INTRODUCTORY LESSON: Facilitator s Guide

INTRODUCTORY LESSON: Facilitator s Guide

GETTING READY FOR THE PROGRAM Overall Curriculum and Introductory Lesson ONE MONTH BEFORE THE PROGRAM: 1. Read through the Introduction and the Introductory Lesson to become familiar with concepts and resources used as teaching tools. 2. Find local health care professionals with whom you can partner throughout the program. Suggestions for partners include: Doctor (an endocrinologist if available) Nurse (RN), certified diabetes educator (CDE) if available Registered dietitian (RD), CDE if available Pharmacist, CDE if available Eye doctor (ophthalmologist) Foot doctor (podiatrist) Dentist Social worker Mental health counselor 3. Identify someone to assist with data collection. 4. Send out the invitation flyer for the class (see appendix for Introductory Lesson). 5. Decide on incentives for participants who complete the Diabetes Checklist and move through the Stages of Change. Note: Suggestions for incentives include pedometers, dynabands, lunch boxes with recipes inside, gift cards to local businesses, and similar health-promoting items. 6. Order materials from the National Diabetes Education Program - www.ndep.nih.gov. Under Publications, search for the following items: 4 Steps to Control Your Diabetes. For Life. (NDEP-67) http://www.ndep.nih.gov/ publications/publicationdetail.aspx?pubid=4 Tips for helping a person with diabetes (NDEP- 57) http://www.ndep.nih.gov/publications/ PublicationDetail.aspx?PubId=45 Tips to help you stay healthy (NDEP-8) http://www.ndep.nih.gov/publications/ PublicationDetail.aspx?PubId=43 Note: Commercial, printer-ready CDs are available by calling 800-860-8747. ONE WEEK BEFORE THE PROGRAM 1. Review Introductory Lesson Outline. 2. Review information from the following Web sites: National Heart Lung and Blood Institute http:// www.nhlbi.nih.gov/health/public/heart/other/ latino/diabetes/ Diabetes Education Online. Diabetes Teaching Center at the University of California, San Francisco http://www.deo.ucsf.edu/type2/index.html 3. Purchase a folder for each participant to keep handouts and factsheets. Print the following documents, one for each participant (see appendix for Introductory Lesson): Cover sheet for each participant s folder Survey (Pre-Assessment) Stages of Change Staging Tool (two copies for each participant) Diabetes Checklist 4. If needed, buy supplies for the following icebreaker activities: Flip chart and markers for Learning From Experience Index cards and pencils for Three Truths and a Lie 5. Arrange for someone to help with questionnaires.

INTRODUCTORY LESSON OUTLINE At this time, have participants sign in and then fill out the Participant Survey (Pre-test). This survey will also be given at the end of the program (Post-test). Collect the survey from participants. Be prepared to read the survey to participants who need this help. Let participants know that you rolled out the red carpet for them. Welcome them in your own way. There are two copies of the staging tool. Agents: keep one completed copy for your records. Participants: Allow them to keep one completed copy in their folders.

Use one of the following icebreaker activities to allow participants to get to know each other. I will grant you three wishes You have just met one of the most interesting people in the world. This person is dressed in a black suit and is wearing a red coat and a magician s hat. He comes up to you and tells you that he has been looking for you for many years and has finally found you. He gives you a magic wand that allows you to make any three changes you want. For example, you may change yourself, your job, or any other part of your life. Choose a partner and share the three changes you will make and why it is important to make those changes. Have participants share what they learned about their partners. Learning from Experience Have participants introduce themselves and explain one thing they have learned the hard way about diabetes. You may want to post what they shared on a flip chart and refer to it at different times during the class. Three Truths and a Lie Give each person an index card and a pencil. Have them write three statements that are true about themselves and one that is false. The goal is to trick others into believing the statement that is false. Allow about five minutes for participants to write their statements. You might want to demonstrate by reading three statements about you that are true and one that is false to demonstrate how the game is played. You might also want to award a prize or prizes to the individual who tricks the group into believing his or her lie. Read information on the slide. Also tell participants: Research has shown that it takes approximately 12 sessions for people to change their behaviors.

Tell participants that even though they may not be managing their diabetes at this point, the program should help them manage their diabetes on a daily basis. Let us look at the way people typically change their behaviors. See if you can see yourself in any of the five stages.

Ask participants where they are in terms of their readiness to change their behavior or, more specifically, their readiness to take steps to manage their diabetes. You may want to provide an example of a change that you want to make and ask participants to stage you. Provide opportunities for interaction. Identify two or three participants and ask them a direct question, such as: Where do you see yourself next? What is your next stage of change? Mention that people generally move backward and forward though the stages. Now tell participants to look at their copy of the Stages of Changes Staging Tool that was filled out earlier. Participants can see what stage they are in currently, and where they should be moving towards. Ask participants to take out their Diabetes Checklist and let them know that by the end of the program they should be able to check off each item on the list.

Share with participants that throughout the sessions they will be asked to set goals. Individuals who set goals for themselves and work toward accomplishing them are more likely to be successful in managing their diabetes. You should set SMART goals for yourself. That is, your goals should be S-pecific, M-easurable, A-ction Oriented, and R-ealistic, and they should have a T-ime frame. Let us look at what this means. Read through the examples. A specific goal has a time frame attached to it. For example, I will eat one vegetable with my meals each day. We will ask you to set goals that you are 70 percent sure you can accomplish. The goals you set should be measurable. One way to measure your goal is to keep a log to record the activity. The goals are measurable because you can tell whether you have completed them. For example, did you exercise for at least 30 minutes? You can then decide if you are accomplishing your goals or if you need improvement.

Thinking through what is needed to achieve your goal helps you to see if your goal is realistic and if it is attainable. It can also help you prepare for accomplishing the goal. Tell participants they are to choose a goal that you are 70 percent sure you can accomplish. If your goal is to walk for 30 minutes on most days of the week, you may want to begin with 10 minutes per day or any amount that allows you to be confident in your goal. Allow participants to set one or two goals for themselves. Ask participants to share goals with the group. Have participants find someone in the group to whom they will provide support. For example, they may provide encouragement for that person to accomplish their goal or they may find out how that person is doing in terms of moving toward accomplishing his or her goal.

L- Each week we will provide a lesson on diabetes. E - We will share stories of individuals with diabetes in Kentucky so that you can learn from their experiences. A - We will ask you to set goals for yourself to help you manage diabetes. R - We will also present a situation in the life of someone with diabetes. We will ask you to help that person solve some of the problems he or she is experiencing. N - At the end of the session, we will prepare recipes each week so that you will develop skills to help you make changes in your diet. Tell participants that in the future, our goal is to develop diabetes peer mentors who would provide support for each other. Let participants know that you look forward to seeing them next week for the first lesson on Understanding Your Diabetes. Show participants the Diabetes Checklist. Ask them to begin working on their lists and checking off items as they are completed. They should bring their Diabetes Checklist for all future lessons. Encourage participants to provide support for other people in the class. This could mean encouraging someone to attend class next week. And lastly, ask participants to begin thinking about goals they can set for themselves.

INTRODUCTORY LESSON: Appendix

STAGES OF CHANGE STAGING TOOL Participant s Name: County: Date: / / Agent s Name: ACTIVITIES ACTION STAGES DO YOU 1. Take part in physical activity (walking, aerobics, swimming, dancing, or sports) for 30 or more minutes on three or more days a week? 2. Follow a diabetes meal plan such as carbohydrate counting, the diabetes food pyramid, or the plate method to help you manage your diabetes? 3. Monitor your blood glucose at least once a day? No, I have no intention of doing these activities in the near future. I plan to begin these activities within the next six months. I plan to begin these activities in the next three months. Pre-contemplation Contemplation Preparation 4. Have your A1C checked (if it was not done in the last six months)? 5. Check blood lipids once a year? 6. Have a yearly foot and eye exam? I have done these activities but for six months or less. Action I have done these activities for more than six months. Maintenance Ingrid Adams, Ph.D. Assistant Extension Professor Nutrition and Weight Management

DIABETES CHECKLIST Name: County: Give 5 points for each area that is checked. Diabetes Management Exercise and Medication Check Points Take part in physical activity (walking, aerobics, swimming, dancing, or sports) for 30 or more minutes on five or more days of the week See a health professional one or more times per year Monitor blood glucose daily Have A1C checked Have blood pressure reading taken by a health care professional Have a blood lipid profile done Complied with the diabetes medication regimen prescribed by health care team Diabetes Management Nutrition Use the plate method to control portion size Eat vegetables and fruits with each meal Eat vegetables for snacks Choose whole grains, such as brown rice, whole wheat bread, gluten-free grains Eat dried beans, such as kidney or pinto beans, and lentils in meals Eat fish two to three times a week Choose nonfat dairy such as skim milk, nonfat yogurt and nonfat cheese Choose water and calorie-free diet drinks instead of regular soda, fruit punch, sweet tea, and other sugar-sweetened drinks Cut back on high-calorie snack foods and desserts, such as chips, cookies, cakes, and full-fat ice cream Goal Setting and Problem Solving Set one or more goals during the program Accomplish one or more goals Manage issues that arise as you deal with diabetes Other Medical Management Get a foot exam during the year Get a dilated eye exam Total Points Ingrid Adams, Ph.D. Assistant Extension Professor Nutrition and Weight Management Educational programs of Kentucky Cooperative Extension serve all people regardless of race, color, age, sex, religion, disability, or national origin.