Focusing on proactive behavior change, innovative program helps patients stop disease before it takes hold.
When asked about the importance of the Philadelphia Diabetes Prevention Collaborative (PDPC), Dr. Mitchell Kaminski—director of the population-health program in the Jefferson College of Population Health (JCPH)—offers up a hypothetical vignette.
In it, doctors or patients are offered access to a free pill which, with no investment necessary beyond treatment time, is proven to prevent diabetes.
“Who wouldn’t want to prescribe that?” Kaminski asks. “That’s what the National Diabetes Prevention Program (DPP) does. Most people don’t realize there is a treatment for prediabetes that can prevent diabetes in many patients, and it has evidence-based success.”
The Centers for Disease Control and Prevention (CDC) developed the DPP in 2010 to address the increasing burden of type 2 diabetes. The lifestyle-modification program focuses on healthy eating and exercise for those with prediabetes.
Last year, JCPH experts met with representatives from the CDC and the American Medical Association (AMA) and key area stakeholders to discuss the local landscape. With funding support from the AMA, JCPH was tapped to lead a targeted patient-centered, diabetes-prevention initiative in the five-county Philadelphia region.
The need for such a program stems from Philadelphia’s standing as the poorest of America’s 10 largest cities and its ranking at the bottom of the commonwealth’s 67 counties in terms of health outcomes.
Those challenges prompted the JCPH to serve as the backbone of a collaborative partnership among community-based organizations, academic health systems, providers, payers and, among others, a coalition of local employers focused on improving the health of their employees through disease prevention and health-promotion activities.
Working with HealthShare Exchange, the Health Promotion Council and the Greater Philadelphia Business Group on Health, JCPH is helping to establish connections that will raise awareness, improve access and expand the capacity and sustainability of local programs that offer DPP.
“The enthusiasm and commitment of our partners to this effort has been remarkable,” says Dr. Alexis Skoufalos, associate dean of JCPH. “They are focused on making a difference for our community, particularly those shouldering additional burdens during the pandemic.”
Prior to the pandemic, its aim was to enroll 2,000 patients in 2020. Despite the challenges related to COVID-19, the regional initiative has powered forward to work virtually with hundreds of locals committed to improving their health. It’s about taking proactive steps to stave off future health problems, according to those involved with the initiative.
“In this country, we have an obesity epidemic and, in line with that, we have a diabetes epidemic,” says Dr. Kaminski, noting that much of the medical care focuses on managing the disease, not preventing it. “JCPH Founding Dean Emeritus Dr. David Nash says, ‘It’s time to turn the faucet off and start mopping the floor.’ All the energy being put into treating diabetes is mopping the floor. There wasn’t enough attention going toward where it is all coming from. Effectively managing the precursors for diabetes is the faucet.”
The collaborative’s focus is twofold: educate providers and patients about effective lifestyle programs, and ensure that interested participants have access to the classes. This has become particularly important in 2020, as diabetes and racial disparities in healthcare are risk factors for COVID.
Dr. Neva White knows that reality all too well as the senior health educator at the Center for Urban Health. Even before the collaboration started, she tirelessly went out into the community on a mission of diabetes education and awareness.
This year, she says the patients are committed to sticking with the year-long commitment instead of drifting off as life took them in different directions.
“We’ve never had as many people remain with the program. It’s amazing. We’ve lost two or three out of 30, which is unheard of. Normally, we would have lost half by the six-month enrollment period due to the weather, transportation, family commitments, etc.,” Dr. White shares. “We are happy to have this virtual platform to keep people connected during the pandemic. People want and need to be connected. This makes our program a good fit.”
In helping patients make better lifestyle choices, improve health conditions and share good information, Dr. White notes that it “checks all the boxes” for moving forward amid unprecedented times.
“DPP allows you to reshape your life and take responsibility for your overall decisions, and then integrate the things you’ve learned through the group into your life,” she adds. “The need has always been there. The collaboration is answering the call to do something about the situation.”
“This is all about implementing change with sound intervention. We really need to reduce the number of people in Philadelphia with diabetes and prediabetes.” –Dr. Neva White
She also cited providers as “our biggest allies,” as a referral from a doctor tends to carry more weight than suggestions from afar, and noted that one of the biggest challenges is engaging people to take action when still in the prediabetes phase.
To expand the program’s reach, Dr. White says that it has been conducted in five languages: Chinese, English, Laotian, Nepali and Spanish.
“The fact that we had bilingual lifestyle coaches that shared the various cultures really helped,” Dr. White says. “This is all about implementing change with sound intervention. We really need to reduce the number of people in Philadelphia with diabetes and prediabetes. ZIP codes tell us a lot about life expectancy.”
As things move forward, and National Diabetes Month approaches in November, the PDPC plans to make a more public push to draw the attention of more potential participants.
They hope to build support for the virtual classes and continue collaborating with stakeholders to transform prevention and health promotion in the city and region.
For more information about the Philadelphia Diabetes Prevention Collaborative, visit Jefferson.edu/PreventDiabetesPHL.