Statewide Infrastructure to Support Diabetes Prevention

Submission Date: August 2014

Entry Type: Case Study

State/Territory Submitted on the Behalf of: New Mexico

States/Territories Involved: New Mexico

Funding Source: NACDD

Other Funding:

NACDD funding

Domain Addressed:

Community-Clinical Linkages

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.
• Statewide or regional efforts to raise awareness of prediabetes and promote increased use of the National Diabetes Prevention Program’s (National DPP) evidence-based lifestyle change program can be more effective when they are aligned and coordinated with organizations that are delivering or supporting this program

Project Objectives:

To define and market the role of  the New Mexico Diabetes Prevention and Control Program (DPCP) in coordinating and building infrastructure for the evidence-based lifestyle change program in New Mexico

Program Action:

The New Mexico DPCP created a statewide infrastructure to support implementation, maintenance and sustainability of the evidence-based lifestyle change program. The infrastructure aims to support site coordinators, health plans, worksites, clinics and tribes in delivering and sustaining their evidence-based lifestyle change programs. New Mexico created this network by assessing the capacity of sites to deliver the evidence-based lifestyle change program and by providing technical assistance on many aspects of the program.
Once the network was established, partners met with health plan and state government risk management leadership to discuss the possibility of adopting the evidence-based lifestyle change program as a covered health benefit. Starting in January 2014, the DPCP offered the program to state employees in a “demonstration” format. Using state funding, the DPCP trained over 40 lifestyle coaches to continue to expand the network and reinforce infrastructure for scaling the program statewide. The DPCP is partnering with a referral system contractor to help develop strategies for referrals to the evidence-based lifestyle change program. Likewise, a marketing contractor is creating a campaign objective, target audience, and effective approach for increasing prediabetes awareness and promoting the evidence-based lifestyle change program to healthcare providers across the state.The DPCP held several meetings and trainings with the network of partners in order to continue to build and sustain the infrastructure.

“Working with NACDD and the other funded states on the
S-DPP project has given the expansion of the NDPP in New Mexico a real boost. It has also confirmed that DPCPs have a critical role to play in this endeavor.” -Judith Gabriele

State Health Department Roles

• Created a robust statewide network of diabetes prevention and management partners
• Convened statewide partners for meetings, trainings, and technical assistance
• Provided training for lifestyle coaches in order to ensure a solid foundation
• Developed a dedicated website with educational and promotional materials and an online referral system with an interactive map and contact information for evidence-based lifestyle change program coordinators
• Coordinated efforts between the program providers to create a more integrated and extensive statewide network
• Engaged health plan and state government benefits leadership to encourage adoption of the evidence-based lifestyle change program as a covered health benefit
• Organized a demonstration of the evidence-based lifestyle change program to be delivered to state employees in 2014

Partners

• Evidence-based lifestyle change program coordinators
• Blue Cross Blue Shield NM
• Molina Health Care NM
• Presbyterian Health Care
• United Healthcare
• Present and future diabetes prevention programs
• State of NM Risk Management
• Department of Health Information Technology

Impact/Accomplishments:

• 20 Partners
• 3 Health Plan Partner Meetings
  • Average of 12 partners participating per meeting
• 40+ Trained lifestyle coaches
• A marketing plan for healthcare providers
• An evidence-based lifestyle change program website (www.stopdiabetesnm.org)
• Discussions with the State about adoption of the evidence-based lifestyle change program as a covered health benefit

Challenges/Lessons Learned:

Factors Supporting Success

• Dedicated Funding: $137,300
• State funding enabled the DPCP to focus on training and other critical components of the system infrastructure
• Capitalized on a strong, existing foundation of evidence-based lifestyle change program providers
• Applied lessons learned from “early adopters,” which allowed for more effective technical assistance to subsequent participating organizations
• Increased healthcare provider awareness through messaging and a referral system

Challenges and Solutions
Challenge: The state procurement process delayed the development of marketing and referral system contracts
Solution: Worked hard to complete as much work as they could in a short period of time

Challenge: Health plan decision-makers were not brought to the table for network meeting
Solution: Reached out to health plans and brought in the right players (Medical Directors) for later meetings, resulting in productive discussions that garnered support for the evidence-based lifestyle change program

Challenge: Changing priorities within Department of Health (DOH) Information Technology (IT) delayed dedicated website development.
Solution: Continued to work with the DOH IT staff to keep the website on their radar, with persistence paying off

Challenge: NM DPCP did not receive CDC Enhanced Funding
Solution: Continued building the evidence-based lifestyle change program infrastructure using state funds

Despite all of the above setbacks,
the DPCP persevered with the support of NACDD to move the program forward.

Next Steps:

The DPCP plans to work with their referral system contractor to convene partners and develop specific strategies and tactics for creating cross-referrals and cross-training of coaches/trainers/leaders in order to expand and strengthen the disease prevention and management system across the state, particularly in underserved areas.

Program Areas:

Diabetes

State Contact Information:

NM
Judith Gabriele
New Mexico Department of Health
(505) 476-7613
judith.gabriele@state.nm.us

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