Feeding America Diabetes Initiative January 2014!
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1 Feeding America Diabetes Initiative January 2014!
2 The Need to Address Diabetes & Food Insecurity! The Epidemic of Diabetes: 26 million Americans currently diagnosed with diabetes 79 million considered prediabetic Cost of diabetes was $245 billion in 2012 Research Shows: Individuals who live with food insecurity are more likely to experience chronic disease, including diabetes For those with diabetes, food insecure individuals have worse glycemic control than those with ready access to healthy foods! 2010 Feeding America
3 Cycle of Food Insecurity & Chronic Disease: Diabetes! Depression Poor sleep quality Fatigue Decreased physical activity STRESS 2010 Feeding America Adapted from Seligman HK, Schillinger D. N Engl J Med 2010;363:6-9.
4 Feeding America Diabetes Initiative: Breaking the Cycle! $3M Bristol-Myers Squibb Foundation investment 3-year project to create bi-directional collaborations between food banks and community health care partners Corpus Christi Food Bank, TX Mid-Ohio Food Bank, Columbus, OH Redwood Empire Food Bank, Santa Rosa, CA Connect food insecure clients living with type 2 diabetes with: Diabetes-appropriate food Nutrition & health education A medical home! 2010 Feeding America
5 Details of Pantry Program! Qualifications: HbA1C 6.5 if no meds Taking diabetes meds or on insulin To enroll: Complete minute survey with participant Once enrolled: Will receive wellness box once a month until 6 th box After the 6 th box: complete post-survey, take HbA1c!
6 PLEASE CHECK THE BOXES WITH AN X IF APPLICABLE Client s blood sugar:. If 140 (random) or 120 (fasting), check Has a doctor ever told you that you have diabetes? No Yes HbA1c. Client s HbA1c Are you on insulin or other medication for diabetes? No Yes Participant ID: _ Client s HbA1c Old diagnosis, TURN FORM OVER HbA1c less than 5.7 MARK CORRECT HbA1c HbA1c HbA1c 6.5 or greater Your risk for diabetes is low. You may be at high risk for diabetes. Your HbA1c value indicates that you may have diabetes. Do you have a doctor or a clinic where you regularly go to get medical care? Yes GOOD. WE RECOMMEND VISITING YOUR DOCTOR OR CLINIC AND LETTING THEM KNOW YOU MAY HAVE DIABETES. END SURVEY MAY I REFER YOU TO A CLINIC WHERE YOU CAN GET LOW-COST MEDICAL CARE? Yes New diagnosis, referred to new PCP No No New diagnosis, declined PCP referral New diagnosis, referred back to existing PCP Staff Initials: TURN FORM OVER
7 Sample Survey Questions! Food Insecurity: The food that (I/we) bought just didn t last, and (I/we) didn t have money to get more. Was that often, sometimes, or never true for (you/your household) in the last 12 months? Dietary Intake: In the last four weeks how often did you eat any fresh fruit, canned fruit, or fruit in smoothies? Don t count juice. Depression: During the past month, have you often been bothered by feeling down, depressed, or hopeless? Coping Strategies: In the last 12 months, how often did you take less medicine than you were supposed to because you could not afford to buy more? Self-Efficacy How confident do you feel that you can follow your diet when you have to prepare or share food with other people who do not have diabetes? Scale 1-10!
8 Resources for Clients! Handout with A1C description and what is recommended List of low cost or free medical or dental clinics in the area Referral when needed to medical or dental clinic Diabetes education classes Assistance finding meter and other testing supplies at participants lowest cost. Assistance with specially fitted orthopedic shoes! 2010 Feeding America
9 Diabetes Project Food Distributions! Non-perishable items in food boxes Additional fresh produce and other perishables such as dairy and meat Education materials and diabetes resources!
10 Diabetes Appropriate Food Boxes! Start by choosing Unrefined and whole grain products Fresh fruits and vegetables Canned fruits in juice High fiber foods Low fat dairy products Always keep the client in mind and ask them about the items Is the food culturally sensitive? Does the client need recipes?!
11 Healthy Food Box & Produce!
12 Cost of Diabetes Wellness Box! Items! Per Box! # of cases! Total per case! Total! No salt added green beans! 2! 84! $3.50! $294.00! No salt added corn! 1! 42! $3.64! $152.88! Light peaches! 1! 42! $3.64! $152.88! Light mixed fruit! 2! 42! $3.64! $152.88! Peanut butter! 1! 84! $2.10! $176.40! Tuna! 4! 84! $32.00! $2,688.00! Oats (24 oz.)! 1! 192! $11.75! $2,256.00! No sugar added spaghetti sauce! 1! 108! $12.70! $1,371.60! Pinto beans (1lb. Bag)! 1! 42! $12.48! $524.16! Brown Rice (1lb.Bag)! 1! 54! $14.54! $785.16! Milk 1% (32 oz.)! 2! 167! $14.62! $2,441.54! Whole wheat pasta! 1! 90! $14.68! $1,321.20! Diced tomatos! 1! 51! $15.02! $766.02! Boxes! 330!! $0.37! $122.10! Boxes! 670!! $0.69! $462.30!
13 Educational Material! Box 1 Diabetes Overview Box 2 Nutrition and Diabetes Box 3 High s, Low s, Sick Days and Monitoring Box 4 Diabetes and Exercise Box 5 Preventing Complications & Dental Care Box 6 Coping with Diabetes and Stress Management and Summary of all topics!
14 Bi-Directional Relationships! Low cost and free clinics in the area Diabetes Education programs Hospital educators
15 Years 1 & 2: Overview! 1,405 clients enrolled in the project across the 3 food bank sites 41 pantries and food bank distribution sites involved in client screening, food box distribution and/or diabetes education 20 local healthcare partners help food banks identify clients with diabetes living in food insecure households and refer to the programs External Presentations: Bristol-Myers Squibb Foundation Grantee Summits, 2012 & 2013 National Minority Quality Forum 2013 American Diabetes Association Disparities Forum 2012 American Public Health Association Conference 2013 Featured in the BMS Foundation Annual Report 2013! 2013 Feeding America
16 Key Learnings and Preliminary Clients Outcomes! There is demand for health screening & education at food distribution sites Clients with type 2 diabetes want healthier foods Food as medicine is having an impact on clients health status: Improved blood sugar control Decreases diabetes distress (burden from the disease) Improved diabetes self-efficacy (ability to cope) Reduce depressive symptoms Local health clinics are willing to partner with food banks! 2013 Feeding America
17 Final Year of the Project! Screening and client enrollment concludes in late January 2014 Anticipate 1,600 clients total Complete evaluation and submit findings for publication in peerreviewed journals Share program models and resources with the Feeding America network via Hungernet, Feeding America webinars, and ACPN Conference October 2014 Explore national partnership opportunities between food banks and local healthcare partners Explore scalable approach for replication across network particularly in communities with high rates of diabetes! 2013 Feeding America
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(*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14%
Health & Wellness BRFSS, 1985 No Data