HN-1-Disease Prevention and Management (2015)
Plan Overview:
Vision - Michigan residents and communities practice and support healthy lifestyle behaviors
resulting in reduced risk of chronic disease.
Mission - To promote health and wellness by reducing and managing the incidence and impacts
of chronic diseases among Michigan residents and communities by using prevention-focused,
evidence-based practices.
Objectives:
1. Apply policy, systems and environment changes towards supporting healthy lifestyle
behaviors.
2. Cultivate resilience and self-motivation for healthy behavioral change.
3. Expand accessibility through local programming, distance learning and train-the-trainer.
4. Engage multi-level partnerships with diverse audiences from local level to national level.
5. Demonstrate accountability through evidence-based, prevention focused practices.
Inputs
HN-1. Disease
Prevention and
Management

Outputs
0 - HN-1-O-01:
Dining with
Diabetes
Learning Outcomes
HN1-DPM-L1:
Disease Prevention and
Management Participants report
knowledge of key
health measures: blood
sugar, blood pressure,
cholesterol, Body Mass
Index, plus A1C if
applicable.

HN1-DPM-L1I1: Disease
Prevention and
Management Number of
participants
report
Action Outcomes
HN1-DPM-A1:
Disease Prevention and
ManagementParticipants report
improved behaviors
related to food
consumption and
physical activity

HN1-DPM-A1I1: Number of
participants
report improved
behaviors
related to food
consumption
and physical
knowledge of
key health
measures:
blood sugar,
blood pressure,
cholesterol,
Body Mass
Index, plus
A1C if
applicable.
activity
HN1-DPM-L2: Dietary
Quality-Participants
improve knowledge
about healthy eating
for diabetes and
management


0 - HN-1-O-02:
National
Diabetes
Prevention
Program
HN1-DPM-L2I1: Dietary
QualityNumber of
participants
improve
knowledge
about healthy
eating for
diabetes and
management
HN1-DPM-L1:
Disease Prevention and
ManagementParticipants report
knowledge of key
health measures: blood
sugar, blood pressure,
cholesterol, Body Mass
Index, plus A1C if
applicable.

HN1-DPM-L1-
HN1-DPM-A1:
Disease Prevention and
ManagementParticipants report
improved behaviors
related to food
consumption and
physical activity

HN1-DPM-A1I1: Disease
Prevention and
I1: Disease
Prevention and
ManagementNumber of
participants
report
knowledge of
key health
measures:
blood sugar,
blood pressure,
cholesterol,
Body Mass
Index, plus
A1C if
applicable.
ManagementNumber of
participants
report improved
behaviors
related to food
consumption
and physical
activity
HN1-DPM-L3:
Lifestyle ChangesParticipants report
increased commitment
to making sound
lifestyle choices and
healthy behaviors.



0 - HN-1-O-03:
PATH
0 - HN-1-O-04:
Diabetes
PATH
HN1-DPM-L3I1: Lifestyle
ChangesNumber of
participants
report increased
commitment to
making sound
lifestyle choices
and healthy
behaviors.
HN1-DPML1: Disease Prevention
and ManagementParticipants report
knowledge of key
HNI-DPM-A2: Health
Care UtilizationParticipants report
improved behavior
related to health care

0 - HN-1-O-05: health measures: blood utilization
sugar, blood pressure,
Chronic
cholesterol, Body Mass
PATH
 HNI-DPM-A2Index, plus A1C if
I1: Health Care
applicable.
UtilizationParticipants
 HN1-DPM-L1report improved
I1: Disease
behavior related
Prevention and
to health care
Managementutilization
Number of
participants
report
knowledge of
key health
measures:
blood sugar,
blood pressure,
cholesterol,
Body Mass
Index, plus
A1C if
applicable.
HN1-DPM-L4: Self efficacy-Participants
have reported levels of
self-efficacy related to
healthy lifestyle
behaviors

HN1-DPM-L4I1: Self efficacyNumber of
participants
have reported
levels of selfefficacy related
to healthy
lifestyle
behaviors

0 - HN-1-O-06: HN1-DPM-L5:
PATH Leader Education-Staff,
partners and volunteers
Training
will report increased
knowledge and skills
to conduct Disease
Prevention and
Management
education.

Outputs without
related indicators





0 - HN-1-OO7: One Time
Presentations
0 - HN-1-O-08:
Geriatric
Education
Center
modules
0 - HN-1-O-09:
Immunization
Project
0 - HN-1-O-10:
College of
Human
Medicine
0 - HN-1-O-11:
Health
HN1-DPM-L5I1: EducationStaff, partners
and volunteers
will report
increased
knowledge and
skills to
conduct
Disease
Prevention and
Management
education.


Insurance
Literacy
0 - HN-1-O-12:
Various DPM
approved
presentations
0 - HN-1-O-13:
Coalitions
Situation:
Chronic diseases are among the most prevalent, costly, and preventable of all health issues. Over
60% of Michigan adults have at least one chronic condition, which results in spending 75 cents
of every health care dollar to treat these conditions. Over 95% of Michigan adults report
engaging in unhealthy behaviors that increase their risk of developing a chronic disease (MDCH
2014). According to the World Health Organization, if the major modifiable risk factors (i.e.,
inadequate physical activity, poor diet, and smoking) were eliminated, at least 80% of heart
disease, stroke, type 2 diabetes, and 40% of cancers would be prevented. To be most effective,
chronic disease prevention requires a multi-sector approach across the lifespan, which includes
health promotion, early detection, and appropriate management of chronic disease (The Power of
Prevention 2009). Michigan State University Extension (MSUE) is positioned to provide
education to Michigan citizens related to the prevention and management of leading chronic
diseases.
In 2009 more Michigan adults had risk factors for chronic disease, such as obesity (30.3%), high
blood pressure (30.4%), high cholesterol (38.9%), and diabetes (9.4%) than the US median
(26.9%, 28.7%, 37.5%, and 8.3%, respectively). More than one half of Michigan adults (58.4%)
reported having at least one of these four health risk factors and adults with a disability (75.6%)
were more likely to report having one of these risk factors than adults without a disability
(53.6%). There were racial disparities, with a higher percentage of African Americans reporting
being obese (41.6%), having diabetes (12.6%), and having high blood pressure (36.8%)
compared to whites (28.7%, 8.6%, and 29.8%, respectively). Additionally, adults with a
disability reported higher percentages of obesity (35.1%), high blood pressure (47.4%), high
cholesterol (50.6%), or diabetes (18.4%) than adults without a disability (27.0%, 25.4%, 35.3%,
and 6.8% respectively).
The prevalence of each risk factor increases with age that leads to higher prevalence of chronic
illnesses, (MDCH 2013). This is particularly alarming for Michigan, because the state’s
population is growing older at a faster rate than the rest of the country (2011 Health Care
Association of Michigan Study). The 2011 U.S. census data shows that the adult population over
the age of 65 in Michigan was 14.1% compared to the national percentage of 13.3%. Eighty-two
percent of older adults have at least one chronic condition, which is putting a financial burden on
the health care system. The annual average expenditure on an older adult with chronic conditions
is $5,115 as opposed to $211 for an older adult without a chronic condition (Chi, 2011).
Currently, the most prevalent chronic condition among older adults in the U.S. is heart disease
(49%) followed by diabetes (8.3%) (Chi, 2011).
In addition, Rural Americans are more likely to have chronic illnesses and lack access to
treatment due to transportation costs, lack of public transit, or distance of closest facility.
In 2011, according to the Michigan Department of Community Health, an estimated 10.0%
(758,300) of Michigan adults 18 years and older have been diagnosed with diabetes, and an
additional 250,200 Michigan adults are estimated to have diabetes but are currently undiagnosed.
Prediabetes, a condition in which blood sugar levels are higher than normal but not yet high
enough to be diagnosed as diabetes has a high prevalence of 35% among U.S. adults. Individuals
with prediabetes are at a higher risk for developing type II diabetes. However, the onset of type
II diabetes can be delayed, and some cases prevented, if individuals lose 5-10% of their body
weight and exercise 150 minutes a week (NIH 2011).
It is estimated that the state can save $545 million spent across all chronic diseases by investing
$10 in preventive care per person per year. Unfortunately, budget cuts to educational programs
and the increasing economic challenges experienced by health clinics and hospitals have put a
serious strain on the current delivery system for diabetes education in many regions of the state.
Other sources of health education are needed to fill this growing gap in service (Peters, C. J. &
Cronk, L., 2008). Another gap in the current health system is the fact that health promotion and
prevention programs lag behind in the senior population, which is perceived as a population
that’s less likely to change its lifestyle habits. As a result, prevention efforts have been heavily
geared toward younger populations such as children and younger adults.
MSU Extension can address some of these gaps by focusing its efforts on delivering research and
evidence based programs focusing on prevention and disease management to adults who need it
the most. MSU Extension will also engage in multi-level partnerships that align with mission and
vision of the Health and Nutrition Institute (HNI) and Disease Prevention and Management to
reduce the prevalence of chronic disease in Michigan. MSU Extension will use existing
resources that target behavior and systems strategies for chronic disease prevention programming
and health promotion that will reduce and manage the incidence and impacts of chronic diseases
among Michigan residents.
Diversity and Civil Rights Efforts:
Please briefly describe your planned diversity and civil right efforts. You may or may not
want to leave some of the narrative that auto-populates from the state plan for this section.
The rate of chronic disease among people with disabilities is three times that of the general
population. Individuals with disabilities have greater obstacles to overcome in order to
participate in physical activities in shopping for and preparing food. Following 2014 federal civil
rights audit, work team members will place a priority on reaching and involving participants with
disabilities in workshops as well as continuous use of the required civil rights verbiage.
African Americans and Native Americans have twice the prevalence of diagnosed diabetes and
Hispanics have seventy-five percent more diagnosed diabetes as compared to white, nonHispanic adults. Through training, coordination and collaboration the Disease Prevention and
Management work team will strive to reach these audiences.
“Eliminating health disparities will also require new knowledge about the determinants of
disease, causes of health disparities, and effective interventions for prevention and treatment. It
will also require improving access to the benefits of society, including quality preventive and
treatment services, as well as innovative ways of working in partnership with health care
systems, State and local governments, tribal governments, academia, national and communitybased organizations, and communities”http://www.cdc.gov/omhd/about/disparities.htm
The majority of participants in DPM programs are female; efforts will be made to reach more
male participants.
Individual work team members will review county demographic data to ensure that diverse
populations are being reached in parity.
DPM materials will be reviewed to ensure that they include statements regarding accommodation
for people with disabilities. “And Justice for All” slide will be included in all PowerPoint
presentations and all DPM members will have the poster for display when PowerPoint is not
being used.
One-time presentation attendance, including racial and ethnic background, will be collected
confidentially.
Deliverables:
Place deliverables here using template provided in attachments.
Outputs/Inputs
Please Note: It is critical that you enter the number of program planned and projected number of
participants into this section. That is the primary way in which MIPRS tracks outputs.
System will auto populate outputs from work group plan (will include audience group). Select
those appropriate for your individual plan. Please complete the following:
The Disease Prevention and Management Work Team have seven curriculum and multiple
presentations for FY2015:
- Dining with Diabetes
- Personal Action Toward Health (PATH, Diabetes PATH and Chronic Pain PATH)
- PATH Leader Training
- National Diabetes Prevention Program
- National Diabetes Prevention Leader Training
- One Time Presentations:
-Geriatric Education Center modules
- Immunization Project
- College of Human Medicine
- Health Insurance Literacy
-Various DPM approved presentations
Total number of workshops planned for Dining with Diabetes: ____
Total number of PATH workshops planned: ____
Total number of Diabetes PATH workshops planed: ____
Total number of Chronic Pain PATH workshops planned: ____
Total number of PATH Leader Training workshops planned: ____
Total number of National Diabetes Prevention Program workshops planned: ____
Total number of One Time Presentation workshops planned: ____
Name of project and number:
Total number of participants you plan to reach with Dining with Diabetes classes: ____
Total number of participants you plan to reach with PATH classes: ____
Total number of participants you plan to reach with Diabetes PATH classes: ____
Total number of participants you plan to reach with Chronic Pain PATH classes: ____
Total number of participants you plan to reach with PATH Leader Training classes: ____
Total number of participants you plan to reach with National Diabetes Prevention Program
classes: ____
Total number of participants you plan to reach with National Diabetes Prevention Leader
Training classes: ____
Total number of participants you plan to reach with One Time Presentations: ____
Professional Development Related to this Logic Model:
Please briefly describe your professional development plans related to this logic model. You
may or may not want to leave some of the narrative that auto-populates from the state plan
for this section.
Trainings will be offered via Adobe Connect as well as face-to-face or other technical avenues,
when appropriate. Work team members have identified technology, worksite wellness and grant
writing as possible training topics for 2014. There is also an interest in learning more about MSU
research departments including but not limited to the MSU College of Human Medicine and
potentially receiving training from MSU CHM so that we are able to provide patient education as
well as train the health care community. Other training topics include: Affordable Care Act,
health insurance literacy, communicating with the medical care community, eXtension
involvement, developing partnerships, and reaching underserved audiences.
Evaluation Overview:
All series participants will complete summative evaluations to measure short term attitude and
knowledge change will be evaluated using standardized pre/posttests or summative evaluations
depending on the program. Demographics will be collected for each participant using the Health
and Nutrition Institute/Disease Prevention and Management standardized Adult Demographic
Form. Pre/post data and demographics have been collected via Survey Monkey and analyzed by
the evaluation committee. Data from the CDC report for the National Diabetes Prevention
Program will be collected. A statewide report will then be generated annually and all team
members who contributed data will be tagged.
Evaluation results will be utilized to inform internal audiences such as supervisors,
organizational directors, and funders and external audiences such as the general public through
sources such as the Report to Our Partners.
Related files:



PLAN4585HNI-DPM i-POW 2015 final.pdf
o Original plan: HN-1-Disease Prevention and Management
o submitted by Laura Anderson 9/22/14
PLAN4585Disease Prevention and Management Work Team Logic Model 2015 final.pdf
o Original plan: HN-1-Disease Prevention and Management
o submitted by Laura Anderson 9/22/14
PLAN4585Auto-text for HNI-DPM I-POW 2015-1 sent 10-21-14.doc
o Original plan: HN-1-Disease Prevention and Management
o submitted by Dawn Contreras 10-21-14