lions district 24-a and the american diabetes association national capital area team up to stop...

Lions District 24-A and The American Diabetes Association National Capital

Area

Team up to

Stop Diabetes® and Blindness

1

Diabetes Association Diabetes and Outreach Pilot Outreach

Pilot ProgramLCIF Core 4 Diabetes GrantMay 2012-June 2013

Lions Core 4 Diabetes Project Lions Preventive Health Screenings and ADA Diabetes/Wellness Education for Underserved Northern Virginian Communities

2

Project Team:

•American Diabetes Association•LCIF•Lions of District 24-A & C•Fairfax County Department of Health•Walgreens•Amerigroup of Virginia•Diabetes Research and Wellness Foundation•Fairfax County Department of Neighborhood and Community Services•Arlington County School and Community Health•United Community Ministries•Hispanic Institute for the Prevention of Blindness•Arcadia Mobile Market•Uno Translations

3

The Lions Diabetes Awareness and Action Program Mission Statement is:

“To conduct and support local and large-scale effort leading to the control and treatment of diabetes and its complications through education, prevention and research.”

The Mission of the American Diabetes Association is:

“To prevent and cure diabetes and to improve the lives of all people affected by diabetes.”

90% of Adult Onset Blindness is caused by POORLY managed diabetes

4

“The partnership between the Lions Clubs, ADA and the Fairfax County Health Department is an example of organizations that recognize that they have shared interests and goals and the way to achieve these goals is by working together”James Copeland, Former Director of Community Health Development and Preparedness at the Fairfax County Health Department

5

From 1995 to 2007, the Virginia population increased by 16%...

Diabetes prevalence increased by 95%.

An estimated 466,883 adult Virginians had diagnosed diabetes and another estimated 233,441 had undiagnosed diabetes.

6

http://www.vdh.virginia.gov/ofhs/prevention/diabetes/documents/2012/pdf/2008%20Diabetes%20Burden%20Rpt_rev%20FINAL.pdf

Why Start in Northern Virginia if Prevalence Rates are Higher Elsewhere?•Volunteer Supply•ADA Office•Connection to Fairfax County Department of Health•Concentrated network of non-profits•Black and Hispanic populations

7

8http://www.vdh.state.va.us/healthpolicy/documents/health-equity-report-08.pdf

9http://www.vdh.state.va.us/healthpolicy/documents/health-equity-report-08.pdf

Lions Preventive Health Screenings

&

American Diabetes Association Diabetes/Wellness Education

10

Lions Clubs Participating in The LCIF Core 4 Diabetes Pilot Project

Clubs Participating

Stafford County Lovettsville

Fairfax Host Greater Falls Run

Reston Lake Ridge

Manassas Lioness Lions Vienna Host

Aquia Harbor Evening Alexandria Asian American

Fort Belvoir Aquia Harbor Host

Arlington South Westmoreland

Bailey’s Cross Roads Alexandria Watergate

Clifton Burke

Sterling Tyson Corner

Gordonsville-24-C Lake of the Woods-24-C11


Pilot ProgramScreening Components– Consent– Diabetic Retinopathy Screening– Blood Pressure– Blood Glucose– Local medical and community services information,

follow-up reminder postcards– BMI

12


Pilot ProgramScreening Components– Type 2 Diabetes Risk Assessment Survey– Health Information: Nutrition, Exercise, Diabetes, Heart

Disease by ADA Diabetes Ambassadors– Drug Discount Cards and “I have diabetes” bracelets – Walgreens Free Flu Shots through 1/13– Amerigroup of Virginia activities for kids and prizes as of 2/13– After screenings, participants who were recommended to

care receive follow-up calls

13

Non-Mydriatic Canon CR-2 Mobil Retinal Imaging Solution

14

n n

The Need for Diabetes Education

“Diabetes is increasing at an alarming rate globally. It is a complex, chronic condition that affects all areas of a person’s life and that requires high quality care. To this end, diabetes education is of critical importance and should be considered an integral part of diabetes prevention and care. Unfortunately this is not the case in many countries of the world where diabetes education is, at best, in its infancy or non-existent. The combination of lack of access to quality medical management and diabetes education leads to poor clinical outcomes, reduced quality of life and high health-related costs due to service utilization and the costs of treatment.”– International Diabetes Federation

16


Pilot ProgramBecoming an Ambassador

Must sign a commitment contract agreeing to teach 2-8 workshops per year and complete a training course. Anyone over the age of 18 can lead these workshops. No medical background is required.

Training Process

Length of training process can vary

depending on trainee’s background.

For someone without any medical

background, the training is typically

a total of 4-6 hours.

17


Pilot ProgramAmbassador Responsibilities

–Become familiar the American Diabetes Association’s mission, programs, and events

–Complete diabetes/wellness volunteer ambassador training

–Organize schedule of 2-8 diabetes/wellness workshops and submit schedule

–Distribute promotional materials for workshops

–Conduct 2-8 diabetes/wellness workshops per year

–At each diabetes/wellness workshop, distribute and collect attendance sheet and relevant pre-/post- questionnaires.

–Submit attendance sheet and completed questionnaires after each workshop.

18


Pilot ProgramADA Provides–Initial and ongoing training (as necessary)–Workshop implementation guides–Powerpoint presentations for each diabetes/wellness educational workshop in English and/or Spanish–Detailed curricula for each diabetes/wellness educational workshop in English and/or Spanish–Promotional items for workshops (flyers to advertise each workshop)–Educational materials for workshop participants–Pre-/post-questionnaires and attendance sheets for each workshop

19


Pilot ProgramADA Diabetes Ambassador Program Curricula

Por tu Familia• Latino population• All materials available in English and Spanish• 6 workshops• Community centers, churches, schools

http://www.diabetes.org/in-my-community/programs/latino-programs/por-tu-familia.html

20






Pilot ProgramADA Diabetes Ambassador Program Curricula

Project Power• African American population• Faith-based curricula to guide conversations about diabetes

and healthy living within church community• Curricula incorporates biblical passages• 6 workshops, ea. 1-1.5 hrs

http://www.diabetes.org/in-my-community/programs/african-american-programs/project-power.html

21






Pilot Program

22

ADA Diabetes Education Implementation

•Completed 10 ADA Ambassador training sessions•5 ADA workshops taught•3 more Ambassador training sessions scheduled•Monthly/weekly workshops to be taught by trained ADA Ambassadors starting in April:

• Bailey’s Community Center• Wilson Community Center• Lincolnia Senior Center• James Lee Community Center• Lovettsville Schools• Arlington County Clinic• UCM Creekside• Christ the Redeemer Church• InterChurch Community Health Initiative Churches

Completed screenings

Place Population Town County Date

24-A Fall Conference (trial-run)

District 24-A Lions Herndon Fairfax 10-6-2012

United Community Ministries

UCM Clients-Primarily Latino

Alexandria Fairfax 10-20-2012

FACETS FACETS Clients- Primarily Asian

Fairfax Fairfax 11-3-2012

Carlin Springs Elementary

Arl County Parents- Primarily Latino and African

Arlington Arlington 12-1-2012

Knights of Columbus Hall

Latino church-members Manassas Prince William 12-8-2012

Westmoreland Dept Health and Human Services

Rural community Montross Westmoreland 1-5-2013

23

Results at Halfway Point

24


Pilot Program

26

Participant Age

***no data collected at District 24-A Conference screening

27http://cj-network.org/cj/wp-content/uploads/2011/05/VALatinos2011WelCoopCenter.pdf


Pilot Program

28

Participant Gender



Pilot Program

29

http://www.vdh.state.va.us/ofhs/prevention/diabetes/documents/2011/pdf/factsheets/Diabetes%20Prevalence/Prevalence%20of%20Diabetes%20in%20VA.pdf


Pilot Program

30

Gestational Diabetes



Pilot Program

31

Family History of Diabetes(mother, father, sister, brother)



Pilot Program

32

Hypertension Diagnosed by Physician



Pilot Program

33

Prehypertensive/Hypertensive Range with No Known History of Hypertension

***hypertension=140+systolic or 100+diastolic (AHA)***prehypertension=120-139systolic or 80-89 diastolic (AHA)


Pilot Program

34

Blood Pressure Results

***hypertension=140+systolic or 100+diastolic (AHA)***prehypertension=120-139systolic or 80-89 diastolic (AHA)


Pilot Program

35

Participant Blood Sugar Levels

***Random Blood Sugar Normal: 80-139 mg/dl Diabetes: 200mg/dl and above (Diabetes Research and Wellness Foundation)


Pilot Program

36

Physical Activity Participation



Pilot Program

37

Weight Ranges from Risk Assessment Survey



Pilot Program

38

Participant BMI Results


Pilot Program

39

Participant Type 2 Diabetes Risk Test Results

***score of 5 or higher qualified for being at increased risk for type 2 diabetes


Pilot Program

40

Diabetic Retinopathy Screening Results

Image Type Quantity

Excellent/good images 27

Fair/poor images 14

Inconclusive findings 10

Diabetic retinopathy 3

Macular degeneration 6

Hypertensive retinopathy 3

Normal 16


Pilot Program

41

Diabetic Retinopathy Screening Results

• 25 individuals were referred for further evaluation. • Lack of quality in 10 images could be the result of

inadequate skill of the photographer or a lack of clarity due to an eye problem or pupil size.

• 20% of known diabetics being screened by the camera have diabetic or related complications in the eye.

• Other eye problems (i.e. optic nerve atrophy, retinal infarcts, macular degeneration, and glaucoma) were found.


Pilot Program

42

Follow-up Calls Results (Data is Incomplete at this Time—34 of 106)


Pilot Program

43

What We’ve Learned So Far• Flu shots are a great incentive for early fall screenings—pre-November• Strong partnerships with county governments, businesses, and local

charities are critical for project success• Turnout diminishes in colder months (not a surprise)• If no incentives are offered outside of medical services in more rural

areas, turnout is very low• Monthly ADA workshops are most-feasible for volunteers• Host-organization community influence and trust is critical to good

turnout• Spanish-speaking volunteers are highly valuable• Turnout is greatest in Hispanic communities• Kid-friendly activities needed to attract families• Direct referral system would be highly beneficial to participants with

abnormal results at screenings• Postcards have not been an effective way of tracking participant follow-

up, calls most effective

Future screenings

44

Place Population Town County Date

Lincolnia Senior Center

Seniors, Latino Population, Uninsured

Alexandria Fairfax 3-30-2013

Our Lady of Angels Catholic Church

Latino congregation Woodbridge Fairfax 4-20-2013

Huntington Community Center

Latino clients Alexandria Fairfax 4-27-2013

Lovettsville Game Club-Lovettsville Cares

Rural community Lovettsville Loudon 5-4-2013

Arlington Arlington Arlington 5-11-2013

United Community Ministries-Creekside Community Center

Latino community Alexandria Fairfax 5-18-2013

Year-end Project EvaluationHow many people were screened?

What was the health profile of screening participants?

How many people were referred to see a health care provider due to abnormal screening results?

How many people followed-up with a health care provider?

How many diabetes education programs were held? How many people attended?

Final Report to LCIF due on 6-22-2013

45

What does this all mean?

What do we do from here?

46

Resources:

Our Blog: www.lc4dp.org

www.valions.org

www.diabetes.org

Like us on Facebook and follow us on Twitter!

47

Questions

48

lions district 24-a and the american diabetes association national capital area team up to stop...

Documents

diabetes prevalence

diabetes grant

managed diabetes

treatment of diabetes

cure diabetes

undiagnosed diabetes

lions diabetes awareness

diabetes pilot project