Developing Community-Based Programs For People With Diabetes
Developing Community-BasedPrograms for People with DiabetesAn Introduction for Community Based Organizations
Using this training This is a printable version of the “DevelopingCommunity Based Programs for People withDiabetes” training. It has all of the information included in the onlineversion. Words and phrases that are underlined will bedefined on the following page. Communities in Action Stories and the Tools andResources Handout are provided in a separate file. You can:– Print out a copy to take notes while you take the onlineversion of the training.– Save a copy to use as a reference later.
Learning ObjectivesBy the end of this training you will be able to:1) Describe the role of community-basedorganizations in providing support to peoplewith diabetes.2) Describe the steps involved in planningcommunity-based diabetes activities.3) Identify resources to support planning,implementing, and evaluating communitybased diabetes activities.
What do you think your organization cando to help people with diabetes?1.I don’t know. I didn’t think there was anything we coulddo to help.–2.I think we can do something. But where do we start?–3.Part 1 of this training will provide an introduction to the kinds ofeducation and support people with diabetes need. You will learnabout the important roles organizations like yours can play.Part 2 of this training will review strategies used by communitybased organizations to support people with diabetes along withkey steps in planning diabetes programs. You will learn about howto get started.We know we can help. We need effective resources thatwill help us make a difference.–Part 3 of this training will direct you to tools designed to helpcommunity-based organizations plan and do diabetes activities.
Community-based organizations play animportant role in the lives of people withdiabetes.This training will introduce you to the important rolethat community-based organizations play inhelping people with diabetes lead healthier lives.You will learn about strategies that have beenshown to help improve the health and quality of lifeof people with diabetes, and you will be introducedto tools and resources to help you get started.
Main MenuYou can go through all three sections, or pick thesection that will meet your needs right now. Completeall 3 sections to earn continuing education credit.1) Part 1: Education and Support for People withDiabetes– An overview of the kinds of education and support neededby people with diabetes.2) Part 2: Planning Community-Based Activities– An introduction to the strategies used by community-basedorganizations to support people with diabetes.3) Part 3: Tools and Resources– Tools designed to help community-based organizationsimplement diabetes activities and programs
Part 1: Education and Support forPeople with Diabetes
My name is Susan. I have diabetes. I am one of the estimated 29million Americans who livewith diabetes. What do you think is on myto-do list for today?
My to-do list probably looks a lot like yours.But, on top of everything else, I have to takesteps each day to manage my diabetes.To-Do Pay bills Get laundry Pick up kids. Check blood sugar (glucose). Check feet. Walk for 30 minutes. Take my medicine. Go to eye doctor. Go to Diabetes self-managementclass.
My list includes things I have to doevery day, like checking my bloodsugar, taking medicine, eatinghealthy foods, and getting physicalactivity along with managing myblood pressure and cholesterol.I have to learn to solve problems,find healthy ways to cope with mydiabetes, and take steps to reducemy risk for complications fromdiabetes.I must also be sure to receiveregular preventive care for my teeth,eyes, feet, and kidneys.To-Do Pay bills Get laundry Pick up kids. Check blood sugar(glucose). Check feet. Walk for 30 minutes. Take my medicine. Go to eye doctor. Go to diabetes selfmanagement class.
Diabetes is serious. While heart disease is the leading cause of death forpeople with diabetes, it can affect every part of mybody. Diabetes can lead to complications like:––––eye diseasekidney diseasenerve damagefoot sores and amputations People with diabetes are also more likely to sufferfrom depression than people without diabetes.
Diabetes is also expensive. My medical costs are more than twice as high asa person without diabetes. It is estimated that the total cost of diabetes inthe U.S. in 2012 was 245 billion dollars.
Managing diabetes is not easy, but with theright care and support I can do it!Like everyone with diabetes, I must: Learn about diabetes.Learn how to take care of my diabetes.Learn to cope with living with diabetes.Get routine medical care.With the right support and care I can managemy diabetes and lower my chances forcomplications.
Managing diabetes is a team effortManaging diabetes is ateam effort that involveshealth care providers,diabetes self-managementeducation, family andfriends and communitysupport.You have already learnedabout what I must do totake care of my health. Inthis section you will learnabout more about eachteam member’s role insupporting me.In this section, you willlearn about the roles of:1. Health Care Providers2. Diabetes SelfManagementEducation3. Communities4. Family and friends
I am Susan’s primary health care provider. I am responsiblefor managing her medical care.I diagnosed her diabetes. I also prescribe her treatments andset goals for her health.These goals include helping her manage her A1C, bloodpressure and cholesterol.During Susan’s regular visits, I will monitor her health to helpreduce her chances of getting complications. If she doesdevelop complications I will provide treatment or send her to aspecialist.To learn more about recommendations for diabetes managementdownload Tips to Help You Stay Healthy with Diabetes help-you-stayhealthy.pdf.
A1C The A1C is a blood test that measures a person'saverage blood sugar level over the past three months. Youneed to know your blood sugar levels over time because youdon’t want those numbers to get too high. High levels ofblood sugar can harm your heart, blood vessels, kidneys,feet, and eyes. Blood pressure is the force of your blood against the wall ofyour blood vessels. If your blood pressure gets too high, itmakes your heart work too hard. It can cause a heart attack,stroke, and damage your kidneys and eyes. Cholesterol is a waxy, fat-like substance that your bodyneeds. There are two kinds of cholesterol in your blood: LDLand HDL. LDL or “bad” cholesterol can build up and clog yourblood vessels. It can cause a heart attack or stroke. HDL or“good” cholesterol helps remove the “bad” cholesterol fromyour blood vessels.
Health Care ProvidersThere are many different health care providers who supportpeople with diabetes. Doctors, nurses/nurse practitioners and physician’s assistants helpmanage the general care for people with diabetes. Diabetes educators and community health workers help people withdiabetes and their families learn about how to manage diabetes andhow to find resources in the community. You will learn more aboutboth in the diabetes education section. Pharmacists help manage medications and provide advice. Somepharmacists teach Diabetes Self Management Education. Eye doctors, dentists and foot doctors check for diabetes relatedcomplications related to the eyes, teeth and feet.
Health Care ProvidersThere are many different health care providers who supportpeople with diabetes. Some people with diabetes may also need to see specialistslike a kidney doctor or diabetes specialist. They help preventand manage diabetes-related complications Dieticians help people with diabetes learn to manage theirdiabetes through healthy eating. Social workers help people with diabetes and their familiescoordinate medical care and may help with other issues likeinsurance. Mental health professionals may help people with diabeteslearn to cope with the emotional side of living with diabetes.
Working with health care providersSusan needs to keep track of her medical appointmentsand the treatments her health care providers recommend.She keeps detailed records of how she is managing herdiabetes to share with her providers.Diabetes self-management education is where she learnedmany of these steps to manage her diabetes.To learn more about the health care team, click here to download, “I CanControl My Diabetes By Working With My Health Care Team!” care-sheet-and-patientcare-checklist-en.pdf.
I am Susan’s Diabetes Educator.Diabetes self-management education or DSME is whereSusan learns to manage her diabetes. This includeslearning how to:– Make plans for healthy eating and being more active;– Check her blood sugar and take her medications;– Solve problems that may come up in managing herdiabetes;– Cope with the stress of diabetes; and– Reduce her risks for diabetes complications.I am guided by Susan’s needs, goals and experiences tobe sure she learns the skills she needs to manage herdiabetes. In general, people who go to diabetes selfmanagement education programs do a better job ofmanaging their diabetes than people who don’t.
People with diabetes are usually referred toDSME by a doctor.DSME is conducted as a group class or one-onone and can take place in a doctor’s office, ahospital or clinic, or in a community setting.The classes may also include family members.They are led by a health care professional orcommunity health worker who has training indiabetes education. Some people who leadDSME are known as Certified DiabetesEducators.
What is a community health worker (CHW)?Community health workers are people who are trusted members of the communities theyserve. They work with people to increase their health knowledge and ability to use healthservices. They do this through activities such as outreach, community education, informalcounseling, social support, and advocacy. Community health workers serve as a linkbetween people in the community and local health services to improve the quality andeffectiveness of those services. A community health worker may also be called acommunity health advisor, outreach worker, community health representative, promotora/promotores de salud (health promoter/promoters), patient navigator, navigator promotoras(navegadores para pacientes), peer counselor, lay health advisor, peer health advisor, orpeer leader.What is a Certified Diabetes Educator (CDE)?A CDE is a health care professional like a registered nurse, pharmacist or registereddietician who has training and experience in prediabetes, diabetes, and diabetesmanagement. A person who wants to be a CDE must have training in diabetes andteaching people how to change their behavior. He or she must also have at least 2 years ofexperience in their profession and 1000 hours teaching diabetes self-management. Oncethe person has met the education and experience requirements, he or she can take a testthat is given by the National Certification Board for Diabetes Educators. CDEs mustcontinue to teach and take classes in order to keep their certification. To learn more aboutCDEs visit the National Certification Board for Diabetes Educators merfaqs/)
Is diabetes education only for people whohave just been diagnosed with diabetes?No. People with diabetes will find their needschange over time.They may have new medications, new toolsto use, or new issues they need to learn tomanage.I am a resource whenever they need helplearning to manage their diabetes.
What is an accredited or recognized selfmanagement program? A DSME program that has been:– Accredited by the American Association of DiabetesEducators, or– Recognized by the American Diabetes Association Recognition or accreditation shows that theprogram is based on research in managingdiabetes and behavior change Recognized programs use a curriculum thatmeets the National Standards for DiabetesEducation.
About the National Standards forDiabetes Education The National Standards for Diabetes Education define what shouldgo into a quality DSME program including:–––––how the program should be organized and coordinated,who should lead the courseswhat the courses should teachhow the program should manage patient follow-upquality control. There are ten standards a program must meet in order to beaccredited or recognized. To learn more about DSME and DSME curricula, visit the DiabetesSelf Management Education Resource athttp://www.chronicdisease.org/?page DiabetesDSMEresource
Why go to an accredited or recognizedprogram? They are shown to improve health and lowercosts. They meet the National Standards for DiabetesSelf Management Education Medicare and many private insurers requireAADE accreditation or ADA recognition forpayment.– Medicaid may pay for accredited/recognized DSME insome states
Medicare is a health insurance program forpeople age 65 or older, people under the age of65 with certain disabilities, and people of allages who have permanent kidney failure thatrequires dialysis or a kidney transplant. Medicaid is a health insurance program for lowincome, non-elderly parents or caretakers,pregnant women, and other non-disabled adults.
I work at a community-based organizationin Susan’s neighborhood.We want to be part of the team thatsupports Susan and her family becausewe are a trusted source of information, andwe understand their values and customs.Since we understand our communitymembers, we are able to provide supportthat is meaningful and familiar.
Community-Based OrganizationsMy organization provides Susan and her family witheducational activities, support groups and resources ina place they already go on a regular basis.We also link them to local resources like places to beactive, get healthy foods, or get needed health care.Some community organizations support accredited orrecognized DSME programs by: Promoting DSME to their members Offering space for DSME Providing community health workers or peercounselors to teach classes Becoming a provider of accredited or recognizedprograms
Community-Based OrganizationsSometimes people want to make a healthy choice likedrink water instead of a sugary drink or go for a walk afterdinner.But if the place where they live, work, worship or play doesnot have these options, it can be hard for them to make thehealthy choice.My organization takes action to create an environmentwhere our members have access to healthy foods, drinksand places to be physically active.Learn more about strategies for community-basedorganizations and worksites in part 2 of this training.
Community-Based OrganizationsWhat we do does not replace educationand care from health careprofessionals.We reinforce what Susan is learningfrom health care professionals, supporther in making healthier choices, andlink her to needed resources.
Family and FriendsSocial support from my family and friends is very important.Think about the changes I have to make to manage my diabetes.Family and friends who are supportive and helpful can make iteasier for me to make these changes.For some people, loved ones may have to help take care theirdiabetes.It is also important for anyone who supports a family member orfriend with diabetes to learn about the disease and to work with theirloved one to find ways to support them.
Family and FriendsThere are many ways family and friends support lovedones with diabetes.1. Provide encouragement–Susan’s loved ones can let her know they are proud ofthe steps she’s taking to manage her diabetes, be ashoulder to cry on when she gets frustrated and supporther goals by being active with her and making healthyfood choices.2. Provide practical support–Practical support is help with everyday responsibilitieslike giving Susan a ride to the doctor, or watching herdaughter so she can go to her DSME class.
Family and FriendsThere are many ways family and friends support loved ones with diabetes.Click the link or type the number to learn more.3.Learn what to do in an emergency–4.It is important for the people closest to Susan to learn about diabetes becausethey may be the first to notice if she is having a problem like low or high bloodsugar. If they learn the warning signs and what to do in an emergency, theycan help keep her safe.Attend DSME or support groups– Family members may be able to attend diabetes self management educationclasses with their loved one to learn more about managing diabetes. Somesupport groups also include family membersFor more tips, download, “How to Help a Loved One Cope with Diabetes” tail.aspx?PubId 45.
Where should Susan go?Susan is having some issues. Where can she go for help? Match the issue with theperson Susan should ask about it.1. Susan’s eyesight isblurry.2. Susan is not sure how touse her new glucometerto check her bloodsugar.3. Susan and her husbandwant to join a walkinggroup for people withdiabetes.A. Diabetes EducatorB. Health care providerC. Community-basedprogram
Where should Susan go? Answers1 B The changes in Susan’s eyesight could be due to herdiabetes. She should see her eye doctor (a health careprovider).2 A Susan’s Diabetes Educator can help her learn to use hernew glucometer.3 C Susan and her family can learn about practical ways tomanage her diabetes from a community based program.Promoting local places that are safe for getting physical activityor holding walking groups are the kinds of activities a communitybased organization can do.
Summary Health care providers, diabetes educators,and community-based organizations canwork together to help improve the health ofpeople with diabetes. Your organization can be an important part ofthis team for your members with diabetes.
Part 2: Planning Community-BasedActivities
Planning community-based activitiesIn this section you will learn about:1. The kinds of activities community-basedorganizations do to help people with diabetes.2. Important areas to pay attention to whendeveloping diabetes activities.
There are many important ways communitybased organizations help people with diabetes.These include:1. Promoting healthy living2. Providing links to recognized or accrediteddiabetes self management education3. Creating healthy environments
Promoting healthy livingActivities that promote healthy living increase theknowledge and skills of community members to makehealthy choices.There are many ways to promote healthy living including:1. Awareness raising activities2. Educational programs3. Support groups
Promoting healthy living, continued1. Awareness raising activitiesActivities that raise awareness include promoting messagesabout healthy living during events and in other resources likenewsletters, giving people health information, and promoting thebenefits of making healthy choices.Activities that raise awareness are an important first step ingetting community members to think about their health and waysthey can improve it.These kinds of activities also make people aware of resourcesand programs that can help them change their behavior.
Promoting healthy living, continued2. Educational programsEducational programs go a step further than awareness raisingactivities by teaching people skills that can help them makehealthier choices.Educational programs include workshops, cookingdemonstrations, and physical activity classes. Any programwhere people can learn a skill, practice it, and get feedbackabout how they are doing can be an educational program.Educational programs can be one-time sessions or a series ofclasses that meet over time. For teaching skills that help peoplewith diabetes manage their illness, having classes that meetover time i
Community health workers serve as a link between people in the community and local health services to improve the quality and effectiveness of those services. A community health worker may also be called a community health advisor, outreach worker, community health representative, promotora/ promotores de salud (health promoter/promoters .
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