SECONDARY AND TERTIARY DIABETES PREVENTION: HRSA DIABETES COLLABORATIVE

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SECONDARY AND TERTIARY DIABETES PREVENTION
HRSA DIABETES COLLABORATIVE

Suzanne Feetham, PhD, RN, FAAN Sam Shekar, MD,
MPH U.S. Department of Health Human
Services Health Resources Services
Administration Bureau of Primary Health
Care Steps to a HealthierUS Putting Prevention
First Summit April 15, 2003 Baltimore, Maryland
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HRSA BPHC Health Centers Patients
Presidents Initiative to Expand Health
Centers By 2006 16 million served, gt 6,000
service sites
CY 2001
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Health Disparity Collaboratives

• Disease Management Collaboratives
• Diabetes, Cancer, Cardiovascular,
• Asthma, Depression
• Prevention Collaboratives
• Diabetes
• Healthy weight management, tobacco use, blood
  pressure, immunizations, lead screening, oral
  health

A national effort to improve health outcomes for
all medically underserved people
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HEALTH DISPARITIES COLLABORATIVES
The Care Model includes six essential elements
for improving the care of people with chronic
illness

• Patient self-management
• Decision support
• Clinical information system
• Delivery system design
• Organization of health care
• Community

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Successes
DIABETES COLLABORATIVE

• Patients and their families
• Improved health outcomes
• Health Centers
• State Based Partnerships HRSA/CDC
• Colorado Diabetes Prevention Control Program
  and Colorado Health Centers
• National Partnerships
• CDC SAMSHA EPA HRSA HIV/AIDS Bureau, MCHB
  NIH NIDDK, NCI RWJs Improving Chronic Illness
  Care Program, Institute Healthcare Improvement
  (IHI) NACHC, AHRQ (Harvard U. of Chicago),
  Corporations

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Phase 2 Diabetes Collaborative Southeast
Cluster Health Centers Average HbA1c's 1999-2002
8305 Patients by March 02
9.5
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Average
8.5
8.3
Goal
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• Weighted Average Hb A1c

7.5
7
J-99
J-00
J-00
J-01
J-01
J-02
S-99
N-99
S-00
N-00
S-01
N-01
M-99
M-99
M-00
M-00
M-01
M-01
M-02
Source C Hupke, IHI, Chupke_at_nibcomp.com
Reporting Month
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DIABETES COLLABORATIVE
Summary Elements

• Health Center teams
• Identify individuals at risk for developing
  diabetes
• Implement a community-based lifestyle
  modification
• Support patients and families to actively
  participate in their health care via
  self-management goals
• Monitor and track clinical outcomes and other
  measures

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DIABETES COLLABORATIVEWhat we are learning

• Shared vision/mission and common national
  measures
• balance uniformity with innovation
• data on gt 75,000 patients with diabetes
• Early and purposeful development of external
  partnerships
• provide expertise capacity
• Models for care and system improvement are
  powerful
• drivers for positive change
• Model for translating research to practice

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DIABETES PREVENTION COLLABORATIVE
KEY GOALS

• Weight loss
• At least 150 minutes of exercise per week (brisk
  walking or the equivalent)
• HbA1c lt7.0 OR fasting glucose lt125 mg/dl

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For more information
HRSA BPHC HEALTH DISPARITIES COLLABORATIVES

• HRSA BPHC Health Disparity Collaboratives
• David Stevens, MD
• dstevens_at_hrsa.gov
• Tricia Trinite, MPH, RN
• ttrinite_at_hrsa.gov
• HRSA BPHC
• Suzanne Feetham, PhD, RN, FAAN
• sfeetham_at_hrsa.gov