Diabetes Prevention programme
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1 Diabetes Prevention programme Helen Booth Business Manager Naomi Jones Worcestershire Service Manager ICS Health & Wellbeing
2 The ICS group
3 Healthier You Healthier You: NHS Diabetes Prevention programme has been developed collaboratively by NHS England, Public Health England and Diabetes UK Up to 100,000 places will be made available, across the country by 2020 The Worcestershire Diabetes Prevention programme has started to accept referrals with 406 people being supported in Year 1, 946in Year 2 and 315 in Year 3
4 Eligibility criteria 18 years old and over Registered with a GP Practice in one of the following: South Worcestershire Redditch & Bromsgrove Wyre Forest HbA1c between mmol/mol (6.0%-6.4%) or Fasting Plasma Glucose between mmols/l within the last 12 months Able to participate in low/moderate physical activity Not pregnant
5 The Service model
6 Referral Referrals to the service will come primarily from: Local GPs and PN s NHS Health Check Programme
7 Programme commitment 9 month programme 1 to 1 initial assessment 10 x weekly group sessions that includes healthy lifestyle advice (2 hours each session) and physical activity (1 hour each session) 4 x monthly groups sessions that include strategies to help you maintain your lifestyle changes 3 x one to one progress review sessions at 3,6 and 9 months
8 1-1 initial assessment (60 minutes) The one-to-one assessment contains a mixture of physical measurements and questionnaires: HbA1c* (if dated 3 months) Weight/Height/BMI Smoking Status General Practice Physical Activity Questionnaire (GPPAQ) Alcohol Use Disorders Identification Test Consumption (Audit-C & Audit-Full) Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) Demographic Data
9 Behavioural intervention The behavioural intervention is delivered over two phases, core and maintenance The core phase consists of alternating nutrition / lifestyle sessions and physical activity sessions
10 Core Phase
11 Healthy Foundations (XPERT Health) Healthy Foundations Session Overview Session 1 What is pre-diabetes and diabetes Session 2 Nutrition for health Session 3 Carbohydrate awareness Session 4 Reading & understanding food labels Session 5 Health check reducing risk of diabetes/other long term conditions Digestion, carbohydrates and blood glucose control? Energy balance, eating for good health, addressing myths and misconceptions, fat awareness, options for weight loss, eating assessment Carbohydrates and blood glucose levels, amount and type of carbohydrates, estimating carbohydrates, daily intake of carbohydrates Nutritional information on food packaging, different dietary approaches, reference intakes, nutritional claims Review the health profile and long-term health problems related to impaired glucose regulation and how to reduce risk.
12 Physical activity
13 Maintenance phase
14 Prevention PLUS Prevention PLUS Session Overview Session 1 Values Session 2 Mindfulness Session 3 Self-compassion Session 4 Dealing with barriers & obstacles Participants to build awareness of, and evaluate, their individual values (i.e. what is important to them). They consider where their health lies within their personal value system and look for links between their health and other aspects of their life in which they place value. Participants acquire basic mindfulness skills. Participants are shown how to use these skills to interrupt old habits by bringing them into their conscious awareness and changing their old automatic reactions into new conscious responses. Participants build a compassionate self-image, shown to promote health-related behaviours. Participants learn how to respond with self-compassion (i.e. when faced with obstacles/ set-backs) rather than self-criticism and how this helps to facilitate behaviour change. Participants are taught strategies to cope with barriers and obstacles (external: financial, competing interests; internal: thoughts, feelings) that can interfere with the implementation of behavioural changes in daily life and develop emotion regulation strategies.
15 Programme Content Review Nutrition for health How to incorporate physical activity into your lifestyle How to solve problems that can get in the way of healthy changes How to develop the skills and knowledge to maintain these changes after completing the programme
16 Post-Programme Ensure service users have a clear plan to manage long term change Work with local services and organisations to support ongoing changes Vouchers for Slimming World and local leisure services will be available as a reward for those who have significantly engaged with the programme
17 Health and Wellbeing Coaches The Health & Wellbeing Coach is responsible for delivering the group and 1 to 1 sessions which facilitate health improvement with a non-judgemental and motivational approach Minimum of an undergraduate degree in nutrition, or exercise science with a specialist interest in nutrition Qualified in fitness instruction and exercise referral (ideally REPs level 3) and have experience of delivering exercise classes to adults at an appropriate level
18 Health and Wellbeing Coaches Training Mental Capacity Act 2005 Equality and diversity Adult safeguarding level 2 Child Safeguarding level 1 Working with vulnerable adults Health and safety Anti-bribery Health behaviour change level 1 & 2 Very brief intervention advice on smoking Clinical Governance X-PERT Health (Healthy Foundations Core Phase) Curriculum Training for Health & Wellbeing Coaches and Advisors Physical Activity Programme and Promotion Training for Health & Wellbeing Advisors Prevention Plus Curriculum Training (Maintenance Phase) for Health & Wellbeing Coaches Competency checks throughout programme
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