Increasing Minority Participation in the National DPP
Submission Date: July 2018
State/Territory Submitted on the Behalf of: North Carolina
States/Territories Involved: North Carolina
Funding Source: CDC, State/local sources
CDC Funding:Yes
CDC Funding (Specified):(1305) State Public Health
Other Funding:State funding
Domain Addressed:Community-Clinical Linkages
Public Health Issue:Type 2 diabetes occurs unequally among racial and ethnic groups in North Carolina. For example, almost 15 percent of African-Americans and 19 percent of American Indians in North Carolina report a diabetes diagnosis (2012 data), compared to slightly less than 10 percent of non-Hispanic whites.
About 630,000 residents of North Carolina report having prediabetes, a condition which can lead to the development of type 2 diabetes (2013 data).
The National Diabetes Prevention Program (National DPP) is designed to empower people with prediabetes to take charge of their health and to make realistic lifestyle changes that can cut their risk of developing type 2 diabetes by 58 percent.
Program Action:The North Carolina Department of Health and Human Services (DHHS), in cooperation with the National Association of Chronic Disease Directors (NACDD), implemented a Diabetes Prevention State Engagement Meeting (StEM) in January 2014, which brought together stakeholders to plan for scaling and sustaining the National DPP.
The StEM spurred creation of a plan, the Diabetes Prevention and Management Guide, completed in late 2015, that highlighted North Carolina racial and ethnic inequalities related to diabetes, the economic burden of diabetes, and the necessity for taking diabetes prevention steps.
In April 2016, the DHHS Chronic Disease and Injury Section Chief delivered an educational presentation to the North Carolina General Assembly Joint Oversight Committee that was based on the content of the Diabetes Prevention and Management Guide.
In August 2016, the North Carolina General Assembly appropriated funds to establish an evidenced-based diabetes prevention program targeting African-Americans, Hispanics/Latinos, and American Indians.
The Office of Minority Health and Health Disparities in conjunction with the Division of Public Health arranged three training sessions conducted by the Diabetes Training and Technical Assistance Center at Emory University and provided guidance to National DPP sites on implementing their lifestyle change programs. They also worked with Wake Forest University to modify a statewide database to help the state meet reporting requirements specific to CDC and the General Assembly.
Impact/Accomplishments:North Carolina legislators who attended the DHHS presentation on the National DPP sponsored a legislative appropriation bill for more than $2 million, specifying that the funds should be used to increase minority participation in the National DPP through the North Carolina Minority Diabetes Prevention Program (NC MDPP). This program implements the National DPP PreventT2 curriculum, through NC MDPP 12-month lifestyle change classes. The Prevent T2 curriculum and Pravenga el T2 — a version for Spanish-speaking populations — meet CDC program standards. The NC MDPP promotes awareness of prediabetes and diabetes through region-specific, targeted marketing campaigns and community screenings. Outreach events, such as community conversations, are an essential component of this program as they provide NC MDPP participants a platform to become advocates for diabetes awareness and change within their communities.
The North Carolina Office of Minority Health grants funds to multi-agency collaboratives with a local health department as the lead agency. Between October 2016 and June 2018, these collaboratives accomplished the following:
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- Developed targeted marketing that reached more than 7 million North Carolina residents with awareness messages about prediabetes and diabetes
- Screened more than 9,300 people for prediabetes
- Referred 2678 eligible residents to 69 classes in 36 counties
- Enrolled 1415 program participants in NC MDPP 12-month lifestyle change classes. More than 80% of participants attended 9 or more classes in the first six months, and almost 20% attended a minimum of four classes and lost 5% or more of their baseline body weight. Enrolled participants were primarily African American (57%); nearly 8% were Native American; 15% self-identified as Hispanic or Latino.
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To help meet the growing expected demand for lifestyle change program coaches DHHS organized training for nearly 120 NC MDPP lifestyle coaches.
Program Areas:Diabetes, Health Equity and Cultural Competency
State Contact Information:
NC
Kamaria Mason
North Carolina Office of Minority Health and Health Disparities
kamaria.mason@dhhs.nc.gov