Recommending a Strategy

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GOOD MORNING!!!!!!
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• NMA
• Diabetes Education Program

ACKNOWLEDGEMENT The NMA Diabetes Education
Program is supported by a cooperative agreement
from the Division of Diabetes Translation,
Centers for Disease Control and Prevention (CDC)
and the National Diabetes Education Program
(NDEP).
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Steps for Developing and Sustaining a Coalition
Presentation for the CDC Translation Conference
Roslyn A. Douglas, M.A. Program
Coordinator Thursday April 23, 2009
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THE OBJECTIVE

• Review the process utilized by the National
  Medical Association to create and sustain
  coalitions.
• Share Lessons Learned (Barriers Pitfalls)
• Provide brief summation of the evaluation efforts
  conducted by the Maya Tech Corporation.

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Diabetes Epidemic

• 23.6 million Americans have diabetes 7.8
  population, (5.7 million undiagnosed)
• 1.5 million people ages 20 or older are diagnosed
  each year
• More than 3500 new cases each day
• 3.7 million African Americans ages 20 or older
  are estimated to have diabetes (14.7 of the AA
  population)
• Type 2 accounts for 90 - 95 all diagnosed cases
  of diabetes

Source NIDDKD. National Diabetes Statistics
fact sheet, 2007.
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Diabetes Education Program

• Purpose Strengthen the NMAs capacity to reduce
  the disproportionate burden of diabetes in
  blacks.
• Goal To prevent the onset of diabetes, promote
  early diagnosis, and improve treatment outcomes
  for people with diabetes
• Strategy Sustain coalitions in at least six
  cities to conduct community outreach and
  education.
• Target Population
• General public (outreach)
• Diabetes patients
• Physicians

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Diabetes Education Program

• Objective 1 Establish and sustain at least six
  diabetes coalitions.
• Objective 2 Conduct community outreach
  activities focusing on the three target groups.
• Objective 3 Educate diabetes patients.
• Objective 4 Educate NMA physicians.

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METHODS

• Review the process utilized by the National
  Medical Association to create and sustain
  coalitions.

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• Step 1 Research
• City sites for the Coalitions were selected
  based on diabetes prevalence.

• NMA Coalition Cities
• Atlanta
• Houston (Originally New Orleans Katrina)
• Indianapolis (Originally Nashville, TN)
• Los Angeles
• Pine Bluff (Originally Tallahassee, FL)
• Washington, DC

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Brief Statistics
ATLANTA In 2005, 8.4 of the adults in
Georgia had diabetes. Blacks 9.4 compared
to 6.0 Whites. Source Atlanta Journal
Constitution, 2008 Source 2003 Georgia
Diabetes Report
HOUSTON In 2005, the death rate of Blacks
with diabetes was 55 per 100,000 compared to 52
Hispanic/Latino and 21 Whites. Source Texas
Diabetes Council Diabetes Fact Sheet 2008
http//www.dshs.state.tx.us/diabetes/PDF/diabet
esfacts.pdf
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Brief Statistics Update (Continued)
INDIANAPOLIS In 2005, diabetes was the 6th
leading cause of death in Indiana. The 4th
leading cause of death of Blacks, 7th
Whites and 6th for Hispanics. Source 2008,
DPCP Indiana State Department of Health, Diabetes
in Indiana. http//www.in.gov/isdh/files/2-08_Diab
etes_Burden.pdf
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Brief Statistics Update (Continued)
Los Angeles 1 out 10 Californians has
diabetes. AA population was the third
highest group affected. Source
California Diabetes Program, 2008 Fact Sheet
http//www.caldiabetes.org/content_display.cfm?con
tentID1029ProfilesID22CategoriesID42
Source L.A. Health http//search.lapublicheal
th.org/wwwfiles/ph/hae/ha/diabetes_82004.pdf
Pine Bluff 233, 255 adults in Arkansas 2005
had diabetes. The number of blacks with the
disease was 26 higher than the White
population. Source 2007, Diabetes Survelliance
in Arkansas, The State of Diabetes in Arkansas
http//www.healthyarkansas.com/services/pdf/July23
_Diabetes_Report.pdf
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Brief Statistics Update (Continued)
DC In 2005, 8 out of every 100 adults in
District of Columbia has diabetes, ranking it
4th highest in the nation for the ratio of
people with diabetes to the general population.
Source District of Columbia Number of
Diabetes Deaths per 100,000 Population by
Race/Ethnicity, 2005 www.StateHealthFacts.org
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Latest Coalition Cities Statistics
IND
D.C.
LA
ATL
PB
HOU
7.5 - 8.9
gt9
4.5 - 5.9
6 - 7.4
Percentage of Adults with Diagnosed Diabetes,
2007
Available at http//www.cdc.gov/nccdphp/aag/pdf/a
ag_ddt.htm. Accessed 3/09.Available at
http//www.cdc.gov/diabetes/statitstics/prev/state
/fg62007htm. Accessed 3/09.Includes women with
a history of gestational diabetes.
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Step 2 Selection of Local Anchors

• It was important to have a group to lead the
  efforts on the ground. Based on the strength, a
  local NMA Society was selected. Physicians
  (Leads) were referred to us by the Presidents.
• Atlanta Medical Association
• Houston Medical Forum
• Hoosier State Medical Society
• Charles R. Drew Medical Society
• Arkansas Medical Network
• Medical Chirological Society of Washington DC
  (Med Chi)

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Step 2 Selection of Local Anchors (Continued)

• Atlanta Paul King, MD Michelle Nichols, MD
  Cyril Spann, MD and Aja Mann Executive Director
  of Atlanta Medical Association.
• Houston Kevin Mc Kinney, MD Gary Sheppard, MD
  and Kevin Kenall, MD.
• Indianapolis Lilli Leavell-Hayes, MD Virginia
  Caine, MD and Jarnell Craig, President of
  Minority Health Coalition of Marion County.
• Los Angeles Arthur Fleming, MD Johnnie
  Cathey-Cook, MD Cynthia Cotharn, MD and Deloris
  Caffey-Fleming.
• Pine Bluff Steven Wright, MD Martha Flowers,
  MD Manuel Kelly, MD and James Campbell, MD.
• Washington, DC Juanita Archer, MD Walter
  Faggett, MD Millicent Collins, MD Rose Shaw,
  Project Assistant.

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Step 3 Discussion of Deliverables

• Conference Calls were set up with the Leads to
  establish deliverables, expectations, goals and
  objectives.
• Memorandums of Agreement between the Societies
  and the NMA regarding the program were signed.
  (Contract)

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Step 4 Mandatory Partners for the Coalitions

• State Based Diabetes Prevention and Control
  Programs (DPCP).
• Local Health Department.
• American Diabetes Association (ADA), local
  chapter.
• Local Historically Black College University
  (HBCU) -. Charles Drew University of Medicine and
  Science (Los Angeles) Howard University College
  of Medicine (D.C) and Morehouse School of
  Medicine (Atlanta).
• Community Based Organizations (Fraternities,
  Sororities, physicians, business, and existing
  coalitions groups).
• Faith Based Organizations/Churches.
• Businesses
• NMA related organizations SNMA and ANMA.
• Memorandums of Understanding (MOUs) must be
  signed with partners.

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Step 5 Establishment of Steering Committee

• The NMA Diabetes Steering Committee is comprised
  of the NMA Regional Chairs. They are updated on
  the progress of the program Quarterly and provide
  advise/feedback on upcoming initiatives.
• It is mandatory for the Lead to be present on
  Steering Committee Conference Calls.

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Step 6 Communication Means

• Quarterly Conference Calls with Steering
  Committee Members.
• Bi-monthly Calls with each Coalition. (Provide
  Technical Support, Review of Work Plan and
  updates from the CDC where applicable.)
• Leads arrange Coalition Meetings to discuss work
  plans, upcoming programs and program
  deliverables.(Either face to face or Conference
  Call)
• Submission of Quarterly Reports to the Central
  Office.
• Emails. (Frequently used between calls)
• Faxes, Snail Mail and Courier.

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Recap

• Process utilized by the National Medical
  Association to create and sustain coalitions.
• STEP 1 Researched state of diabetes within
  cities
• STEP 2 Selected a solid local anchor (NMA
  Society)
• STEP 3 Discuss deliverables (Conference Calls,
  MOA)
• STEP 4 Establish Mandatory Partners (MOUs)
• STEP 5 Establish a Steering Committee
  (Quarterly Calls)
• STEP 6 Establish consistent communications
  means.

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Key Results

• SIX COALITIONS
• Outreach Activities 160
• TOTAL COALITION REACH PROGRAMS 2, 308, 273
• NMA CENTRAL OFFICE
• Outreach Activities 60
• Publications 20
• TOTAL CENTRAL OFFICE REACH
• (PROGRAMS PUBLICATIONS) 700, 000
• OVERALL
• 180 Outreach Efforts
• 180, 000 pieces of NDEP Materials Disseminated
  

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Key Results
Launched March 27, 2007
Hits To Date 100,000

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Materials Disseminated by Coalitions

• Diabetes Prevention
• NMA Diabetes Education Program
• Small Steps Big Rewards Prevent Diabetes
• Tips to Help You Feel Better and Stay Healthy
• More Than 50 Ways to Prevent Diabetes
• The Diabetes Epidemic Among African Americans
• Power to Prevent
• Diabetes Control
• If You Have Diabetes You Are at High Risk for
  Heart
• Attack and Stroke
• Diabetes Numbers At-a-Glance
• If You Have Diabetes, Take Care of Your Heart
• Control the ABCs of Diabetes
• If You Have Diabetes Know You Blood Sugar Numbers

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Share Lessons Learned

• Follow up after the conference calls is essential
  for urgent deliverables and reports.
• A need for face to face re-orientation (Site
  Visit) is needed at least once a year or for the
  benefit of new Leads/Coalition partners.
  (Depending on length of Program)
• Central Office has to act as project assistant
  for Coalitions who need more support due to
  physician time constraints. (Pitfall)
• Late Reports can be frustrating. (Pitfall)
• Rescheduling of Conference Calls due to medical
  emergencies. (Pitfall)
• Withholding Coalitions stipend is a great way to
  get attention.

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Share Lessons Learned

• Need for administrative assistant.
• Optimize local resources/Seek new partners.
• Conduct regular assessment and engagement of
  Coalitions members.
• Offer additional incentives to Coalition leads
  for professional development to interact with
  others who are engaged in community outreach
  efforts, I.e Attending Conferences.

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Evaluation Benefits

• Evaluation of your program will aid in
• Determining problem areas in a timelier manner
  and thus allowing you the opportunity to
  implement strategies to combat them.
• Finding out the opinions of the partners.

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Some Findings
Atlanta After the death of the previous
Executive Director the Coalitions major
shortcoming was an over reliance on the Medical
Society and thus has reduced the visibility of
the coalition and limited the reach of their
partnership. Houston Site has the strongest
partnership with the ADA out of all the other
Coalitions. The ADA has 95 upcoming activities to
tap into however needs to expand to have its own
identity. Indianapolis The group has the
strongest collaboration. An average meeting has
25 people showing up. Coalition has a triad
leadership team, with a good shared leadership
model, each taking the lead in different areas.
They also have a strong collaborative community
model.

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Some Findings
Los Angeles The best HBCU representation and
conducted outreach efforts in diverse areas/parts
of Los Angeles. The Coalition efforts have
reached AA audiences in wide areas. The lead
delegates which placed members in a leadership
position has administrative support. Pine
Bluff A solid on-going patient education
component. They demonstrated the ability to
change. After one meeting they were able to
implement all recommendations made by the
evaluator. Added a new Lead to meet those
goals. DC Site has a solid coalition management
system because of their reliable administrative
assistant/project assistant. They use an
exclusive approach, only invite people who have a
shared mission.  This has worked well for them,
but at the same time if they broadened their
scoop they could perhaps reach more sectors.

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Recommendations

• Develop tool to conduct member education.
• Orientation packet for new members.
• Conduct Coalition Branding/Marketing.
• Use of the media
• T-shirts
• Re-engage partners constantly.
• Routinely evaluate needs of partners.
• Identify local resources to remove burden from
  partners (i.e., Ameri-Corp, HBCUs or Graduate
  Schools for volunteers/interns).

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• NMA Diabetes Staff
• Wilma J. Wooten, M.D. M.P.H
• Principal Investigator
• Ivonne Fuller Bertrand, M.P.A, NPRR
• Associate Executive Director Project
  Administrator
• Roslyn A. Douglas, M.A.
• Diabetes Program Coordinator

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Want to Get Involved?
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CONTACT

• Roslyn A. Douglas
• Diabetes Program Coordinator
• EMAIL rdouglas_at_nmanet.org
• Telephone [phone]
• http//www.NMAdiabetesnet.org
• http//www.NMAnet.org

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www.NMAdiabetes.org