Prediabetes and Evidence-Based Lifestyle Change Program Awareness Campaign

Submission Date: August 2014

Entry Type: Case Study

State/Territory Submitted on the Behalf of: Minnesota

States/Territories Involved: Minnesota

Funding Source: NACDD

Other Funding:

NACDD funding

Domain Addressed:

Environmental Approaches

Public Health Issue:

• 86 million (more than 1 out of 3) American adults have prediabetes, and 9 out of 10 people with prediabetes do not know they have it. Without lifestyle changes to improve their health, 15 – 30% of people with prediabetes will develop type 2 diabetes within five years.
• The Diabetes Prevention Program research study showed that making modest behavior changes helped participants lose 5 – 7% of their body weight and reduced the risk of developing type 2 diabetes by 58% in people with prediabetes.
• Most people with prediabetes do not know they have it and that there is a program that can prevent or delay the onset of diabetes. Raising awareness of prediabetes risk factors and the National Diabetes Prevention Program’s (National DPP) evidence-based lifestyle change program among people at risk for developing diabetes can promote increased used of the lifestyle change program.

Project Objectives:

Increase the number of people living in the 7-county Twin Cities Metropolitan Area who have enrolled in the evidence-based lifestyle change program from 165 to 1,250 by December 31, 2013.

Program Action:

The MN Department of Health (MDH) developed the Prediabetes and National Diabetes Prevention Program Awareness Campaign for implementation in the 7-county Twin Cities Metropolitan Area. This included an overarching campaign for general use and components designed to reach the African American, American Indian, Latino, Asian/Hmong, and Somali communities. The media campaigns included radio, public service announcements, posters, social/electronic media, and bus shelter ads. In addition, “human media” was fostered to carry the messages and stories through person-to-person contact at community events and success stories from evidence-based lifestyle change program participants which is a media strategy identified as being important to the five partner communities.

State Health Department Roles

• Dedicated funding to support formative evaluation necessary to design culturally-specific awareness campaigns
• Involved the community from inception to ensure buy-in
• Utilized an existing relationship with a community leader experienced with traditional and social media campaigns and respected across all cultural communities
• Engaged this community leader to identify trained facilitators who invited participants and led five culturally-specific Community Conversations
• Partnered with five facilitators to plan and implement a Collective Conversation across all five communities, including designing a combined group process that embraced and celebrated each community’s cultural norms
• Provided scientific background and knowledge of diabetes prevention to inform the development of the campaign
• Contracted with communication vendors to refine campaign messages and create materials
• Linked the campaign to other state efforts aimed at recruiting participants to the evidence-based lifestyle change program
• Worked with health clinics to identify and recruit successful participants from the Hmong, Latino and Somali communities to share their experience in the evidence-based lifestyle program for success story videos and posters

Partners

• Team of five community engagement facilitators for the Community Conversations
• I CAN Prevent Diabetes programs in Twin City metro area, e.g. Stairstep and LaClinica
• We Can Prevent Diabetes/Medicaid Incentives for Prevention of Chronic Disease study clinics, program participants and YMCA coaches
• Five communications vendors representing the communities
• Ampers, Diverse Public Radio for Minnesota

Data/Other Information Collected:

To guide the development of the culturally-specific campaigns, the MDH worked with community partners to implement five community conversations, one for each cultural community. Conversations were led by trained facilitators from the communities. Facilitators used either the World Café model or the Circle model. The MDH and the facilitators co-hosted a sixth conversation with representation from all 5 communities to continue the diabetes prevention discussion. The Collective Conversation produced the over-arching message for the general awareness campaign, revealed universal themes of the importance of family, and identified the need to convey messages through personal stories. MDH worked with the facilitators to identify respected communication agencies to develop and deliver the campaign messages. In 2014, a seventh conversation was held to show the original community participants the resulting outreach efforts and materials. These conversations created a sustainable community engagement process centered in the community’s culture and built on trust.

“To enroll multicultural communities in diabetes prevention, take the time to engage the community and listen. Help people take ownership of preventing diabetes for themselves, their families and community. All communities told us they want to hear stories and be in diabetes prevention groups with people who look and sound like them. They listen from their hearts to people who come from the world they live in. Their hearts, not their heads, will motivate them to make lifestyle changes.” -Rita Mays

Impact/Accomplishments:

• 7 Community Conversations with 244 participants; 1 additional conversation planned
• 7 Marketing campaigns
  • 875,000 adults with prediabetes living in the geographic area covered by these campaigns
• 4 DPP Participant Success Story Videos: Hmong, Latino, Somali, American Indian
• Patient and provider materials about prediabetes and the DPP
• Consumer prediabetes website with sections for each community

Challenges/Lessons Learned:

Factors Supporting Success

• Dedicated Funding: $36,464
• Trust and interest from the five communities
• Experience with the evidence-based lifestyle change program
• Established connections with clinic and community organizations offering the program
• Awareness of cultural commonalities and differences
• Access to respected leaders in cultural communities willing to partner to address diabetes prevention
• Engaged stakeholders from the beginning and secured their buy-in
• Recognized communities as strong partners who understand the seriousness of diabetes
• Directed funding to engage the communities, resulting in culturally-acceptable campaigns
• Tailored approach to invite community members to provide input
• Listened to each community and acted upon their suggestions
• Recognized the importance of “human media” as a way to support traditional and social media
• Developed ways to sustain the campaign by increasing community capacity and assuring ownership

Challenges and Solutions

• Challenge: State contracting procedures took longer than expected and impacted start up
  • Solution: State staff, contractors, and community partners willing to complete the work in a shortened time period
• Challenge: The one-year project time-frame was short for full implementation of the campaigns
  • Solution: Planned to use other funds to continue campaigns through 2014
• Challenge: Identifying vendors within each community was often a challenge, as contact persons or information was not always accessible
  • Solution: Used information at hand and built new relationships with vendors
• Challenge: Vendors recommended social/electronic media to reach their communities, but the state’s websites were not designed for community users
  • Solution: Developed a consumer web page with separate, culturally unique pages for communities to post stories and information in their own languages

Program Areas:

Diabetes

State Contact Information:

MN
Gretchen Taylor
Minnesota Department of Health
651-201-5390
gretchen.taylor@state.mn.us

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