One in three people is at risk of prediabetes and the trend has been increasing. To stem the tide, Prevention 1^st is modeling and testing system changes to create effective and efficient strategies to take to scale.

Prevention

The Diabetes Prevention Program (DPP) is a year-long class with evidence-based results for participants that include 5 percent to 7 percent weight loss and increased physical activity—enough to reverse the path to diabetes in most.

YMCA of the Inland Northwest (YMCA) and Inland Northwest Health Services (INHS), an affiliate of Providence Health System (Providence), offer DPP classes in Spokane County, Washington. Considering its linkages to Providence, the region’s largest health care system, specific to the impact of INHS involvement in offering the classes, there is opportunity to create needed system changes to increase participation in DPP classes.

Health Care System

INHS has a long and respected history of providing diabetes education to newly diagnosed patients and those struggling to control their disease. Through Prevention 1^st, INHS is leading the shift in health care to embrace prevention of this costly and devastating disease.  

INHS staff educated all 11 of Providence Medical Group Clinics in Spokane County where more than 72,000 patients are served annually. Physicians were educated on the new Clinical Practice Algorithm: Diabetes and Prediabetes Identification and Intervention, establishing which patients to screen for prediabetes. Key office staff responsible for referrals learned how to refer patients to classes.

Insurance Coverage

INHS also helped Providence move forward with a plan to offer enterprise-wide coverage for staff to attend DPP classes (including more than 70,000 employees across Washington, Oregon, California, Alaska, Nevada, and Texas). This includes about 9,000 employees in northeastern Washington.  

With encouragement from Prevention 1^st, employees covered by Washington State Public Employee Benefit Board (PEBB) in eastern Washington are being screened and referred to DPP classes at the YMCA for the first time. PEBB covers approximately 10,000 workers in Spokane County. A protocol of employee screening or physician diagnosis precedes enrollment. PEBB coordinated screenings at three agencies since August 2016 and more screenings are scheduled. An initial 15 employees, and more employees everyday, are enrolled in YMCA DPP classes as a result.

Worksite Wellness

Businesses can play a large part in improving employees’ health. Through Prevention 1^st, INHS is working with nine worksites to initiate or improve wellness programs for more than 2,500 employees. Along with employee education programs, walking groups, and information on healthy eating, INHS promotes information and screening on prediabetes.

Prediabetes Screening for Low Income Residents

INHS taught food pantry volunteers to conduct paper, and pencil and waist, circumference screenings for prediabetes. Through the screenings and referral process, 10 food panty customers started a DPP class held at Spokane’s 2^nd Harvest Food Bank.  

Washington State University - College of Pharmacy, INHS, YMCA, and Spokane Regional Health District coordinated prediabetes screenings at four low income or affordable housing sites. The pharmacy students screened 75 residents, 55 completed the A1C tests, and 17 were referred to DPP classes. Interpreters were available for Russian-speaking residents.  

The screenings and class at 2^nd Harvest Food Bank were supported by Providence Community Benefits program.