Progress 09/01/15 to 08/31/18
Outputs
Target Audience:A total of 659participants participated in the study since grant inception 9/1/2015. Descriptive characteristics of the participants, including age, gender, and race/ethnicity are summarized below. Demographics Median Age 66 % Female 77% Race* % Asian 1% % Black/African-American >1% % Hispanic/Latino 1% % Native American or Alaska Native 1% % Native Hawaiian or other Pacific Islander >1% % White/Caucasian 97% % Other 1% *Totals may exceed 100% due to mixed-race participants. Changes/Problems:A major challenge for the Dining with Diabetes program was marketing and promotion of the program. Throughout the course of the grant project, Extension educators were challenged with community groups, organizations, and health care systems that viewed this program as competition to their Diabetes Prevention Program, even though the target audience and program content was different. Enrollment was sporadic. Many participants expressed concern over having to pay for the program, and that there was no insurance reimbursement. By reducing the program fees to $5, enrollment increased in many areas. An online version of the program was developed and launched. To date, 29 people have taken the online course. The Extension Dining with Diabetes face-to-face and online programs areprogram are research-based, well-received, and program participants have excellent outcomes. As part of the Program Development Process (PDP), the health and wellness team has conducted a needs assessment, and is developing a marketing and sustainability plan. What opportunities for training and professional development has the project provided?This year Penn State Extension Dining with Diabetes educators participated in the Pennsylvania AADE (American Association of Diabetes Educators) annual conference in Bedford Springs, PA. This two day conference provided education and on current trends in diabetes education along with updates on AADE program requirements and standards. The educators not only gained knowledge and insights into diabetes education, but they had the opportunity to network with other diabetes educators from across the state and to share DWD's successful impact on the communities where it is offered. Attached is an agenda from this two day conference. In addition to the conference, AADE requires that dietitians in the DWD program complete 15 continuing education credits in diabetes related topics. All DWD team members participated in quarterly ZOOM meetings which addressed current issues, concerns, and programmatic updates. How have the results been disseminated to communities of interest?Success stories have been shared with the Extension Diabetes Working Group, Health and Wellness Program Team, and the Food, Families, and Health Unit, National Dining with Diabetes working group. Results have also been shared with stakeholders, Extension staff and local program participants. Data has been compiled for a state annual report that is shared with Extension administration, health-related organizations, and other interested individuals.Wheneducators conduct poster sessions during health fairs and health related meetings, they share the program results whichhighlight the impacts of the program. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
What was accomplished under these goals? Quantitative Results: 1. Two site leaders were hired and they facilitated 61 classes in the intended counties. 2. Extension educators (n=10) were able to reach a total of 659 participants who completed the program, with 465 completing the 3 month follow-up session. 3. 67 percent of the participants have been able to lower their A1c score by the three month follow-up class. 4. 54 percent of the participants have lower blood pressure readings by the three mnth follow-up class. 5. 44 percent have increased their exercise for 20 minutes or more a day by the three mnth follow-up class. 6. 34 percent have shown their blood test results to their healthcare provider. 7. At the 3 month follow-up, 91 percent can explain their A1c result to someone else and 89 percent can explain their blood pressure result to someone else. 8. At the 3 month follow-up 80 percent (n=465)indicated that they had made an appointment with their health care provider. Diabetes status of participants: Biomarker Population Baseline n Follow-up n % of participants with a decrease* Systolic BP All 134.5 563 130.1 427 60% Diastolic BP All 75.9 563 73.8 426 58% A1C All 6.6 637 6.4 438 56% A1C Pre-diabetes (baseline A1C 5.7-6.4) 6.1 183 6.4 156 50% A1C Diabetes (baseline A1C>6.4) 7.6 295 7.0 195 67% Ability to adopt health behaviors % of participants with an improvement* Exercise for 20 minutes or more. 44% Baseline (n=605) Follow-up (n=439) Average # of days per week 2.7 3.3 Eat a variety of fruits and vegetables. 41% Baseline (n=616) Follow-up (n=451) Average # of days per week 4.7 5.2 Count daily carbohydrates eaten. 46% Baseline (n=469) Follow-up (n=344) Average # of days per week 1.4 3.4 Sleep between 6.5 and 8.5 hours per night. 36% Baseline (n=617) Follow-up (n=444) Average # of days per week 5.1 5.2 Eat out at a restaurant. 18% Baseline (n=484) Follow-up (n=360) Average # of days per week 1.9 1.6 Prepare foods at home. 46% Baseline (n=487) Follow-up (n=258) Average # of days per week 5.4 5.5 Monitor blood sugar at least once per day. 18% Baseline (n=472) Follow-up (n=337) Average # of days per week 3.1 3.2 *Based on participants with baseline and follow-up measurements Impact on knowledge % of participants with an improvement* Ability to explain your A1C result to someone else. 27% Baseline (n=597) Follow-up (n=448) Somewhat Well to Very Well 45% 57% Ability to explain your blood pressure result to someone else. 18% Baseline (n=613) Follow-up (n=445) Somewhat Well to Very Well 52% 57% Qualitative Results: Impact Story "I first took the Dining with Diabetes class in August 2014 where I learned to count carbs. Since then I have lost 80 pounds in 1 ½ years, lowered my A1C from 7.8 to 5.9, and lowered my BP. I have more energy and this is the easiest program I have ever tried to lose weight. I took 16 prescriptions before and now only take 5 prescriptions and NO diabetes medications. I am taking the class again (1/3/2017) and have recommitted to carb counting and lost 5 lbs. by the fourth class (had gained weight over the holidays and blood sugar had increased) and by the 4th class my blood sugar was back under control. I am excited to feel back in the driver's seat again. Can't say enough about how much better I feel and secondly how much healthier I am. Thanks SO MUCH for helping me be better!!!"
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Progress 09/01/16 to 08/31/17
Outputs
Target Audience:A total of 403 participants participated in the study since grant inception 9/1/2015. Descriptive characteristics of the study population, including age, gender, and race/ethnicity are summarized in Table 1. Table 1. Participant Characteristics Median Age 67 % Female 78% Race* % Asian <1% % Black/African-American 5% % Hispanic/Latino 2% % Native American or Alaska Native 1% % Native Hawaiian or other Pacific Islander 1% % White/Caucasian 91% % Other 1% Changes/Problems:A major challenge for the Dining with Diabetes program is marketing and promotion of the program. Educators are challenged with many health systems seeing Dining with Diabetes as competition. Additionally, participants seem unwilling to pay to take the class. We did reduce the cost to $5.00 per person and that seems to help with enrollment. We continue to need to be very proactive and motivating to encourage enrollments. There is more competition now with hospitals and other organizations that are offering basic diabetes education. We are convinced that our extension program is still a well-designed, well-accepted program. What opportunities for training and professional development has the project provided?The project team organized various professional development programs to learn about the latest medical information related to diabetes. Continuing education offered in the calendar year 2016-2017: Dr. Diann Westrick presented to the entire Dining with Diabetes team on the.cognitive challenges of elderly patients and how to present material in a way that makes it easier for them to understand. Non-dietitians on the Dining with Diabetes team attended a one day workshop on incorporating Mindfullness into the curriculum. The presenters also addressed stress management for those living with diabetes. All dietitians are required to complete 15 continuing education credits in diabetes related topics as part of the AADE requirements for our accredited program. Some examples of these trainings include:one educator took the AADE : Career Path Certificate Diabetes Educator Level 1 Program for 47 CEU's. Others attended the PA AADE Annual Conference and the Diabetes Care and Education practice group of the Academy of Nutrition and Dietetics. Many online webinars were provided by the American Diabetes Association that were very informative. How have the results been disseminated to communities of interest?Success stories have been shared with the Extension Diabetes Working Group, Health and Wellness Program Team, and the Food, Families, and Health Unit, National Dining with Diabetes working group. Results have also been shared with stakeholders, Extension staff and local program participants. Data has been compiled for a state annual report that is shared with Extension administration, health-related organizations, and other interested individuals. The 2015 Dining With Diabetes Report is publicly available on Penn State Extension's website:https://extension.psu.edu/dining-with-diabetes-2015-annual-report. Results have also been shared with potential class participants to encourage them to attend the class. When educators conduct poster sessions during health fairs and health related meetings, they share the program results which highlight the impacts of the program. What do you plan to do during the next reporting period to accomplish the goals?Extension educators will continue to conduct the program and encourage all participants to complete the program by attending all of the sessions and the 2 month follow up. The Diabetes Working Group has regular face-to-face and conference calls to keep educatiors updated on program successes and challenges. Challenges are identified and addressed, particularly the issue of promoting and marketing the program which are major challenges state-wide. Educators and the leadership team will also continue to promote Dining with Diabetes at Ag Progress Days, county fairs and local health fairs. Educators also promote the program in their communities through coalition meetings, Chamber of Commerce meetings, and by contacting medical practitioners. The Extension Health and Wellness Team, that includes the Dining With Diabetes program, will be participating in a formal Program Development Process (PDP) during the third and fourth quarters of 2017. In the initial stages of the PDP Product Strategy Specialists, will work to assist the Dining with Diabetes team in gathering and analyzing data, making decisions about topics and products, developing and marketing products, and address the important issue of sustainability.
Impacts
What was accomplished under these goals?
Quantitative Results: Two site leaders were hired and they facilitated 39 classes in the intended counties (n=19). Extension educators (n=10) were able to reach a total of 403 participants who completed the program, with 224 completing the 3 month follow-up session. 61 percent of the participants have been able to lower their A1c score by the three month follow-up class. 54 percent of the participants have lower blood pressure readings by the three mnth follow-up class. 46 percent have increased their exercise for 20 minutes or more a day by the three mnth follow-up class. 34 percent have shown their blood test results to their healthcare provider. At the 3 month follow-up, 91 percent can explain their A1c result to someone else and 89 percent can explain their blood pressure result to someone else. At the 3 month follow-up 80 percent (n=224) indicated that they had made an appointment with their health care provider. Diabetes status of participants: A1C>6.4% Baseline 196 Follow-up 97 A1C 5.7 - 6.4% Baseline 107 Follow-up 50 A1C <5.6% Baseline 91 Follow-up 57 Qualitative Results: Participant feedback indicates that the program had positive impacts on their management of their diabetes and their overall health and well-being. Participants indicated that they are more confident discussing their diabetes with health care providers. At follow up a greater percentage indicated that they had made appointments with their primary care physicians, opthomoligists, dentists, and podiatrists. There has been universally positive feedback about participants' increase in knowledge, how easy and tasty the recipes are, and how they felt empowered by meeting in a group to talk over challenges and successes of living well with diabetes. Participants who were not diabetic reported that they chose to participate in the program to learn how to eat more healthfully and to support family members because they realize how a diabetes diagnosis affects the entire family. Additionally, they reported that becoming aware of the incidence of diabetes in their communities made them more willing to make lifestyle changes that could potentially decrease their risk of developing diabetes in the future. Impact Statements: An extension educator reported that two participants in her class never ate breakfast. They followed our recommendation, began to eat breakfast and both lost weight during the 3 month period. One lost 10 pounds, the other over 20! Also, the educator had a participant who took the class 2 1/2 years ago and took it again as a refresher. She had maintained her 80 pound weight loss (+/- 5 pounds) and is no longer on ANY diabetes medications. A.R. from Mill Hall, Pennsylvania took a Dining with Diabetes class in 2013 to learn how to improve her A1C. She was having trouble controlling her diabetes, struggled to eat healthy, and had difficulty finding time to exercise. She heard about our class that was being offered at a local senior center and encouraged a few of her friends, who were also struggling with diabetes related issues, to sign up and take the class with her. A participant in Clarion, PA took the class and reported that she visited her doctor after completing the program, and was told that she no longer needed to take Metformin. Several educators reported that their participants are excited about losing weight. Although weight loss is not stressed in the program, if participants follow the meal plan presented may find that they eat healthier and experience weight loss.
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Progress 09/01/15 to 08/31/16
Outputs
Target Audience:74% of the audience is female with an average age of 67, 95% of the audience is white, 3% Hispanic/Latino, 1% Asian, 1% Black/African-American,1% Native American, 1% Native Hawaiian or other Pacific Islander. All participants live in rural areas of the state. Changes/Problems:During the winter, we had challenges with weather which hindered attendance for classes. Some people are snowbirds and move to warmer climates in the winter, some called in sick, and others had poor internet access which limited our ability to communicate via email. However, we continue to be very positive and encourage people to register for the program, and when they do they are almost always amazed at what they are able to accomplish. What opportunities for training and professional development has the project provided?A training was provided on July 6 and 7, 2016to update the extensioneducators and program assistantson new components of the Dining with Diabetes curriculum. A guest speaker provided information on medications needed by individuals with diabetes, and, another speaker addressed how to market the program to reach a variety of audiences. The AADE new national accreditation was discussed, as well as, the economic analysisthat will be submitted in a journal article. How have the results been disseminated to communities of interest?Success stories have been shared with educators in the group. Results from this program will be shared with stakeholders, extension staff and local program participants. Data will be compiled for the Dining with Diabetesstatewide extension report. program which will be shared broadly. Some educators also share results as they promote upcoming classes. When we conduct poster sessions at health fairs and health related meetings, we share the results of the program which highlights the postive impact of the program. What do you plan to do during the next reporting period to accomplish the goals?We will continue to motivate and encourage staff to conduct the program and complete 3 month follow-ups.More classes are scheduled in the fall which we will continue to market to ensure strong attendance. We will continually addresschallengesand as the weather changes, address weather related challenges. We have regular quarterly conference calls scheduledto move activities forward. We will also promote the program during the state Ag Progress Days event in August and at local fall health fairs. Wewill havesome newly hired extension educators to train. For our next team meeting we will have a medical doctor who specializes ingerontology speak about cognitive challenges in the elderly.
Impacts
What was accomplished under these goals?
Several individuals have provided feedback about how the Dining with Diabetes program has impacted their lives: A female participant in Southwest Pennsylvaniaindicated thatthe carb counting she learned in our class really does work! She lost almost 80 pounds and was then able to have major surgery since the doctors said she had also reduced her risks of complications. Doctors were amazed at her drop in her A1C score and theytold her that her numberswere as good as a non-diabetic. When asked by hospital and rehab staff about her wieght loss, she has been a strong advocate of our program.She is pleased that she not only lost 103 pounds, but kept it off for a year.In other non-extension classes, shehas always gainedthe weightback. She also told her husband "not to ever bring any iceberg lettuce home," saying she believed dark greens have helped her too, againtaking the advice of eating darker greens from our classes. Bob and Myrtle E. said the Dining with Diabetes "is an excellent and worthwhile program." By following the information they learned, Bob kept a journal and recorded his meals and carbohydrates. He lowered his A1C from 9.5 to 6.5 and they both lost 30 lbs.! A class participant who caresfor her diabetichusband, shared thatafter carb countingshe made her husband eat more carbs for breakfast (he wasn't eating carbs at breakfast) and his glucose levels had dropped and were stable all week! Based upon the goals of the program, the following has been accomplished: 1.Two site leaders have been hired and have heldgood size classes whereparticipants have been very responsive. 2. With the assistance of several extension educators and the two site leaders, a total of 114 participants completed the program and 60 participants have attended3 month follow-up sessions.. Some follow-up classes have yet to be held, so the follow-up numbers are likely to increase. 3. 58% of the participants have been able to lower their A1c score by the three month follow-up class. 4. 62% of the participants have lower blood pressure reading by the three month follow-up class. 5. 47% have increased their exercise for 20 minutes or more a day by the three month follow-up class. 6.49%have shown their lab results to their healthcare provider. 7. At the 3 month follow-up, 47% can explain their A1C result to someone else and 33% can explain their blood presssure result to someone else.
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