is to attach a scheduling form to each referral form. In the moment that the provider chooses to refer the patient to a screening, a date and time would thereby be assigned. Both the scheduling and referral forms would get routed to the DPP office, and the DPP staff would take it from there, ensuring that the patient was set up to attend the screening.

Hope for Diabetes Prevention Grows in Chabaso’s New Haven Garden – Press Release

In About the Program on November 4, 2010 at 5:02 PM

Click below to read a comprehensive view of Chabaso and the Fair Haven Community Health Center’s partnership.

News Release

Contact: Dorothy Radlicz
203.562.9007 x838
dradlicz@chabaso.com

Hope for Diabetes Prevention Grows
in Chabaso’s New Haven Garden

New Haven, Conn. (October 8, 2010) – Chabaso Bakery and Fair Haven Community Health Center have partnered to prevent diabetes in the Fair Haven neighborhood of New Haven, with a new garden and education program to promote healthy lifestyle habits among people at risk.

Fair Haven Community Health Center (FHCHC) is a not-for-profit health care organization providing primary care and a full spectrum of community wellness programs in the surrounding underserved neighborhood.  Alarmed by diabetes rates approaching an epidemic scale among younger individuals, FHCHC medical professionals founded the Diabetes Prevention Program in 2007 as a family-focused lifestyle intervention program.  Through nutrition and physical education classes, participants battle a calamitous disease that many forget or don’t know is treatable and preventable.

The Diabetes Prevention Program starts by screening all at-risk patients of the FHCHC identifying those individuals most likely to contract the debilitating and deadly disease. The second phase of the prevention program engages whole families, enlisting children and parents to learn about diet and nutrition, exercise, and other aspects of healthy lifestyles. This program was initially funded by Connecticut Health Foundation and is now part of a larger research study with the Donaghue Foundation-supported Yale Center for Clinical Investigation.

According to Anne Camp, MD, the Director of FHCHC’s unique family-oriented Diabetes Prevention Program, “We’ve added an innovative community gardening component to our strategy.  People with borderline diabetes can become members of the garden by planting, weeding, and taking home a share of the harvest. As an added benefit, the garden provides at-risk patients of all ages with plenty of healthful exercise, as well as education about nutrition-packed vegetables not ordinarily found in this area of the city.”

The Garden itself embodies the vision of local New Haven entrepreneur and community benefactor, Charles Negaro, owner of Chabaso Bakery. Mr. Negaro designed this garden adjacent to his artisan bakery some years ago.  “It was intended to provide healthy food for bakery employees,” Negaro said. “Realizing that the garden required more than part-time attention, I began searching for volunteer gardeners from the community. At the same time, Dr. Camp was looking for a garden space not too far from Fair Haven Community Health Center.” Conveniently, the Diabetes Prevention Program fit right into Chabaso’s neighborhood gardening initiative. Gardening has since become a mainstay of family health, fitness, and fun at FHCHC.”

“It has been proven that high-risk individuals can delay or avoid developing Type 2 Diabetes through regular physical activity and a diet low in fat and calories,” said Rebecca Kline, Diabetes Prevention Program Communications Manager at FHCHC, and FHCHC/Chabaso Community Garden Manager. “We are reducing the prevalence of Type 2 Diabetes here in New Haven,” Ms. Kline reports. “In an urban area where 88% of the population lives below the federal poverty level, and fresh produce is an anomaly, it is not an easy task to stay healthy. Access to tasty, fresh veggies, knowledge of their nutritional and dietary value, beneficial gardening exercise and awareness of the implications of diabetes have been combined to successfully reduce the risk of diabetes among program participants.”

Improved access to nutritious foods through the garden, and comprehensive lifestyle education are signs of a win-win health intervention. The program aims to expand participation, garden acreage, and influence throughout the neighborhood.

For more information on the FHCHC/Chabaso Community Garden, contact Rebecca Kline, Garden Manager, at rebkline@gmail.com

To make a donation to the FHCHC Diabetes Prevention Program go to this web link:https://www.justgive.org/basket?acton=donate&ein=06-0883545
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Chabaso Bakery was established in New Haven, Connecticut in 1995. The local community recognized the outstanding taste and bona fide quality of the bakery’s bread and sustained the fledgling business. Using authentic old-world ovens, only the best natural ingredients and no trans-fats, founder Charles Negaro, and some very talented bakers, set out to match the best ciabattas, loaves, batards, rolls, Stix™, baguettes and boules in the world. Today Chabaso breads are available fresh every day in small food stores and large supermarket chains along the US east coast. For more information call (203) 562 9007, or visit online at www.chabaso.com

http://www.chabaso.com/index.php?mact=News,cntnt01,detail,0&cntnt01articleid=54&cntnt01detailtemplate=press_releases&cntnt01returnid=133

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