Lions District 24-A and The American
Diabetes Association National Capital
Area
Team up to
Stop Diabetes® and Blindness
1
Diabetes Association
Diabetes and Outreach Pilot Outreach
LCIF Core 4 Diabetes
Grant
Pilot Program
May 2012-June 2013
Lions Core 4 Diabetes Project
Lions Preventive Health Screenings and ADA Diabetes/Wellness
Education for Underserved Northern Virginian Communities
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Project Team:
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American Diabetes Association
LCIF
Lions of District 24-A & C
Fairfax County Department of Health
Walgreens
Amerigroup of Virginia
Diabetes Research and Wellness Foundation
Fairfax County Department of Neighborhood and Community Services
Arlington County School and Community Health
United Community Ministries
Hispanic Institute for the Prevention of Blindness
Arcadia Mobile Market
Uno Translations
3
The Lions Diabetes Awareness and Action Program
Mission Statement is:
“To conduct and support local and large-scale effort
leading to the control and treatment of diabetes and its
complications through education, prevention and research.”
The Mission of the American Diabetes Association is:
“To prevent and cure diabetes and to improve the lives of
all people affected by diabetes.”
90% of Adult Onset Blindness is caused by POORLY
managed diabetes
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“The partnership between the Lions Clubs,
ADA and the Fairfax County Health
Department is an example of organizations
that recognize that they have shared
interests and goals and the way to achieve
these goals is by working together”
James Copeland, Former Director of Community Health Development and Preparedness
at the Fairfax County Health Department
5
From 1995 to 2007, the Virginia population
increased by 16%...
Diabetes prevalence increased by 95%.
An estimated 466,883 adult Virginians had
diagnosed diabetes and another estimated
233,441 had undiagnosed diabetes.
http://www.vdh.virginia.gov/ofhs/prevention/diabetes/documents/2012/pdf/2008%20Diabetes%20Burden%20Rpt_rev%20FI
NAL.pdf
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Why Start in Northern Virginia if
Prevalence Rates are Higher Elsewhere?
• Volunteer Supply
• ADA Office
• Connection to Fairfax County Department of
Health
• Concentrated network of non-profits
• Black and Hispanic populations
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http://www.vdh.state.va.us/healthpolicy/documents/health-equity-report-08.pdf
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http://www.vdh.state.va.us/healthpolicy/documents/health-equity-report-08.pdf
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Lions Preventive Health Screenings
&
American Diabetes Association
Diabetes/Wellness Education
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Lions Clubs Participating in The LCIF Core 4 Diabetes Pilot Project
Clubs Participating
Stafford County
Lovettsville
Fairfax Host
Greater Falls Run
Reston
Lake Ridge
Manassas Lioness Lions
Vienna Host
Aquia Harbor Evening
Alexandria Asian American
Fort Belvoir
Aquia Harbor Host
Arlington South
Westmoreland
Bailey’s Cross Roads
Alexandria Watergate
Clifton
Burke
Sterling
Tyson Corner
Gordonsville-24-C
Lake of the Woods-24-C
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Diabetes Association
Diabetes and Outreach Pilot Outreach
Pilot Program
Screening Components
– Consent
– Diabetic Retinopathy Screening
– Blood Pressure
– Blood Glucose
– Local medical and community services
information, follow-up reminder postcards
– BMI
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Diabetes Association
Diabetes and Outreach Pilot Outreach
Pilot Program
Screening Components
– Type 2 Diabetes Risk Assessment Survey
– Health Information: Nutrition, Exercise, Diabetes,
Heart Disease by ADA Diabetes Ambassadors
– Drug Discount Cards and “I have diabetes” bracelets
– Walgreens Free Flu Shots through 1/13
– Amerigroup of Virginia activities for kids and prizes as
of 2/13
– After screenings, participants who were
recommended to care receive follow-up calls
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Non-Mydriatic Canon CR-2 Mobil Retinal Imaging Solution
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The Need for Diabetes Education
“Diabetes is increasing at an alarming rate globally. It is a
complex, chronic condition that affects all areas of a
person’s life and that requires high quality care. To this end,
diabetes education is of critical importance and should be
considered an integral part of diabetes prevention and care.
Unfortunately this is not the case in many countries of the
world where diabetes education is, at best, in its infancy or
non-existent. The combination of lack of access to quality
medical management and diabetes education leads to poor
clinical outcomes, reduced quality of life and high healthrelated costs due to service utilization and the costs of
treatment.”– International Diabetes Federation
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Diabetes Association
Diabetes and Outreach Pilot Outreach
Pilot Program
Becoming an Ambassador
Must sign a commitment contract agreeing to teach 2-8 workshops
per year and complete a training course. Anyone over the age of 18
can lead these workshops. No medical background is required.
Training Process
Length of training process can vary
depending on trainee’s background.
For someone without any medical
background, the training is typically
a total of 4-6 hours.
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Diabetes Association
Diabetes and Outreach Pilot Outreach
Ambassador Responsibilities
Pilot
Program
– Become familiar the American Diabetes Association’s mission,
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programs, and events
Complete diabetes/wellness volunteer ambassador training
Organize schedule of 2-8 diabetes/wellness workshops and submit
schedule
Distribute promotional materials for workshops
Conduct 2-8 diabetes/wellness workshops per year
At each diabetes/wellness workshop, distribute and collect attendance
sheet and relevant pre-/post- questionnaires.
Submit attendance sheet and completed questionnaires after each
workshop.
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Diabetes Association
Diabetes and Outreach Pilot Outreach
ADA Provides
Pilot Program
– Initial and ongoing training (as necessary)
– Workshop implementation guides
– Powerpoint presentations for each diabetes/wellness educational
workshop in English and/or Spanish
– Detailed curricula for each diabetes/wellness educational
workshop in English and/or Spanish
– Promotional items for workshops (flyers to advertise each
workshop)
– Educational materials for workshop participants
– Pre-/post-questionnaires and attendance sheets for each
workshop
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Diabetes Association
Diabetes and Outreach Pilot Outreach
ADA Diabetes
Pilot Ambassador
Program Program
Curricula
Por tu Familia
• Latino population
• All materials available in English and Spanish
• 6 workshops
• Community centers, churches, schools
http://www.diabetes.org/in-mycommunity/programs/latino-programs/por-tufamilia.html
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Diabetes Association
Diabetes and Outreach Pilot Outreach
ADA Diabetes
Pilot Ambassador
Program Program
Curricula
Project Power
• African American population
• Faith-based curricula to guide conversations about diabetes
and healthy living within church community
• Curricula incorporates biblical passages
• 6 workshops, ea. 1-1.5 hrs
http://www.diabetes.org/in-my-community/programs/africanamerican-programs/project-power.html
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Diabetes Association
Diabetes and Outreach Pilot Outreach
ADA Diabetes
Implementation
PilotEducation
Program
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Completed 10 ADA Ambassador training sessions
5 ADA workshops taught
3 more Ambassador training sessions scheduled
Monthly/weekly workshops to be taught by trained ADA Ambassadors
starting in April:
• Bailey’s Community Center
• Wilson Community Center
• Lincolnia Senior Center
• James Lee Community Center
• Lovettsville Schools
• Arlington County Clinic
• UCM Creekside
• Christ the Redeemer Church
• InterChurch Community Health Initiative Churches
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Completed screenings
Place
Population
Town
County
Date
24-A Fall Conference
(trial-run)
District 24-A Lions
Herndon
Fairfax
10-6-2012
United Community
Ministries
UCM Clients-Primarily
Latino
Alexandria
Fairfax
10-20-2012
FACETS
FACETS ClientsPrimarily Asian
Fairfax
Fairfax
11-3-2012
Carlin Springs
Elementary
Arl County ParentsPrimarily Latino and
African
Arlington
Arlington
12-1-2012
Knights of Columbus
Hall
Latino churchmembers
Manassas
Prince William
12-8-2012
Westmoreland Dept
Health and Human
Services
Rural community
Montross
Westmoreland
1-5-2013
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Results at Halfway Point
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25
Diabetes Association
Diabetes and Outreach Pilot Outreach
Participant Age
Pilot Program
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
60 or older
50-59
40-49
Less than 40
***no data collected at District 24-A Conference screening
26
http://cj-network.org/cj/wp-content/uploads/2011/05/VALatinos2011WelCoopCenter.pdf
27
Diabetes Association
Diabetes and Outreach Pilot Outreach
Participant Gender
Pilot Program
100%
90%
23
6
80%
22
14
4
46
27
7
69
70%
60%
50%
40%
30%
71
25
176
20%
Male
Female
10%
0%
***no data collected at District 24-A Conference screening
28
Diabetes Association
Diabetes and Outreach Pilot Outreach
Pilot Program
http://www.vdh.state.va.us/ofhs/prevention/diabetes/documents/2011/pdf/factsheets/Diabetes%20Prevalence/Prevalence%20of%
20Diabetes%20in%20VA.pdf
29
Diabetes Association
Diabetes and Outreach Pilot Outreach
Gestational Diabetes
Pilot Program
100%
90%
80%
No History of
Gestational
Diabetes
70%
60%
50%
History of
Gestational
Diabetes
40%
30%
20%
10%
0%
***no data collected at District 24-A Conference screening 30
Diabetes Association
Diabetes and Outreach Pilot Outreach
Family History of Diabetes
Pilot Program
(mother, father, sister, brother)
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
No Family History of
Diabetes
Family History of
Diabetes
***no data collected at District 24-A Conference screening
31
Diabetes Association
Diabetes and Outreach Pilot Outreach
Hypertension
Diagnosed
by Physician
Pilot
Program
100%
90%
80%
70%
60%
50%
40%
30%
20%
No Hypertension
10%
Hypertension
0%
***no data collected at District 24-A Conference screening
32
Diabetes Association
Diabetes and Outreach Pilot Outreach
Pilot Program
Prehypertensive/Hypertensive Range with No Known History of Hypertension
Prehypertensive Range w/o
Known Hypertension
Diagnosis
30%
52%
18%
***hypertension=140+systolic or 100+diastolic (AHA)
***prehypertension=120-139systolic or 80-89 diastolic (AHA)
Hypertensive Range w/o
Known Hypertension
Diagnosis
Normal Range w/o Known
Hypertension Diagnosis
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Diabetes Association
Diabetes and Outreach Pilot Outreach
Blood Pressure
PilotResults
Program
Prehypertensive Range
25%
43%
Hypertensive Range
Normal Range
32%
***hypertension=140+systolic or 100+diastolic (AHA)
***prehypertension=120-139systolic or 80-89 diastolic (AHA)
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Diabetes Association
Diabetes and Outreach Pilot Outreach
Participant
Sugar Levels
PilotBlood
Program
8%
5%
Blood Glucose <200, >139
Blood Glucose >199
87%
Blood Glucose <140
***Random Blood Sugar
Normal: 80-139 mg/dl
Diabetes: 200mg/dl and above (Diabetes Research and Wellness Foundation)
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Diabetes Association
Diabetes and Outreach Pilot Outreach
Physical Activity Participation
Pilot Program
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
No Physcial Activity
Physical Activity
0%
***no data collected at District 24-A Conference screening
36
Diabetes Association
Diabetes and Outreach Pilot Outreach
Weight Ranges from Risk Assessment Survey
Pilot Program
100%
90%
80%
70%
60%
50%
40%
Least Healthy Weight
Range
Even Less Healthy Weight
Range
30%
Less Healthy Weight
Range
20%
Healthy Weight Range
10%
0%
***no data collected at District 24-A Conference screening
37
Diabetes Association
Diabetes and Outreach Pilot Outreach
Participant BMI Results
Pilot Program
All Screenings
Westmoreland DHHS
Knights of Columbus Hall
BMI>24 (overweight, obese)
Carlin Springs Elementary
BMI<25 (healthy weight)
FACETS
United Community Ministries
District 24-A Conference
0%
20%
40%
60%
80%
100%
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Diabetes Association
Diabetes and Outreach Pilot Outreach
Participant Type 2 Diabetes Risk Test Results
Pilot Program
100%
90%
80%
70%
60%
Not at Risk for Type 2
Diabetes
50%
40%
At Risk for Type 2
Diabetes
30%
20%
10%
0%
***score of 5 or higher qualified for being at
increased risk for type 2 diabetes
39
Diabetes Association
Diabetes and Outreach Pilot Outreach
Pilot Program
Diabetic Retinopathy
Screening Results
Image Type
Quantity
Excellent/good images
27
Fair/poor images
14
Inconclusive findings
10
Diabetic retinopathy
3
Macular degeneration
6
Hypertensive retinopathy
3
Normal
16
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Diabetes Association
Diabetes and Outreach Pilot Outreach
Pilot Program
Diabetic Retinopathy
Screening Results
• 25 individuals were referred for further evaluation.
• Lack of quality in 10 images could be the result of
inadequate skill of the photographer or a lack of clarity
due to an eye problem or pupil size.
• 20% of known diabetics being screened by the camera
have diabetic or related complications in the eye.
• Other eye problems (i.e. optic nerve atrophy, retinal
infarcts, macular degeneration, and glaucoma) were
found.
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Diabetes Association
Diabetes and Outreach Pilot Outreach
Follow-up Calls Results
(Data isProgram
Incomplete at this Time—34 of 106)
Pilot
3%
Followed-Up
6%
9%
47%
Appointment
Scheduled
Information Given
No Answer
23%
In Progress
Disconnected
9%
Other
3%
42
Diabetes Association
Diabetes and Outreach Pilot Outreach
What We’ve Learned So Far
Pilot
Program
• Flu shots are a great incentive
for early
fall screenings—pre-November
• Strong partnerships with county governments, businesses, and local
charities are critical for project success
• Turnout diminishes in colder months (not a surprise)
• If no incentives are offered outside of medical services in more rural areas,
turnout is very low
• Monthly ADA workshops are most-feasible for volunteers
• Host-organization community influence and trust is critical to good
turnout
• Spanish-speaking volunteers are highly valuable
• Turnout is greatest in Hispanic communities
• Kid-friendly activities needed to attract families
• Direct referral system would be highly beneficial to participants with
abnormal results at screenings
• Postcards have not been an effective way of tracking participant follow-up,
calls most effective
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Future screenings
Place
Population
Town
County
Date
Lincolnia Senior
Center
Seniors, Latino
Population, Uninsured
Alexandria
Fairfax
3-30-2013
Our Lady of Angels
Catholic Church
Latino congregation
Woodbridge
Fairfax
4-20-2013
Huntington
Community Center
Latino clients
Alexandria
Fairfax
4-27-2013
Lovettsville Game
Club-Lovettsville
Cares
Rural community
Lovettsville
Loudon
5-4-2013
Arlington
Arlington
5-11-2013
Alexandria
Fairfax
5-18-2013
Arlington
United Community
Ministries-Creekside
Community Center
Latino community
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Year-end Project Evaluation
How many people were screened?
What was the health profile of screening participants?
How many people were referred to see a health care provider
due to abnormal screening results?
How many people followed-up with a health care provider?
How many diabetes education programs
were held? How many people attended?
Final Report to LCIF due on 6-22-2013
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What does this all mean?
What do we do from here?
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Resources:
Our Blog: www.lc4dp.org
www.valions.org
www.diabetes.org
Like us on Facebook and follow us on Twitter!
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Questions
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