South Dakota Raises Awareness of Prediabetes Through the Undo the Risk Campaign

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Submission Date: July 2023

State/Territory Submitted on the Behalf of: South Dakota

States/Territories Involved: South Dakota

Funding Source: CDC

CDC Funding:


CDC Funding (Specified):

Other CDC Funding

Grant Number:

CDC-RFA-DP18-1815PPHF18: Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke

Domain Addressed:

Health Promotion

Public Health Issue:

As of 2021, approximately 11% of South Dakotans age 18 and older—nearly 98,500 adults—reported they had been diagnosed with diabetes, according to the South Dakota Behavioral Risk Factor Surveillance Survey. Those who are American Indian reported significantly higher prevalence, with 18% reporting they had been diagnosed with diabetes (approx. 14,500). Approximately seven percent of South Dakotan adults (nearly 62,700) were diagnosed with prediabetes, which puts them at increased risk for developing type 2 diabetes. Based on national data, one in three adults have prediabetes, but 80% of them do not know it. This suggests nearly 240,000 adults in South Dakota have prediabetes but do not know it.

Project Objectives:

The South Dakota Diabetes Program (SDDP), housed in the Office of Disease Prevention and Health Promotion at the South Dakota Department of Health, seeks to collaboratively promote prevention and population-based interventions to improve the quality of life for all South Dakotans with or at risk for diabetes.

In September 2019, South Dakota held a State Engagement Meeting (StEM), supported by the National Association of Chronic Disease Directors (NACDD), with state and local partners to focus on sustaining and expanding the National Diabetes Prevention Program (National DPP) lifestyle change program. The year-long program helps people build healthy habits and reduce their risk for type 2 diabetes. A task group aimed at increasing awareness of prediabetes emerged from the meeting and began work immediately to support, launch, and expand efforts to raise awareness of prediabetes in South Dakota.

Program Action:

The Undo the Risk campaign was created by the SDDP to raise awareness of prediabetes and encourage South Dakotans to take the Prediabetes Risk Test. Campaign materials were customized to reach more people through modifications to language and images with input from members of those populations. Materials were developed in Spanish and English, with some versions including Lakota words, a language spoken by the Lakota people of the Sioux tribes. The people and settings represented in campaign materials were intended to reflect the diversity of South Dakotans.

The initial campaign website and two television ads launched in September 2019. The ads ran through the end of 2019 and again in May, June, and November of 2020. The COVID-19 pandemic prompted modifications to the original campaign to reach people in other ways. Additional materials were developed by the Awareness task group, including cards for pharmacy racks and floor stickers that could double as social distancing markers while bringing awareness to prediabetes. In the fall of 2020, the campaign was expanded to include the risk test in Spanish and ads intended for Hispanic/Latino populations. Streaming audio ads intended to reach Hispanic/Latino and Indigenous and/or Native American populations, and radio buys intended to reach Indigenous and/or Native American populations were launched in the fall of 2021.

The campaign was accompanied by several resources developed by the Awareness and Screening/Testing/Referral task groups intended to help support partners, providers, and individuals access information about the campaign and prediabetes. A social media implementation guide was developed with images and sample posts to bolster the campaign and centralize messaging. Additionally, an implementation guide was developed to support new organizations in starting the DPP lifestyle change program. The Undo the Risk website was expanded to include a Find A Program page and a Providers tab to deliver provider specific information about prediabetes.


General audiences and specific, intended populations were successfully reached through different forms of media. The number of average weekly responders taking the Prediabetes Risk Test increased by nearly 13 times during the television ad campaign. The streaming audio ad campaign and radio spot buy intended for Indigenous and/or Native American populations resulted in nearly nine times the number of average weekly respondents. After the Spanish language version of the risk test was released, ads intended for Hispanic/Latino populations were run and resulted in over two times the number of average weekly respondents.

A series of advertisements created by the South Dakota Diabetes Program (SDDP) to raise awareness of prediabetes and encourage South Dakotans to take the Prediabetes Risk Test:

Next Steps:

The SDPP hopes to add a “Reduce My Risk” button to the Undo the Risk website that will allow individuals to self-refer themselves to the National DPP lifestyle change program through the South Dakota Community Information Exchange, a statewide collaboration of health care and social service providers sharing information using an integrated technology platform and referral system to promote health improvement among populations who are at higher risk and underserved. Once the “Reduce My Risk” option is added, the campaign may be expanded to other populations including older adults in rural areas and the Karen population, an ethnic minority from Myanmar. Other opportunities include expanding the Undo the Risk website to include additional information on other chronic diseases that can be prevented through lifestyle changes.

Primary web link for more information:
Program Areas:


State Contact Information:

South Dakota
Kayla Magee, RN / Diabetes Program Coordinator
South Dakota Department of Health

Board President's Challenge:


Program Activities Date Range:

March 2023

Organization's Social Media Links:
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