Montana s Experience. Telehealth Delivery of the Diabetes Prevention Program (DPP)

Transcription

1 Telehealth Delivery of the Diabetes Prevention Program (DPP) Montana s Experience Sonja Tysk, MS Health Education Specialist Montana Department of Public Health and Human Services stysk@mt.gov

2 Montana DPP Locations

3 Montana Telehealth Studies Participants receiving the DPP remotely (n=256) are as successful in maintaining attendance, participating in physical activity, and achieving weight loss as those participating at an on-site (n=638) location. No statistically significant difference among TH and OS participants in achievement of 5% weight loss goal, 150 minute physical activity goal, and mean attendance. 1 Between , 667 participants were enrolled in a study comparing outcomes between one Montana face-toface urban site and 15 rural communities which received the DPP simultaneously via telehealth delivery. The urban and rural interventions were comparable with 33.5% and 34.6% of participants achieving 7% weight loss, respectively. 2 Vadheim et. al (2017). Telehealth delivery of the diabetes prevention program to rural communities. Transl Behav Med, 7(2): Ciemins EL, Coon PJ, Coombs NC, et al. Intent-to-treat analysis of a simultaneous multisite telehealth diabetes prevention program. BMJ Open Diab Res Care 2018;6:e doi: /bmjdrc

4 Logistics Technology telemed equipment (Polycom) or web based Telehealth (TH) can be delivered simultaneously with the on-site (OS) group or as stand-alone delivery Selecting the telehealth site Access to appropriate technology, meeting space, establish service agreement with facility and TH site coordinator.

5 Telehealth Site Coordinator Room reservations and set-up Minimal technology management Weigh participants at start of class Collect previous week s food and PA trackers and distribute class session materials Mail food/pa trackers to coach Assist with TH participant engagement and group discussions

6 Delivery Helpful if coach can make an in-person visit to TH location TH site - Place camera so the coach can see the entire TH group on the monitor OS - Place camera so TH site can see the slide presentation as well as the coach Be careful with visuals (i.e. food examples) Schedule time for TH site to have its own group discussion and then share with the OS group Technology problems happen, have a backup plan hardcopies of PPT, ability to FT, cell numbers

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8 Technology Written instructions to site coordinator for operating and troubleshooting tech issues. Visit for assistance delivering telehealth programs in your state. TRC is comprised of 2 national and 12 regional resource centers.

9 Challenges Lack of personal contact between TH participants and coach Community buy-in Technology Source: Vadheim, L. (2016, Dec 13). Using Telehealth to Deliver Diabetes Prevention Programs. A webinar for Clinicians & Administrators Interested in Reaching People with Prediabetes in Rural and Frontier Areas.

10 Ida s Telehealth Journey Established relationship in Deer Lodge Referrals Web Ex vs. Polycom technology Simultaneous vs. stand-alone delivery Snail mail Must have a good OS coordinator

11 Implications May geographic access to DPP 1 May allow large number of participants at the same time 1 May improve cost effectiveness of delivering DPP 1 Could reduce participant travel cost 1 Increase access to the DPP in remote/rural areas where there can be a shortage of team-based obesity, diabetes and self-management support services 2 Vadheim et. Al (2017). Telehealth delivery of the diabetes prevention program to rural communities. Transl Behav Med, 7(2): Ciemins EL, Coon PJ, Coombs NC, et al. Intent-to-treat analysis of a simultaneous multisite telehealth diabetes prevention program. BMJ Open Diab Res Care 2018;6:e doi: /bmjdrc

12 Telehealth In Conclusion Given that we know TH participants achieve the same weight loss, attendance, and physical activity outcomes as OS participants, we believe that delivering the DPP via telehealth is an effective strategy to increase access to this lifestyle change program.

13 Montana Medicaid DPP Coverage Established working relationship with Medicaid State Medical Officer also Medical Director for Medicaid Chronic Disease (CD) programs are in the same department as Medicaid Chronic Disease programs have ongoing partnership with Medicaid to implement surveillance and intervention projects (e.g., tobacco cessation) Collaborating on CMS Medicaid Incentives to Prevent Chronic Diseases grant from Formalized relationship between DPP and Medicaid. Provided incentives to adults Medicaid beneficiaries enrolled in the DPP to evaluate if it improves participation rates and weight loss outcomes. Discussed Medicaid beneficiary needs for the Diabetes Prevention Program such as targeted marketing efforts, transportation to classes, curriculum, tracking tools for self-monitoring food and physical activity, adaptive physical activity, and reimbursement. Identified reimbursement policy change as key activity and goal.

14 Questions Sonja Tysk