Diabetes Prevention Program Cherryl Matias, PA-S AltaMed Health - PowerPoint PPT Presentation

Barriers to Utilizing the YMCA Diabetes Prevention Program Cherryl Matias, PA-S AltaMed Health Services Corporation Los Angeles, CA

Introduction YMCA Diabetes Prevention Program • 12-month program • 16 weekly group courses • Monthly one-on-one meetings with Lifestyle Coaches • Goals: • 7% body weight reduction • 150 minutes of physical activity per week • 58% reduced risk for diabetes (CDC study) • # of AltaMed patient referrals: 0

Background Se Servi vice ce Plannin anning g Area ea 7: 7: Ea East t Lo Los Angeles geles Key y Indicato icators rs of He Health th (2013) 3) Obesity (BMI > 30.0) Diabetes • National: 28.3% • National: 9.0% • SPA 7: 30.1% • SPA 7: 15.1% Overweight Diabetes death rate • National: 34.5% • National: 20.8% • SPA 7: 40.1% • SPA 7: 27.5%

Project Goals Providers & Staff Patients 1. Identify barriers to making 1. Identify barriers to patient referrals enrolling in the program 2. Design interventions to 2. Design interventions to increase patient referrals increase patient participation

Methodology Informal interviews with YMCA & AltaMed Literature review Medical Provider and Staff Needs Assessment • 15-question Surveymonkey • Pretested for understandability • Email reminders Patient Needs Assessment • 17-question paper survey (English and Spanish) • Spanish translators available • Recruitment: health education classes and waiting rooms of Commerce, Pico Slauson, and Pico Passons

Results Provider/Staff Needs Assessment, n=117

Results Provider/Staff Needs Assessment, n=117 • Diabetes prevention practices : • AltaMed Health Ed Program (80%) • Moderate physical activity (74%) • Weight reduction (72%) • Calorie reduction & healthy foods (72%) • YMCA DPP (11%) • YMCA DPP knowledge gaps “I do not know ” • Description and goals (74%) • Qualification criteria (74%) • Cost (88%) • Referral process (93%) • Suggested solutions : staff training, improved NextGen referral system, brochures for patients

Results Patient Needs Assessment, n=56 Demographics Male 41% (23) Average age: 43 y/o (Range: 20-76 y/o) Hispanic/Latino: 93% (52) Self-reported prediabetics: 36% (20)

Results Patient Needs Assessment, n=56 • YMCA DPP interest: • Yes (89%) • Willing payments: • Insurance only (73%) • 4 monthly payments of $32.25 or less (25%) • Identified barriers to program participation: • Not a YMCA member (64%) • Cannot afford program (57%) • Unsure if health insurance covers program (55%) • Suggested solutions: • Program information (71%)

Discussion • Major findings • Staff: lacking knowledge of the YMCA DPP • Patients: lacking knowledge of diabetes risk factors, cost barriers • Interesting findings • Patients suggest having the skills to succeed in a program like the YMCA DPP (weight loss) • Unexpected findings • Only 22.5% of providers attributed time as a barrier for referring patients to the YMCA DPP • Low interest, low motivation, and limited time to commit to the program not major barriers for patients

Recommendations • Handouts and flow sheets for providers/staff • Educate providers/staff on importance of diagnosing prediabetes • Highlight program at AltaMed Orientation • Improve NextGen referral process • Have brochures available for patients (English, Spanish) • Appoint staff members to assist with DPP registration • Recruit more health insurances and financial assistance programs to cover the cost of the program • YMCA DPP program expansion

Conclusion • The YMCA Diabetes Prevention Program is a valuable community asset and resource • This program has the potential to benefit countless AltaMed patients • Through employee trainings, improved referral processes, and patient education and support, AltaMed patient referrals and participation in the program are expected to increase • AltaMed patient health outcomes will improve and the incidence of diabetes will decrease

Acknowledgements • GE Foundation • Michael Hochman, MD • National Medical • Anne Escaron Fellowships • Jane Chung • AltaMed Health Services • Alissa Singer Corporation • Jennifer Torres • Center for Disease Control • Maria Maldonado, PA-C and Prevention (CDC) • Ji (Jean) Hye Lee • YMCA