Diabetes Providers

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NATIONAL DIABETES PREVENTION RECOGNITION PROGRAM (DPP) LIFESTYLE CHANGE PROGRAM

OVERVIEW

Individuals with prediabetes are at higher risk of serious health problems, including:

Heart attack
Stroke
Blindness
Kidney failure
Loss of toes, feet, or legs

Having prediabetes doesn’t guarantee a person will develop type 2 diabetes. Participation in a CDC-recognized lifestyle change program can help people prevent or delay type 2 diabetes and improve their overall health.

PROVEN SCIENCE BASED PROGRAM

Studies have shown that people with prediabetes who take part in a structured lifestyle change program and lose 5% to 7% of their body weight through healthier eating and 150 minutes of physical activity per week can cut their risk of developing type 2 diabetes by 58% (71% for people over 60 years old).

CDC monitors and evaluates programs to ensure quality and provides feedback on data submitted so you can make improvements if needed. Because the CDC-recognized programs are so effective, some employers and insurers are offering them as covered benefits.

The National Diabetes Prevention Program is a year-long program that teaches participants to make lasting lifestyle changes—like eating healthier, adding physical activity into their daily routine, and improving coping skills.
The CDC recognizes organizations to provide DPP as they meet certain standards and show they can achieve results. These standards include following an approved curriculum and facilitation by a trained Lifestyle Coach.

T he Diabetes Prevention Program (DPP) was a major multicenter clinical research study. The intervention involved a lifestyle change program focusing on calorie reduction and increasing physical activity to at least 150 minutes per week. Results from the study showed that this structured lifestyle change program—in which participants achieved weight loss of 5 to 7 percent of their body weight (10 to 14 pounds for a person weighing 200 pounds)—reduced the risk of developing type 2 diabetes by 58 percent in adults at high risk for the disease.

A 10-year follow-up study, T he Diabetes Prevention Program Outcomes Study, showed that participants were still one-third less likely to develop type 2 diabetes a decade later than individuals in placebo groups.

Summaries of additional research studies can be found in CDC’s National DPP Coverage Toolkit.

Check out the National DPP Toolkit to learn more about the NDPP and who covers it.

Program participants must meet ALL 4 of these requirements:

Be 18 years or older.
Have a body mass index (BMI) of 25 or higher (23 or higher if you’re an Asian American person).
Not be previously diagnosed with type 1 or type 2 diabetes.
Not be pregnant.

They will also need to meet 1 of these requirements:

Had a blood test result in the prediabetes range within the past year (includes any of these tests and results):
- Hemoglobin A1C: 5.7%–6.4%
- Fasting plasma glucose: 100–125 mg/dL
- 2-hour plasma glucose (after a 75g glucose load): 140–199 mg/dL.
Be previously diagnosed with gestational diabetes (diabetes during pregnancy).
Received a high-risk result (score of 5 or higher) on the Prediabetes Risk Te st

If your patient is enrolling in the Medicare Diabetes Prevention Program, different criteria apply. Find them here.

IF YOU ARE A HEALTH CARE PROFESSIONAL, BRING DPP PROGRAMS TO YOUR ORGANIZATION

The Diabetes Prevention and Control program is actively looking for ways to increase access to diabetes prevention programs and support services.

If you are interested in starting a NDPP or currently have a NDPP and would like assistance. Available assistance consists of technical assistance from National State Quality Specialist for DPP, training opportunities for Lifestyle Coaches, continuing education opportunities, assistance with the application for program recognition, and start-up and expansion costs (as funds allow).

For more information about and assistance with establishing a Diabetes Prevention Recognized Program, contact the Arkansas Diabetes Prevention and Control Program at 501-661-2075.

DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT (DSMES) PROGRAM

THE IMPORTANCE OF DSMES SERVICES TO HEALTH CARE PROVIDERS

Patients count on their health care provider more than any other source of information to help them manage a serious chronic condition like diabetes. However, all healthcare professionals have felt the strain of keeping to a schedule at some point in their career. It is unfortunate, but there is only so much time a provider and their staff can spend with a patient resulting in limited information and education about a chronic disease. Referring patients to a DSMES program takes the stress off the provider to provide comprehensive diabetes education at a single appointment.

As a health care provider, you play a vital role in helping your patients manage their diabetes by referring them to DSMES services. Here are some great reasons to refer your patients with diabetes to DSMES services.

People need access to services and support to help them make the lifestyle changes required to effectively manage their diabetes.
Additional support helps people with diabetes stay motivated, lets them know they are not alone, and can help them stay on track with their management goals.
Better health management can help people with diabetes live longer and healthier lives.
DSMES is an evidence-based diabetes management service model that can help people with diabetes prevent or delay diabetes complications.
Participation in DSMES is cost effective. Studies show these services reduce hospital admissions and avoidable readmissions.
DSMES participants have higher satisfaction rates with their care, improved knowledge, better treatment adherence, more positive outcomes, and improved quality of care.
Diabetes care and education specialists offer personalized care that supports your treatment plan and improves your patients’ self-efficacy.
DSMES participants are more likely to get routine lab work, recommended immunizations, medication adherence support, and regular care for eyes, ears, teeth, and feet.

T he National Standards of Medical Care in Diabetes states that all people with diabetes should participate in diabetes self-management education and support (DSMES) and individualized medical nutrition therapy (MNT).

WHERE CAN A PROVIDER FIND A DSMES RECOGNIZED OR ACCREDITED PROGRAM?

There are two entities that can give this recognition or accreditation, the American Diabetes Association (ADA) and the Association of Diabetes Care and Education Specialists (ADCES). Both programs meet the same six National Stan dards but have slightly different interpretive guidance on how to best meet those standards.

Locate a program near your practice here.

INTERESTED IN STARTING A DSMES?

The Centers for Medicare & Medicaid Services (CMS) has authorized ADCES and ADA to grant accreditation and recognition, respectively, to DSMES service providers. Both require the following:

Formal application process
Supporting documentation
Fee with application
Annual reports and renewals
Audit of existing services to ensure compliance with requirements

Benefits of being an accredited or recognized provider include:

DSMT* billing through Medicare, private insurers, and some state Medicaid agencies
Improved care and health status reporting
Alignment with quality improvement and population health goals
Access to ADCES or ADA resources and support

*CMS uses the term “training” (DSMT) instead of “education and support” (DSMES) when defining the reimbursable benefit. This term relates specifically to Medicare billing.

Check out the CDC’s DSMES Tool kit to learn more about the application process.

DSMES programs are traditionally delivered by nurses, registered dietitians, and other important members of the health care team, but they are not limited to just clinical or hospital settings. Additional health care settings and professionals, such as Shared Medical Appointments (SMA) and pharmacists can also provide and bill for DSMES services. Check out Georgia Department of Health and how they have utilized pharmacies to improve diabetes outcomes in their state.

See this Diabetes Self-Management Education Training video.

If you are interested in starting a DSMES or currently have a DSMES and would like assistance. Available assistance consists of technical assistance from a DSMES State Specialist, continuing education opportunities, and assistance with the application for program recognition.

For more information about and assistance with establishing a Diabetes Self-Management Education and Support Program (DSMES), contact the Arkansas Diabetes Prevention and Control Program at 501-661-2075.

COMPLEMENTARY DIABETES EDUCATION AND SUPPORT

Are you not sure if your program has the capacity to provide an accredited or recognized DSMES program? There are other options. Complementary diabetes education and support opportunities are available that provide community-based diabetes education. These programs do not replace a DSMES program but can provide continued education and support after DSMES services are provided or if services are not immediately or readily available.

Examples of complementary diabetes education programs can include:

Diabetes focused cooking classes
Comprehensive diabetes care programs that include diabetes basics and lifestyle management techniques
Physical activity programs that incorporate diabetes risk reduction
Other diabetes-focused programs or events

HOW ADH IS HELPING TO EXPAND DSMES AND COMPLEMENTARY DIABETES PROGRAMS

The Arkansas Department of Health is working to increase access to diabetes management and support services. Current activities include:

Providing technical assistance to healthcare systems, clinics, Federally Qualified Health Centers (FQHC), pharmacies, and other programs in establishing DSMES and/or complementary diabetes programs.
Connecting programs with diabetes resources and evidence-based information.
Assisting with start-up and program expansion costs (as funds allow).
Providing enrollment opportunities for pharmacies in the National Community Pharmacists Association’s Di abetes Accreditation Bootcamp.
Facilitating continuing education and training in DSMES supportive topics like billing, networking, and program expansion. Partnering with various clinics, diabetes management and prevention-focused programs, and the U niversity of Arkansas Clinton School of Public Service to initiate a statewide assessment of Arkansans’ perceptions & barriers to diabetes care programs in their specific community.

The Diabetes Prevention and Control program is actively looking for ways to increase access to diabetes programs and support services.

SOCIAL DETERMINANTS OF HEALTH (SDOH)

The Arkansas Department of Health is working to improve social determinants of health. Current activities include:

ARKANSAS WALKING COLLEGE

In July 2021, the Arkansas Department of Health engaged Americ a Walks to deliver its national Walking College program within the State of Arkansas (Arkansas Walking College).

Goal: build the capacity of local change agents to increase walking and improve walkability in their communities.

Focus: organizing for policy change to create safe, walkable, livable communities:

16 week online educational program for walkable community advocates
Towards the end of the course, each fellow develops a Walking Action Plan for their community, which establishes specific goals and an implementation strategy

SDOH ASSESSMENTS

The Arkansas Diabetes Prevention and Control Program conducts periodic assessments in collaboration with diabetes programs in various communities. These assessments help the programs understand the current strengths, resources, and needs of the identified communities that will allow the programs and the Diabetes Prevention and Control Program to tailor activities, communications, and partnership so that they are well-received and address the unique needs of the priority populations. The aim is to increase participation and retention in the diabetes programs, and to identify resources to assist participants in addressing social determinants of health to achieve prevention and management goals.

Complete a 1-hour interview (via zoom).
Introduce researchers to potential & current diabetes program participants who may be interested in participating in a focus group (via email, flyers, etc.).
Introduce researchers to additional practitioners who may be interested in completing an interview (via email)
Help us find a community space to conduct focus groups.

Partners will receive results of the assessments and financial (as available) and technical assistance with implementing awareness/marketing campaigns and tailoring materials.

For more information or to nominate your program/community for the assessments, please contact the Arkansas Diabetes Prevention and Control Program at 501-661-2075.

COMMUNITY HEALTH WORKERS (CHWS)

The Arkansas Diabetes Prevention and Control Program is collaborating with the Arkansas Community Health Worker Associatio n (ARCHWA) to:

Implement a state-wide summit of Arkansas CHWs including sessions on diabetes related topics.
Train CHWs on barriers to social services and support needs (e.g., childcare, transportation, language translation, food assistance, and housing) within populations at highest risk of cardiovascular disease and/or diabetes.
Equip CHWs with regional community resources to enhance community-clinical links with Housing and Urban Development (HUD), food banks and pantries, and transportation resources for patients identified to have SDOH-related social service and support needs.
Host the Diabetes Prevention CHW Network and train Network to better integrate diabetes Team-Based Care and referrals to National Diabetes Prevention Program (DPP) lifestyle intervention and Diabetes Self-Management Education and Support (DSMES) services.
Engage community organizations (e.g., churches, employers, healthcare clinics) to facilitate integration of CHWs into DPP/DSMES delivery teams.

Social Determinants of Health (SDOH)

Social Determinants of Health (SDOH) are non-medical factors that affect a wide range of health, functioning, and quality-of-life outcomes and risks. They include the conditions in which people are born, grow, work, live, and age. SDOH also include the broader forces and systems that shape everyday life conditions.

Arkansas Diabetes Prevention and Control Program (DPCP) adapted this definition from CDC and Healthy People 2030 definitions of SDOH. You can also find more information about SDOH at the links above.

“Diabetes can be prevented or controlled only through supportive policies, social conditions, and environments and by promoting more prepared, proactive health systems practice teams that enable informed and activated patients.” (Source: Connecting SDOH and HRSN to Prediabetes and Type 2 Diabetes).

ARKANSAS DIABETES PREVENTION AND CONTROL PROGRAM’S APPROACH TO ADDRESSING SDOH FOCUSES ON:

Food and Nutrition Security – Having reliable access to enough high-quality food that is safe, affordable, and culturally acceptable to avoid hunger, and lead an active, healthy life.
Built Environment – Human-made surroundings that influence overall community health and people’s behaviors that drive health.
Community-Clinical Linkages – connections made between healthcare, public health, and community organizations to improve population health.

ARKANSAS WALKING COLLEGE

In July 2021, the Arkansas Department of Health engaged America Walks to deliver its national Walking College program within the State of Arkansas (Arkansas Walking College).

Goal: build the capacity of local change agents to increase walking and improve walkability in their communities

Focus: organizing for policy change to create safe, walkable, livable communities through:

16 week online educational program for walkable community advocates
each fellow develops a Walking Action Plan for their community, which establishes specific goals and an implementation strategy

SDOH ASSESSMENTS

The Arkansas Diabetes Prevention and Control Program conducts periodic assessments in collaboration with Diabetes Self-Management Education and Support programs, Diabetes Prevention Programs, and complimentary diabetes programs in various communities. These assessments help those programs understand the current strengths, resources, and needs of the identified communities that will allow the programs and the Diabetes Prevention and Control Program to tailor activities, communications, and partnerships so that they are well-received and address the unique needs of the priority populations. The aim is to increase participation and retention in the diabetes programs, and to identify resources to assist participants in addressing social determinants of health to achieve prevention and management goals.

Complete a 1-hour interview (via zoom).
Introduce project team members to potential & current diabetes program participants who may be interested in participating in a focus group (via email, flyers, etc.).
Introduce project team members to additional practitioners who may be interested in completing an interview (via email)
Help us find a community space to conduct focus groups.

Partners will receive results of the assessments and financial (as available) and technical assistance with implementing awareness/marketing campaigns and tailoring materials.

For more information or to nominate your program/community for the assessments, please contact the Arkansas Diabetes Prevention and Control Program at 501-661-2075.

COMMUNITY HEALTH WORKERS (CHWS)

The Arkansas Diabetes Prevention and Control Program is collaborating with the Arkansas Community Health Worker Association (ARCHWA) to:

Implement a state-wide summit of Arkansas CHWs including sessions on diabetes related topics;
Train CHWs on barriers to social services and support needs (e.g., childcare, transportation, language translation, food assistance, and housing) within populations at highest risk of diabetes and/or cardiovascular disease;
Equip CHWs with regional community resources to enhance community-clinical links with HUD, food banks and pantries, and transportation resources for patients identified to have SDOH-related social service and support needs;
Host the Diabetes Prevention CHW Network and train the Network to better integrate diabetes Team-Based Care and referrals to National Diabetes Prevention Program (DPP) lifestyle intervention and Diabetes Self-Management Education and Support (DSMES) services;
Engage community organizations (e.g., churches, employers, healthcare clinics) to facilitate integration of CHWs into DPP/DSMES delivery teams.

OTHER STRATEGIES TO IMPROVE SOCIAL DETERMINANTS OF HEALTH

FOOD ENVIRONMENT

Promote local garden projects, small farms, farmers’ markets, farm to school, and gleaning programs.
Promote participation in nutrition assistance programs.
Utilize evidence-based nutrition education programs.
Educate health care professionals and cross-functional hospital teams in nutrition education and about access to healthy food.
Promote current public policies to assure inclusion of healthy foods for distribution to low-income Arkansans.

BUILT ENVIRONMENT

Connect more people to parks, particularly in nature-deprived communities.
Promote active transportation and land use policies to support physical activity.
Promote built environment interventions, (e.g., parks, walking paths) community programs (e.g., social support programs), and policies (e.g., complete streets policies) which can help reduce or eliminate barriers to making it easier for people to be physical active.

COMMUNITY-CLINICAL LINKAGES

Provide training and disseminate training resources on SDOH for CHWs, DSMES and DPP partners, Office of Health Disparities, Arkansas Pharmacy Association (ArPA), and other healthcare professionals through partnership with relevant entities.
Improve capacity of the diabetes workforce to address social determinants of health (SDOH) related barriers.
Collaborate with the Arkansas Community Health Worker Association (ARCHWA) to engage and educate CHWs to promote and disseminate diabetes-related culturally adaptive materials and services in Team-based Care for priority populations with diabetes.

FIND SDOH RESOURCES HERE.

Programs & Services