National Health Outreach and Engagement Conference 2024

Rafie, C.
Diabetes is a significant health issue in the U.S. Diabetes diagnosis has doubled in the past 20
years. Prediabetes is a condition of slightly elevated blood sugar that increases risk for diabetes.
Over 96 million people in the U.S., and 1 in 3 adults in Virginia have prediabetes. Research
shows that people with prediabetes who participate in a structured lifestyle intervention can cut
their risk for developing diabetes in half. Virginia Cooperative Extension joined the National
Diabetes Prevention Program (National DPP), a partnership of public and private organizations
supported by the CDC working to prevent or delay type 2 diabetes, in 2017. Partners work
together to increase access of people with prediabetes to the 12-month lifestyle diabetes
prevention program that can reduce risk of developing diabetes by 58% in people who lose 5-
7% body weight.

Strategic planning for implementation of the VCE Diabetes Prevention Program (VCE DPP)
was conducted by a team of Extension Specialists and Agents with the goal of building an
accessible, effective program. The team used guidelines from the Extension National
Framework for Health Equity and Well-Being in their planning. The National DPP lifestyle
change program aligns with the Framework recommendation to adopt programming for the
prevention and control of chronic disease. One of the Framework recommendations included in
strategic planning was to establish links with the healthcare community that permits direct
referral of individuals that can benefit most from Extension health programs. As part of our
strategic planning we developed a three-pronged strategy for outreach to local healthcare
providers to increase awareness of the VCE DPP and referral to the program.

The strategy involved 1) production of referral materials for use by the healthcare professional
including Rack cards for display in practice waiting room that included a QR code for patient
self-referral to the VCE DPP, and a fax form for direct referral by the physician to the VCE
DPP program; 2) Collaboration with a physician working with the Virginia Department of
Health who sent letters of introduction of the VCE DPP to the local healthcare practices; 3)
Direct visits to the healthcare practices by two Extension community health workers to
introduce the VCE DPP program and referral materials.

There were 12 family practices in the outreach area of the CHW’s. Two letters of introduction
were sent to all 12 offices by the VDH Physician Liaison prior to the CHW’s contacting them to
make an appointment to discuss the availability of the VCE DPP and methods of referral.
CHWs were able to schedule 4 provider visits and dropped by the other 8 offices to provide
Rack Cards and the fax referral form. The VCE-DPP has received 24 physician referrals to date,
12 of whom have been successfully placed in a VCE DPP program. The CHWs are repeating
the strategy in a second community with health disparities. We will present lessons learned and
recommendations for successful implementation of this strategy for healthcare outreach.