Background

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(No Transcript)
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Background

• National Diabetes Prevention Program
• End-Points
• 7 body weight lost
• Exercise for 150 minutes per week
• Patient Population
• Results
• Reduced risk of developing diabetes if maintained
  for 6-months

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Patient Population

• Fayette County, Pennsylvania- Intervention
• Westmoreland County, Pennsylvania- Control
• Rural
• High rates of diabetes- Fayette has highest in PA

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Population Characteristics

• Shift Workers
• Irregular working schedules
• Sleep deprivation- 24 hour shifts
• Erratic Eating Times
• Easy Access to Fast Food
• High Risk Jobs
• High Stress Jobs

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Methods

• Both Groups
• Health screenings at baseline, 3 months and 6
  months
• Health education handouts
• Free gym membership, pedometer and water bottle
• Intervention Group Only
• 12 weeks modified DPP
• Peer-led

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Inclusion Criteria

• BMI 25 AND at least three of the following
• Abdominal obesity (waist circumference 102cm in
  males and 88cm in females)
• Fasting triglycerides 150mg/dL
• High density lipoprotein lt40mg/dL for men and
  lt50mg/dL for women
• Blood Pressure (one of three criteria)
• Systolic blood pressure 130mmHG
• Diastolic blood pressure 85mmHG
• History of a diagnosis of hypertension and on an
  antihypertensive medication
• Fasting glucose 100mg/dL, and lt126mg/dL

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Results Participant Eligibility

• Fayette Westmoreland
• Total People Screened 55 23
• Eligible and provided PCP approval 15 10
• Eligible but did not provide PCP approval 5 0
• (did not participate)
• Ineligible 35 13
• Participating as of 3 month screening 11 9
• Participating as of 6 month screening 9 7
• Number of people who completed Fayette
  classes 11 n/a
• Fayette Group One person dropped out after
  classes and did not attend 3 month or 6 month
  screening and one person attended 3 months
  screening but we were unable to reach him for 6
  month screening-
• One participant broke her hip (not study
  related) and could not attend 6 month screening
  but will complete it at later date

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Results Demographics

• Age
• Intervention Group
• Average age completed 48.90
• Average age dropped 33.43
• Average age no PCP consent  34.60
• Average age eligible 43.10
• Control Group
• Ave age completed 48.14
• Ave age dropped 40.33
• Ave age eligible 45.80

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Results Demographics

• Gender
• Intervention
• Fayette Completed 6 male (67 ), 3 female (33
  )
• Fayette Not Completed 5 male (83 ), 1 female
  (17 )
• Fayette no PCP 1 male (20), 4 females (80)
• Fayette Total 12 male (60 ), 8 female (40 )
• Control
• Westmoreland Completed 3 male (43 ), 4 female
  (57 )
• Westmoreland Not Completed 2 male (67 ), 1
  female (33 )
• Westmoreland Total 5 male (50 ), 5 female
  (50)

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Results Demographics

• Income
• Intervention Group
• Median income 40,000-49,999
• Control Group
• Median income between 70,000 and over
  60,000-69,999

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Results Participation by Job
1 person doubled listed themselves as Fire and
EMS, so that is why there are 16 people listed
when there are only 15 people enrolled
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Summary 6-Month Results

• Final Results for
• Intervention- 9 people and Control- 7 people
• Intervention group
• Average weight loss-16.6 lbs
• 89 (8/9) reduced risk factors and 89 (8/9) lost
  weight
• 1 person gained a risk factor but lost 6 lbs
• 1 person lost a risk factor bit gained 6.5 lbs
• 44 reduced total body weight by 7
• One person lost 66.5 pounds (29 of weight 233
  lbs to 166 lbs)
• Control group participants
• Average weight loss-12 lbs
• 100 (7/7) reduced risk factors and 71 (5/7)
  lost weight
• 2 people gained 4 pounds but lost risk factors
• 43 lost goal of 7 of total body weight

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Summary Results (cont)
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Results Summary

• Too small sample size but positive results all
  around
• Unclear if classes made a differences
• Control and intervention groups are different
  with respect to income
• People who dropped were younger

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Lessons Learned- Screening

• Privacy
• Concern about employer
• Concern about peers
• Management Buy-In
• Shift Work
• Timing of screening
• Evening shift
• Night shift
• 24 hour shifts
• Difficult for them to not eat prior to screening
• Marketing

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Lessons Learned- Participation

• Timing
• Peer-led
• Location
• PCP approval
• Classes
• Family members

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Lessons Learned- Results

• Individual Impact
• Willingness to change if given tools
• 89 (8/9) of the intervention group felt the
  intervention was a valuable use of time (with
  50 strongly agree and 39 agree) and 1 person
  was neutral
• Public Safety Impact
• Physically fit
• Potentially less diabetes, chronic disease,
  absenteeism, and injuries in public safety
  workers
• Community Impact

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Questions

• Kelly Close MD, MPH
• c/o Emed Health
• 10 Allegheny County Airport
• West Mifflin, PA 15122
• kbclose_at_emedhealth.com
• www.emedhealth.com
• Thank You for Your Time!