Northeast Louisiana Regional Pre-Diabetes Prevention Program
- Need: To prevent or slow the progression of diabetes for at-risk residents in Rural Northeast Louisiana.
- Intervention: The North Louisiana Regional Alliance developed a program that offers screenings, education, and an intense course for participants throughout the Northeast Louisiana region to lower the risk of diabetes.
- Results: The program saw an overall decrease in blood sugar levels in residents who participated in their initiatives.
Promising (About evidence-level criteria)
Northeast Louisiana is home to five parishes that represent one of the most distressed regions statewide and nationally, with high rates of poverty and unemployment. The Northeast Louisiana Regional Pre-Diabetes Prevention Project (RPDP) serves an area that is sparsely populated where residents have less access and lower utilization of healthcare services compared to the rest of the state.
All five parishes RPDP serves are designated as Medically Underserved Areas (MUAs) and Health Professional Shortage Areas (HPSAs). According to research funded by the Health Resources and Services Administration (HRSA), diabetes was reported as one of the top health disparities in the area. They found that the rate of elevated blood sugars was higher than the national average, and people were not concerned about reducing them.
RPDP was created by the North Louisiana Regional Alliance (NLRA) Health Network in response to medical providers’ growing concerns about the lack of disease prevention and management programs in their rural areas. Using the American Diabetes Association as their guide, they set up a pilot project in Louisiana’s Richland Parish in 2009 and have since expanded to Franklin, Morehouse, Richland, Tensas, and Union parishes with outreach activities reaching to East Carroll, West Carroll, and Madison parishes. RPDP’s goal is to help prevent or slow diabetes progression through:
- Repeat adult screenings over a 3 year period
- Health education that promotes behavioral and lifestyle changes
- Medical management with pharmacological intervention
Partners of RPDP include organizations that are NLRA members, share a desire to implement a diabetes prevention program, and have the capabilities of implementing a project in their respective parishes. RPDP partners include Franklin Medical Center, Union General Hospital, Morehouse General Hospital, Richland Parish Hospital, North LA Regional Alliance.
This program received support from a 2012-2015 Federal Office of Rural Health Policy Rural Health Care Services Outreach grant.
Through a heavy promotional campaign, 64,000 people were exposed to information regarding RPDP’s progressive diabetes prevention track. Below is an outline of their diabetes prevention initiatives.
- Prediabetes screenings – The RPDP sets up screenings in different locations, including local businesses that promote the screenings to the public and their employees.
- Point-of-contact education – Every participant receives health education during the time of their screening, including their current health status and their risk of developing diabetes and other chronic diseases.
- Follow-up testing – If the screening’s result suggests the participant is prediabetic, they are asked to come back for additional tests.
- Pre-Diabetes Prevention Program (PDP) – After a prediabetes diagnosis, an intensive course invites the participant to attend regular health assessments, screenings, personal wellness profiles, health education sessions, one-on-one coaching sessions, and advice on diet and exercise. Participants also receive a monthly newsletter, bimonthly phone calls, and an annual PDP dinner invitation for extra encouragement.
- Certified Diabetes Education Development – This certification qualifies clinicians to offer in-depth education to other healthcare professional on issues including prediabetes diagnoses, treatments, and the risks of type 2 diabetes.
- 1,839 people completed a prediabetes screening, exceeding their original goal by 125% in the second year of the program
- 1,659 screenings were conducted on participants who had never before been screened, of which 10.7% met the preliminary criteria for prediabetes
- Over one quarter (26.7%) of PDP enrollees graduated with normal blood sugar scores
- Nearly 42% of enrollees who were re-screened during the third year of the program had improved A1c (blood sugar) scores, while almost 47% had improved fasting blood sugar levels
- As a result of this project, 3 clinicians became Certified Diabetes Educators and 3 more are currently pursuing certification
- RPDP launched an annual “Grin & Bear It” 5K/10K race in Richland Parish. Local businesses sponsored over 100 runners from all over Northeast Louisiana
- During the program’s second year, the FDA ruled against any off-label (non-FDA approved) use of certain tests. The RPDP complied, but due to higher cost, more stringent screening methods, and longer test-processing times, had to close their prediabetes screenings across the region during the third year of the program.
- Specific processes established by the Richland Parish were difficult to duplicate on a broader scale.
- Commitment from participants was inconsistent. Many who signed up for the PDP course did not take full advantage of the opportunities offered to them.
- Personnel turnover in partner parishes was a continual problem during the grant period
Many of the lessons learned through the RDPD experiences were put into an extensive toolkit that can be accessed upon request. Below are a few of key principles.
- Take the initiative with community partnerships. They will see your dedication, and their trust will be more-easily gained.
- Seek out other prediabetes programs in your area and offer to collaborate with their efforts.
- As you initially collaborate with your partners, decide on a shared mission, vision, and strategic priorities together.
- Engage a program evaluator in the early stages of your planning, and act on their input.
- Rigorously work out your screening model by setting up a pilot program before launching your services regionally.
- Use multi-media avenues, including traditional and social media, in promoting your prediabetes screening and diabetes prevention information to your communities.
- Have experienced staff from your pilot project work side-by-side with new staff, closely training them on how to conduct the screenings.
- When conducting screenings, ask the patient if they are already aware of their blood levels and take time to talk about them. One-on-one education about the dangers of high blood sugar levels is an important aspect in gaining results.
- Use a system that collects and stores data in a way that can be easily retrieved and analyzed.
Charlotte Poland, RN, Certified Diabetes Educator
Richland Parish Hospital
Northeast Louisiana Regional Pre-Diabetes Prevention Program
Wellness, health promotion, and disease prevention
November 6, 2015
Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.