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

Posts Tagged ‘Lifestyle Intervention’

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.

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.

 

 

Community-Based Participatory Research Overview

In Intensive Lifestyle Intervention - General on October 24, 2011 at 2:17 PM

Guest blogger Rosette Chakkalakal will be posting updates on the Community-Based Participatory Research project that she is managing with the FHCHC DPP and Yale’s Bright Bodies Program. This post is an overview of the research so far:

We are using a community-based research approach to conduct a program evaluation of Fair Haven Community Health Center’s (FHCHC) Diabetes Prevention Program.  Our team includes program leadership and staff from the FHCHC Diabetes Prevention Program (DPP), the Bright Bodies program, and the Robert Wood Johnson Foundation Clinical Scholars Program at Yale.   The program evaluation specifically focuses on making the program more family-centered and improving the quality of the self-monitoring aspect of the program.  Over the summer, our project team met several times to review the processes and goals of each program and find opportunities to incorporate additional “family time” activities in each session.  Some of these activities include family food tastings of healthy recipes and exercising together.  We also devised a strategy to encourage participants to self-monitor their physical activity using quality improvement techniques to attain a goal of having 50% of our participants return their exercise diaries by the end of the 12-week program.  Right now, we are meeting twice per month to think about how these new interventions and strategies are working as we implement them with the current participants of the programs.  We are constantly thinking of ways to adapt the program to make it better—for example, we haven’t seen many of the participants return their exercise diaries so we will now be giving out “Bright Bodies Bucks” to participants who return their diaries that we will then use to enter them in raffles.  We also realize that right now, we only receive feedback from the program leaders regarding these new elements of the curriculum.  We will start handing out brief “activity evaluation” forms to the participants so they can tell us what they think of the programs as well.

Bright Bodies Bucks

In Intensive Lifestyle Intervention - General on October 24, 2011 at 2:14 PM

A Bright Bodies “Buck” is basically a raffle ticket.  We will have a raffle twice per each 12-week session.  When a participant in the Bright Bodies program does the following, they earn a buck (raffle ticket) towards a raffle prize:

  1. Weigh the same weight as you did the week before (i.e., don’t gain weight)
  2. Weigh less than you did the week before
  3. Bring in your exercise log for the staff to review

___________________________

Congratulations, you’ve earn a:

BRIGHT BODIES BUCK

 

NAME __________________

Photo Food Diaries – Do You See Any Difference In Food Intake?

In Food Diaries on May 2, 2011 at 1:18 PM

The photos below were taken by the same people , once in the first few weeks of the FHCHC DPP and once in the last few weeks.
Do you see any differences?

January 2011 Participant #1

March 2011 Participant #1

January 2011 Participant #1

March 2011 Participant #1

January 2011 Participant #2

March 2011 Participant #2

January 2011 Participant #2

March 2011 Participant #2

January 2011 Participant #3

March 2011 Participant #3

January 2011 Participant #3

March 2011 Participant #3

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.’

January 9, 2011 Intensive Lifestyle Intervention Group – The Players

In Intensive Lifestyle Intervention - General on January 18, 2011 at 10:59 AM

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!

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.

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