Raising Healthcare Provider Awareness of Prediabetes

Submission Date: September 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:

Community-Clinical Linkages, Health Systems Strategies

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.
• Healthcare providers do not always know how to best recognize and treat prediabetes. Raising awareness of prediabetes and the National Diabetes Prevention Program’s (National DPP) evidence-based lifestyle change program among healthcare providers can promote increased identification of individuals with prediabetes and facilitate provider referral to the lifestyle change program.

Project Objectives:

Increase the number of providers that receive information and tools about prediabetes and the evidence-based lifestyle change program from 7 to 140 by December 31, 2013.

Program Action:

A prediabetes webinar, toolkit, and print ads were used to raise awareness among healthcare providers in Minnesota, with a focus on the 7-county Twin Cities Metropolitan Area. To develop and distribute prediabetes awareness materials, the Minnesota Department of Health (MDH) partnered with healthcare organizations and clinics involved in the We Can Prevent Diabetes (WCPD) Minnesota study. The MDH worked with contract partners and an endocrinologist to produce, promote, and deliver a healthcare provider webinar. It was initially presented during a live computer/phone event, after which it was made available online and through provider discussions held at WCPD clinics. Furthermore, the MDH updated an existing healthcare provider toolkit, which was stored online. Three unique print advertisements were published in Minnesota Physician, a monthly newspaper that circulates to 17,000 physicians.

State Health Department Roles

• Partnered with WCPD healthcare organizations and clinics to develop and distribute healthcare provider awareness materials
• Partnered with the Institute for Clinical Systems Improvement (ICSI) and prediabetes and health system experts to create and deliver a healthcare provider webinar
• Provided funding, guidance, and content for the awareness campaign
• Updated the existing Prediabetes Provider Toolkit, including the prediabetes screening and treatment algorithm
• Contracted with a prediabetes clinical expert to provide on-site provider discussions about prediabetes to WPCD clinics

Partners

• Institute for Clinical Systems Improvement
• Contract consultant and endocrinologist
• Healthcare organizations and clinics participating in the We Can Prevent Diabetes Minnesota project
• Minnesota Physician Publishing, Inc.

Data/Other Information Collected:

The MDH contracted with the ICSI, a reputable organization among clinics in Minnesota; Teresa Pearson, MS, RN, CDE, FAADE; and Michael Gonzalez-Campoy, MD, PhD, FACE to create a 45 minute webinar titled Screen, Counsel, Refer, and Follow-up for Diabetes and Prediabetes. The goal of the webinar was to raise awareness of prediabetes among healthcare providers and prompt referrals to the evidence-based lifestyle change program. The consultant and physician initially delivered the live webinar. Afterward, slides and a recording were made available online, and the consultant and MDH used the slides during in-person provider discussions at WCPD clinics.

In addition, the MDH updated an existing Prediabetes Provider Toolkit, which included a prediabetes screening and treatment algorithm, information about identification of people with prediabetes and referral to the evidence-based lifestyle change program, and a list of lifestyle change program providers in Minnesota. Previously developed awareness and referral materials were replaced with new CDC materials. The webinar and advertisements in three consecutive issues of the Minnesota Physician directed healthcare providers to the toolkit. The ads listed ways that physicians could help their patients prevent diabetes. Three half-page ads were created, two covering general risk factors and one focused on gestational diabetes.

“The provider discussions brought members from the clinic team together to learn more about prediabetes and the National Diabetes Prevention Program, as well as to discuss patient identification and referral strategies.” -Sara Vine, WCPD Project Coordinator

Prediabetes Webinar (listed as Pre-Diabetes – What Can We Do About It?): https://www.icsi.org/education__services/learning_center/past_event_materials/

Prediabetes Healthcare Provider Toolkit: http://icanpreventdiabetes.org/health-provider-toolkit/

Impact/Accomplishments:

• 13 Healthcare system partners
  • 24 Healthcare delivery sites
  • 114 Primary care health providers
• 48,679 Adult patients served by these providers
• 227 Providers or clinic staff educated about prediabetes
  • 88 Attended a provider discussion
  • 78 Attended a live webinar
  • 61 Viewed the webinar online
• 51,000 Print media impressions reaching 17,000 providers

Challenges/Lessons Learned:

Factors Supporting Success

• Dedicated Funding: $48,177
• Experience with communications and marketing activities aimed at preventing diabetes
• Partnership with the ICSI and WCPD to increase provider and public awareness of prediabetes
• Existing healthcare provider toolkit and prediabetes algorithm
• Selected consultants who have experience with healthcare systems and knowledge of prediabetes and the evidence-based lifestyle change program
• Ads pre-purchased by the MDH allowed flexibility in placement following the webinar
• Worked with a physician who could address the physiology and diagnosis of prediabetes
• WCPD project provided the opportunity to work closely with healthcare systems and clinics
• Posted the webinar on the ICSI website, a credible source in the medical community, to generate more traffic
• Invited the medical directors at WCPD clinics to speak about the significance of prediabetes awareness, which was a useful peer-to-peer strategy to underscore the importance of the presentation and encourage attendance and participation in the discussion

Challenges and Solutions

• Challenge: Limited availability of busy providers made scheduling awareness activities challenging
  • Solution: To allow providers to select the option that would best fit their schedule, the MDH used a variety of formats and times of day to deliver the awareness activities; formats and times included an early morning live webinar, an in-person provider “Lunch and Learn,” and an online pre-recorded webinar.
• Challenge: Linking clinics with community organizations already delivering the evidence-based lifestyle change program and engaged in prediabetes awareness
  • Solution: MDH staff lead encouraged community partners delivering the evidence-based lifestyle change program to invite providers from their networks to attend the webinar.
• Challenge:Webinar registration was limited by a set number of phone lines
  • Solution: To maximize participation, the MDH team lead encouraged webinar participants from the same organization to call-in on one phone line

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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