Diabetes Education and Outreach with the WVU Extension Service

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1 Diabetes Education and Outreach with the WVU Extension Service David Roberts, WVU Extension Families and Health Agent Lincoln County Dana Wright, WVU Extension Families and Health Agent Logan County

2 Extension s work in the community Ø Community-Based Diabetes Screening and Risk Assessment in Rural West Virginia Ø Dining with Diabetes Ø Taste of Health

3 Mission of the Families and Health Unit

4

5 The Facts of West Virginia Ø From 1995 to 2007, the population increased by.16%, but the prevalence of diabetes has increased by 129%. Ø In 2012, 13% or 268,000 adults were affected by diabetes (1) Ø Another estimated 99,800 adults are living with have undiagnosed diabetes and possible complications (2) Ø 107,867 adults over the age of 2o have pre-diabetes i.e., they have elevated blood glucose levels above the normal [ mg/dl] but not reached the levels for diabetes [ 126 mg/dl]. Ø 83% of individuals who have elevated blood glucose levels do not know about it.

6 The Facts of West Virginia Ø Median household income is $12,000 below national average Ø 18.5% live in poverty Ø An estimated 24 % of households do not earn enough money to cover food costs at least once in a 12 month period Ø 1 in 5 receive SNAP benefits Ø Low income residents in 42% of WV have low access to grocery stores that supply sufficient qualities of fresh produce and other healthy foods.

7 The deck is stacked against us Due to Ø Aging Population Ø Physical inactivity Ø Obesity Ø Geography Ø Culture of distrusting the health care system By 2025 it is estimated the number of West Virginians living with diabetes (diagnosed and undiagnosed) will increase to 17% or 314,000 individuals. (3)

8 Community-Based Diabetes Screening and Risk Assessment in Rural West Virginia Ø A cross sectional study design to assess diabetes risk among 540 individuals in the following WV counties. McDowell Boone Cabell Braxton Logan Lincoln Wirt Clay Greenbrier Jackson Berkley Wood Ø Established networks of community organizations was used to engage participants in the study.

9 Purpose Of The Study Ø To assess WV adults risk of diabetes, family history, and life style behaviors in West Virginia Ø To assess individual s diabetes risk score to identify undiagnosed cases of diabetes and pre-diabetes.

10 Diabetes Risk Screening Assessments Ø We used a validated and reliable 7-item diabetes risk assessment survey developed by the Centers for Disease Control and Prevention [CDC]. Ø Glycosylated A1c test (A1c Now Kit from Bayer) if participants wanted to confirm their risk. Ø Demographic Information Ø Lifestyle behaviors Ø 540 individuals surveyed without Diabetes diagnosis

11 Demographics Total = % 78.8% Females Males White Ethnicity Other

12 Educational Background Smoking Status 60 18% % 82%% % High School or Less Some College or Degree YES NO

13 Obesity Level Read Food Label 20% 48% 35% 32% 65% Normal Yes No Overweight Obese

14 Diabetes Risk Score % 12.5 Average Score Category 1 High Risk 38.3% 4.5 Average Score Low Risk High risk participants were provided with their score and encouraged to make an appointment with their health care provider. Area Community Health Center was provided if needed.

15 Average Score

16 Diabetes Risk Factors Diabetes Risk Family HX of DM WT more than HT Sedentary lifestyle > 45 years

17 Conclusion Ø Numerous positive results that were attained in this service project. Ø Sixty percent of the participants who were screened showed an increased risk for diabetes. Ø Referrals for follow-up with a health care provider. Ø Diabetes screening and referrals allowed the WV Extension with improved community outreach to improve health and reduce health disparities.

18 Extension s Role Ø Knowledge of leaders Ø Knowledge of community resources Ø Established infrastructure Ø Statewide outreach Ø Long-term sustainability Ø Community-based programming

19 Dining with Diabetes Ø Began as a research project in 2005 Ø 5 sessions (4 sessions 1xweek for 4 weeks; 5 th session three months after first session) Ø HbA1c test pre and post course to measure improvements in self-management of blood glucose skills Ø Pre/Post questionnaire to gauge increase in knowledge and health behaviors Ø Healthcare partner (nurse, CDE, pharmacist, etc)

20 Dining with Diabetes Each session includes an educational lesson Ø Ø Ø Ø Ø Session 1 On the road to living well with diabetes Session 2 Carbs and Sweeteners Session 3 Fats and Sodium Session 4 Vitamins, Minerals, and Fiber Session 5 follow up

21 Dining with Diabetes Each session includes a cooking demonstration Ø Present healthy and easy to prepare versions of familiar foods Ø Demonstrate cooking techniques that use healthy ingredients. Ø Encourage behavior changes in healthy eating. Ø Give participants time to share and learn from each other.

22 Dining with Diabetes Each session includes a physical activity Ø Gentle stretching Ø Chair yoga Ø Walk a mile in your living room Ø Resistance bands

23 Taste of Health Single Session program developed in 2013 Ø Cooking demonstrations Ø Added value to scheduled programs Ø Recruiting opportunity for more in-depth program

24 We can reverse this trend!!!!!!

25 Thank you! For more information, contact: David Roberts Dana Wright