related to diabetes. with diabetes die, on average 11 to 16 years earlier than saw virtually no type 2 diabetes in children before the 1990s. …
MINNESOTA DIABETES PLAN 2010
Year 1 Progress Report October 2003-December 2004
Facilitated by the Minnesota Diabetes Steering Committee and the Minnesota Diabetes Program at the Minnesota Department of Health
Minnesota Diabetes Plan 2010 Year 1 Progress Report October 2003-December 2004
Financial support was provided through a Cooperative Agreement U32/CCU522705 with the Centers for Disease Control and Prevention CDC Development of the Progress Report was facilitated by the Minnesota Diabetes Steering Committee and the Minnesota Diabetes Program at the Minnesota Department of Health
Printed: March 2005 For more information, contact: Minnesota Diabetes Program Minnesota Department of Health PO Box 64882 85 East 7th Place, Suite 400 St Paul, MN 55164-0882 Telephone: 651 281-9849 or 651 215-5800 Email: diabetesplan@healthstatemnus Website: http://wwwhealthstatemnus/diabetesplancentral
Suggested Citation: Minnesota Diabetes Steering Committee and Minnesota Department of Health 2005 Minnesota Diabetes Plan 2010 Year 1 Progress Report St Paul, Minnesota: Minnesota Department of Health
Minnesota Diabetes Plan 2010 Progress Report 2005 Table of Contents
1 OVERVIEW OF THE MINNESOTA
DIABETES PLAN 2010 2 UPDATE ON THE BURDEN OF DIABETES IN MINNESOTA 3 THE PURPOSE OF THIS REPORT 4 YEAR 1 HIGHLIGHTS AND ACCOMPLISHMENTS
a Outreach Promotion b Tools Resources c Partners Plan Champions d Media Coverage Recognition e Implementation f Evaluation
5 PRIORITIES FOR THE FUTURE
MINNESOTA DIABETES PLAN 2010
1 OVERVIEW OF THE MINNESOTA DIABETES PLAN 2010
The Minnesota Diabetes Plan 2010 the Plan is a statewide strategic plan to reduce the burden of diabetes in Minnesota It consists of a broad set of goals and recommendations for collaborative action It communicates the vision of creating a healthier future for all people in Minnesota It provides a call to action, urging everyone to play a role
A Purpose and Vision
Diabetes is a leading cause of death and disability in Minnesota Thats why the Minnesota Medical Association endorsed the Minnesota Diabetes Plan 2010 Its a call to action for everyone who has a stake in diabetes care to work together to develop and apply creative solutions, such as finding ways to change policies and behaviors to promote and support healthy living - Minnesota Medical Association MMA
The Plan goals and recommendations represent areas
where action is needed on diabetes in Minnesota, according to the consensus of a broad range of experts and stakeholders in the state The Plan is also a tool and a catalyst for motivating coordinated action on diabetes The Plan is more than a wish list; it is a public health initiative with a statewide scope and a broad spectrum of stakeholders Diabetes in a leading cause of death and disability in Minnesota; the burden in terms of human suffering and cost is very high and growing There continues to be an epidemic of type 2 diabetes in Minnesota The number of cases has increased dramatically in the last five years Major complication, the death rate and costs associated with diabetes are also rising dramatically There is every indication that these trends will continue throughout the next decade Minnesota is the healthiest state in the nation, according to a recent United Health Foundation survey http://wwwunitedhealthfoundationorg/shrhtml We are a leader in health care and innovative change This status could be eroded quickly if we dont take immediate and concerted action to reverse these trends It is only through concerted action toward a common vision that we will move ahead in
dramatically reducing the impact of diabetes in Minnesota The Minnesota Diabetes Plan 2010 is a guide for
A poster at the Kickoff Celebration reminds us that the Plan is dedicated to the late Dr Bruce Zimmerman
achieving that vision
The Minnesota Diabetes Plan 2010 consists of five broad, overlapping themes Each theme is defined by a 5-year vision and goals that describe the general course of action for the next 2-3 years Each goal is supported by specific recommendations for activities Most recommendations are supplemented with examples Plan goals are outlined in Table 1 For additional detail on the Plan recommendations and examples, please refer to pages 13-46 in the Minnesota Diabetes Plan 2010 document Copies of the Plan can be ordered or downloaded from the Diabetes Plan CENTRAL website at: http://wwwhealthstatemnus/diabetesplancentral
B Plan Contents
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YEAR ONE PROGRESS REPORT
Table 1 Minnesota Diabetes Plan 2010: themes and goals Theme Area 1: Community Health Promotion Goal 1: Encourage healthy lifestyle behaviors for youth Goal 2: Raise public awareness about diabetes Goal 3: Foster community-based collaboration and communication Goal 4: Create a healthier
environment Theme Area 2: Health Care Delivery and Professional Issues Goal 1: Stimulate diabetes awareness and action Goal 2: Promote professional development and resolve workforce shortages Goal 3: Make diabetes services fully accessible Goal 4: Improve diabetes services Theme Area 3: Diabetes Education and Support Systems Goal 1: Make diabetes education accessible and culturally appropriate Goal 2: Inform consumers about financial resources for diabetes health services Goal 3: Develop support systems for people with diabetes Theme Area 4: Financial and Resource Issues Goal 1: Maximize and effectively use diabetes resources Goal 2: Make the economic case for diabetes prevention and care Goal 3: Assure health care coverage for all people in Minnesota Goal 4: Address socioeconomic factors impacting diabetes Goal 5: Increase legislative support for diabetes Theme Area 5: Diabetes Data Assessment and Communication Goal 1: Improve the collection, quality, and scope of Minnesotas population-based diabetes data Goal 2: Encourage and support routine evaluation of diabetes programs in Minnesota Goal 3: Generate support and action for collecting diabetes data through advocacy,
communication and marketing Goal 4: Effectively share, communicate, and use diabetes data
Additionally, eight issues were identified as being important to all themes in the Plan You will find these crosscutting issues embedded into goals throughout the Plan Cross cutting issues are listed below
Policy change and advocacy Eliminating health disparites Prevention Access to care Coordination and partnership Evidence and best practices Research and technology
2 UPDATE ON THE BURDEN OF DIABETES IN MINNESOTA
Diabetes is not just a common disease; it is an epidemic with devastating human and economic consequences Diabetes prevalence has increased steadily in Minnesota in recent years Since 1994, diabetes prevalence has increased 45, from 38 to 55 in 2003 In light of increasing trends in diabetes risk factors, it is unlikely that the trend of increasing prevalence of diabetes will be easily reversed In 2002, half of all adults in Minnesota had sedentary lifestyles, and 3 out of 5 were overweight or obese A quarter of a million people in Minnesota nearly as many as currently have diabetes, are at increased risk of developing diabetes, because they have impaired fasting glucose IFG
Having IGF, and/or impaired glucose tolerance IGT, results in the condition, pre-diabetes Pre-diabetes is the state that occurs when a persons blood glucose levels are higher than normal but not yet high enough for a diagnosis of diabetes Many Minnesotans diagnosed with pre-diabetes, without proper intervention, will eventually develop diabetes
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MINNESOTA DIABETES PLAN 2010
The good news is that diabetes can be delayed or even prevented in people with pre-diabetes through lifestyle changes eg changes to diet and increased physical activity combined with a 5-10 reduction in body weight Additionally, proper management and care of diabetes can reduce the risk of developing complications including shortened life, heart disease, stroke, blindness, kidney failure, amputations, birth defects, and even infant death Pregnancies complicated by diabetes are also a growing problem in Minnesota Diabetes complicated pregnancies generally fall into two categories Diabetes that is diagnosed prior to pregnancy, is called pregestational diabetes PDM, and can be either type 1 or type 2 diabetes Gestational diabetes mellitus GDM is diabetes that is diagnosed for the first time during pregnancy
Between 1993 and 2002, PDM nearly doubled in Minnesota from 26 to 49 per 1,000 live births, and GDM increased 35 from 256 to 347 Increases occurred in all demographic groups; additionally, existing racial and ethnic disparities in diabetes complicated pregnancies worsened The shortterm consequences of PDM and GDM are increased risk of complications for both mothers and infants In the long-term, diabetes during pregnancy increases the risk to the offspring for developing obesity and diabetes later in life This trend constitutes a vicious cycle, which may contribute to increases in the future burden of diabetes in Minnesota
Dr J Michael Gonzalez-Campoy calling the Minnesota diabetes community to action at the Kickoff Celebration
Minnesota has made good progress in some diabetes preventive care practices over the last several years eg increases in annual foot check and dilated eye exams However, almost 80 of Minnesotans with diabetes are overweight or obese, 34 have no leisure time physical activity, over 50 report high blood pressure, 30 have not had an annual cholesterol check, 35 do not self-monitor their blood glucose daily, and 15 are current smokers Clearly, there is much work
to do to reduce the human and economic burden of current and future diabetes on people in Minnesota
3 PURPOSE OF THIS REPORT
The purpose of this report is to keep Minnesota Diabetes Plan 2010 stakeholders, and other members of the Minnesota diabetes community, up-to-date on the progress being made on the Plan The Minnesota Diabetes Program MDP compiled this report with assistance from the Minnesota Diabetes Steering Committee MDSC, and with funding from the Centers for Disease Control and Prevention CDC As a public health program, one of the roles of the MDP is to monitor and report on progress toward achieving Plan goals This is the first such progress CCCH supports the Minnesota Diabetes Plan 2010 because report, and it documents activities both to promote the Plan and to implement its the overall intent of the Plan is to create a healthier future recommendations for all people in the state The Plan also closely aligns with The MDSC is an advisory group comprised of experts in diabetes, representing professional and voluntary organizations, health care delivery systems, and people with diabetes in Minnesota Its mandate is to provide expertise to guide the MDP and to diabetes
activities at the Minnesota Department of Health
CCCHs efforts to promote community-wide dialogue and initiatives, reduce health disparities, and improve access to care for all Minnesotans - The Center for Cross-Cultural Health CCCH
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YEAR ONE PROGRESS REPORT
MDH Additionally, they oversee the implementation and evaluation of the Minnesota Diabetes Plan 2010 The MDSC plays a critical role in the ultimate success of the Plan by providing leadership, facilitating communication, and partnership building among diabetes stakeholders in Minnesota
This report will be a part of an ongoing series of progress reports intended -Stratis Health to inform Minnesotas diabetes community, showcase examples of Planrelated strategies and innovations, and identify gaps where more action is needed You can help play an important role in monitoring activities and evaluating the impact of the Plan If you are aware of other key milestones or achievements, please contact us or enter them into the Action Network on Diabetes Plan CENTRAL website http://wwwhealthstatemnus/diabetesplancentral We will highlight these accomplishments on the Plan CENTRAL website and in future publications
Stratis
enthusiastically endorses the Minnesota Diabetes Plan 2010 because it is important to the health of seniors in Minnesota Also, the goals of the Plan are consistent with the goals and mission of Stratis Health As Minnesotas Medicare Quality Improvement Organization, Stratis Health provides resources at no cost to health care organizations to support care improvement efforts on priority topics, which includes diabetes
4 YEAR 1 HIGHLIGHTS ACCOMPLISHMENTS
The Minnesota Diabetes Plan 2010 was officially released at the end of October 2003 Since then, much progress has been made in promoting and implementing the Plan Among the Plans early accomplishments are:
Numerous examples of outreach and Plan promotion statewide; Development of tools and resources to help facilitate Plan implementation; A strong and growing alliance of Plan Champions; Extensive media coverage and recognition throughout Minnesota
A Outreach Promotion
A key strategy for building awareness of the Plan and motivating individuals and organizations to take action on the Plan is an active campaign of promotion and outreach Plan partners have promoted the Plan to their colleagues and communities in many different
ways, including events and presentations A few key examples are highlighted here
Events
Kickoff Celebration: Building a Healthier Future
The Minnesota Diabetes Plan 2010 Kickoff Celebration: Building a Healthier Future was held on Monday, October 27, 2003 at Minnesotas historic Landmark Center in downtown St Paul Nearly 200 members of the Minnesota diabetes community attended, despite an early showing of winter weather
Storyteller and diabetes advocate, Cathy Feste, sharing a bit of wisdom with diabetes stakeholders at the Kickoff Celebration
Among those represented were legislators, business people, nonprofit organizations, health care providers, diabetes educators, public health professionals, community-based organizations and people with diabetes Attendees had the opportunity to network and visit with exhibitors representing over 20 different diabetes-related organizations in Minnesota In addition, thirteen members of the Minnesota diabetes community stepped forward to endorse the Plan, becoming the first diabetes Plan Champions
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MINNESOTA DIABETES PLAN 2010
Join the Journey: Regional Plan Promotion Forums
Several chronic disease programs at the Minnesota
Department of Health worked together to create regional forums to share information on important state plans for diabetes, cardiovascular health, cancer, obesity and arthritis Four daylong forums were hosted around the state in late 2004 The purpose of the forums was to learn about the important work that rural Minnesota organizations are doing in chronic disease It was also to share information about the various Minnesota chronic disease plans; to share tools and resources for implementing the plans locally; and to continue to strengthen the network of Plan partners Two forums were held in mid-October 2004, one in Winona, and one in St James, Minnesota Two additional forums were held in Grand Rapids and Fergus Falls, Minnesota in mid-December 2004 Over 110 people attended the forums statewide Local program examples shared at the forums that addressed Minnesota Diabetes Plan 2010 goals included: A faith-based exercise group; Holly Downing and Laurie Benge describing the Plant to Plate program at the Grand Rapids Join the Journey forum Worksite health promotion and employee walking programs; A county-wide Kids Walk to School Day; Quality improvement efforts in a rural clinic;
Community specific diabetes education programs; A community gardening and health promotion program; A local public health multi-media health promotion program; and Vending machine policy changes in elementary schools
Presentations
Plan partners, including the MDP, have been invited to give presentations on the Minnesota Diabetes Plan 2010 to a variety of audiences over the past year Presentations have been given at the national, state, and local levels, each tailored for the specific audience A downloadable PowerPoint presentation with basic information described on page 11 has been available on the Plan website, since January 2004 This presentation was downloaded 135 times in 2004 It is likely that this template has been used to develop presentations that are not accounted for in Table 2
Endorsing the Minnesota Diabetes Plan 2010 was important to me because I am a strong proponent of utilizing collaboration of all community members in addressing health care issues and especially diabetes This Plan helps facilitate ongoing communication and brain storming to address the needs of the people of Minnesota regarding diabetes - Tara Kaup, RN, MSN, LSN, CDE School Nurse,
DiabetesEducator-Saint Paul Public Schools
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YEAR ONE PROGRESS REPORT
Table 2 Examples of Plan-related presentations Presentation The State of Diabetes in Minnesota: Successes, Challenges and Opportunities DiabetesThe Heart of the Matter MSDE Spring Retreat Pediatric Diabetes Education in Schools PEDS Trainings Designing the Evaluation of a Statewide Strategic Plan to Address Diabetes Developing a Database to Evaluate and Coordinate a Statewide Strategic Plan Changing Face of Diabetes in Minnesota Conference Culturally Appropriate Change Strategies to Prevent Diabetes Meeting Convener Novo Nordisk Pharmaceuticals Minneapolis-St Paul Diabetes Educators MSDE School Nurse Organization of Minnesota MSDE CDC Division of Diabetes Translation CDC Division of Diabetes Translation Minnesota Diabetes Program, MDH Aging Adult Services, DHS Health Promotion and Chronic Disease Division, MDH Date November 2003 Audience Reached Statewide Number of Attendees 30
May 2004
Statewide
60
April, August October 2004
Statewide
110
May 2004
National
75
May 2004
National
75
September 2004 September 2004 October December 2004
Statewide
175
Caring For Elders with Diabetes Video
Conference
Statewide
275
Join the Journey Regional Plan Forums
Regional
110
B Tools Resources
Several tools have been developed to help facilitate Plan implementation Since the Plan is a road map or blue print for focusing efforts on diabetes statewide, a major focus of the tools has been to promote and coordinate communication
Plan CENTRAL
Diabetes Plan CENTRAL Collaborative Exchange Network To Raise Awareness Learning is a web tool designed to serve as an interactive communication hub for the diabetes community to facilitate accomplishing the goals of the Plan Plan CENTRAL is a regularly updated website and database designed to assist in the sharing of activities, resources, and lessons learned by partners working to implement the Plan In 2004, the Plan document was downloaded more than 1,200 times Table 3 describes the various components of the Plan CENTRAL website
The homepage of the Diabetes Plan CENTRAL website
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MINNESOTA DIABETES PLAN 2010
Table 3 Plan CENTRAL website components
Web Component Home About Read/Access the Plan Plan Accomplishments News Events Dialog Participate Promote Diabetes Data Contact Us
Description of Contents Stay up-to-date with
the hot topics box Learn about the Minnesota Diabetes Plan 2010 and Plan CENTRAL Download a PDF of the Plan or order copies using an online form Learn about Plan milestones and Plan evaluation Access resources for the media and review previous media coverage and events Read current and back issues of the Diabetes Plan Dialog Newsletter Register to endorse the Plan or view the current list of Plan Champions Do a free text search of the goals of the Plan, or look for resources to help implement the Plan Download tools and resources to help promote the Plan Explore the Diabetes in Minnesota data report, or find a data fact sheet and links to additional data E-mail the webmaster or the Diabetes Plan Coordinator
Diabetes Plan Dialog Newsletter
The Diabetes Plan Dialog newsletter is a free, online publication developed to facilitate an ongoing conversation about the Minnesota Diabetes Plan 2010 The Dialog newsletter is one component of a set of web-based tools for ongoing exchange about the Minnesota Diabetes Plan 2010, which can be accessed from Diabetes Plan CENTRAL The Dialog provides a forum for
the Minnesota diabetes community to share stories, celebrate accomplishments and provide ongoing, support, inspiration and motivation for accomplishing the goals of the Plan Four issues of the Dialog were published in 2004 The first, titled Bringing the Plan to Life was released in February The second, released on June, focused on the issues of providing diabetes education and was entitled Improving Diabetes Education and Support Systems The third, released in August was entitled Keeping Current on Diabetes: The Challenge to Professionals, and featured innovative examples of professional education being provided to diabetes professionals in Minnesota The fourth issue, Health Promotion and Diabetes Education in Diverse Communities, was released in December
Thumbnail sketch of the Diabetes Plan Dialog newsletter
The first issue of the Dialog was emailed to invitees of the Kickoff Celebration, members of the Minnesota Diabetes Steering Committee, and individuals who had requested copies of the Plan following the Kickoff Celebration The original subscription list included 200 people Prior to the release of the second issue a
Listserv was established to manage the growing number of subscribers As of the December 2004 issue, with only wordof-mouth marketing, there were over 300 subscribers to the Diabetes Plan Dialog newsletter All past issues of the Dialog can be viewed or downloaded from Plan CENTRAL at: http://wwwhealthstatemnus/diabetesplancentral
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YEAR ONE PROGRESS REPORT Plan Resources
The Plan Resource List is one way for the Minnesota diabetes community to share tools, including manuals, journal articles, presentations, maps, reports, survey instruments, software, websites and other resources with the rest of the community Any individual or organization may add a resource to the listing that they have used, developed or would like to recommend to others working to achieve the goals of the Plan These resources are listed on Plan CENTRAL under Participate and can be browsed or searched by keyword As of December 2004, over 100 Plan-related resources were listed
Other Promotional Tools Resources
In addition to Plan CENTRAL and the Dialog newsletter, a number of other materials have been developed, as needed, to help promote the Minnesota Diabetes Plan 2010 All of these tools are available
for download from Plan CENTRAL These include handouts such as: Plan Executive Summary, Plan order form, Paper endorsement form, and A list of the 350 individuals and organizations that helped develop the Plan
Additionally, three issue briefs have been developed on key aspects of the Plan: Why a Diabetes Plan? Unified Statewide Action Required to Address Diabetes Minnesota Diabetes Program Data Publications
As previously mentioned, a PowerPoint presentation provid 
ing a general overview of the Minnesota Diabetes Plan 2010, including speakers notes, has been developed All tools described here are available for download on the Plan CENTRAL website under Promote the Plan
C Partners Plan Champions
Endorsing the Plan means indicating public support for the vision and goals of the Minnesota Diabetes Plan 2010 In its first year a total of 58 individuals and organizations registered to endorse the Minnesota Diabetes Plan 2010, thus becoming Plan Champions Plan Champions are acknowledged on the Diabetes Plan CENTRAL website and in Plan-related promotional materials Registering as a Plan Champion ensures receiving up-to-date information on Plan-related activities Plan Champions will
also have the opportunity to provide feedback on various aspects of the implementation and evaluation of the Plan A continuously updated list of registered Plan Champions can be found on Plan CENTRAL under Participate http://wwwhealthstatemnus/diabetesplancentral Testimonials from Selected Plan Champions Plan Champions represent a cross section of the Minnesota Susan Head endorsing the Plan on behalf of the Bemidji Area Indian Health Service diabetes community To highlight the diversity of this group of partners, endorsement statements or testimonials provided by several Plan Champions can be found in the maroon boxes throughout this document
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MINNESOTA DIABETES PLAN 2010 D Media Coverage Recognition Media Coverage
The Minnesota Diabetes Plan 2010 received television, radio and print coverage in its first year Prior to the Kickoff Celebration in October 2003, a press release describing the Plan was issued to all Minnesota media outlets, resulting in a flurry of Plan coverage in October 2003 The Plan continued to capture the medias attention throughout the first year, due in part to the medias appetite for stories on obesity, diabetes and related health topics The coverage
received by the Plan has been very positive Table 4 summarizes media coverage of the Plan in the first year
Table 4 Media coverage of the Plan
Media Venue WCCO News Minnesota News Network
Media Type TV Radio
Date October 2003 October 2003
Approximate Number of People Reached 170,000 Taped interview distributed to 75 radio stations statewide Total reach unknown 44,000 28, 210 146,000 6,600 255,000 28,100
Minnesota Public Radio Morning Edition Show St Cloud Times FOX 9 News Faribault Daily News KARE 11 News Minnesota Public Radio Mid Morning Show
Radio Newspaper TV Newspaper TV Radio
October 2003 October 2003 January 2004 January 2004 March 2004 June 2004
Additionally, the Plan has been highlighted in newsletters and professional publications including Minnesota Medicine 8,500 readers, Minnesota Physician 14,000 readers, the Center for Cross Cultural Healths Crosswinds newsletter 500 readers, and the Minneapolis-St Paul Diabetes Educators newsletter 200 readers
Other Recognition
The Minnesota Diabetes Plan 2010 has received attention, support and recognition from elected officials Most notably, Governor Tim Pawlenty declared October 27, 2003 Diabetes Call to Action Day in
Minnesota To read the Governors Proclamation, please visit http://wwwhealthstatemnus/diabetesplancentral and click on Recent Events
E Implementation
There are already numerous examples of partner organizations addressing goals and recommendations of the Plan The following is not meant to be a comprehensive listing of Plan related activities, but a brief sampling of programs addressing multiple Plan goals Inclusion in this listing does not imply that these programs were untaken in direct response to the Plan, but rather that the lead organization acknowledges the fit of their program to the intent of the Plan For the most up-to-date and comprehensive listing of Plan-related activities and programs please visit the Action Network at Plan CENTRAL under Participate
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YEAR ONE PROGRESS REPORT
EXAMPLE 1: Step to it North Side
Program Purpose: To create a community walking program in North Minneapolis Lead Organizations: NorthPoint Health and Wellness Center and Hennepin County Target Audience: Initially geared toward seniors, but open to all residents of North Minneapolis Activities: Weekly two-mile group walk on Saturdays at 8:00 am Accomplishments To-Date: Group has
successfully overcome real and perceived safety concerns This includes getting the City of Minneapolis to fix sidewalks, and getting local police to accompany the walkers Group has been meeting continuously since 2001 Approximately 20 people walk every week Spin-off Step to it groups are being planned for other parts of the Twin Cities metro area
Pam Cosby presenting Step to it North Side at the Changing Face of Diabetes in Minnesota Conference
Plan Goals Addressed: Create a healthier environment Foster community-based collaboration communication
EXAMPLE 2: International Diabetes Center and Multiple District 5M Lions Diabetes Awareness Committee of Minnesota - On-site Continuing Professional Education
Program Purpose: To improve diabetes care and education in all Minnesota communities through education and training initiatives for healthcare professionals Lead Organizations: International Diabetes Center IDC at Park Nicollet and Multiple District 5M Lions Diabetes Awareness Committee of Minnesota Target Audience: Healthcare systems throughout Minnesota Activities: Provide organizational assessment and assistance with infrastructure change to improve diabetes care and
education in the community Provide on-site training, customization of practice guidelines and follow-up consultation on IDCs Staged Diabetes Management, a systematic approach to prevention, diagnosis, and treatment of diabetes Provide training and follow-up consultation on IDCs Type 2 Diabetes BASICS curriculum for patient education Offer assistance to organizations as they apply for national recognition from American Diabetes Association Education Program Recognition and National Committee on Quality Assurance/American Diabetes Association Diabetes Physician Recognition Conduct blood glucose screenings and community diabetes education programs Accomplishments To Date since 1993: Greater than 50 healthcare organizations statewide have received continuing training and education supported by Lions Fourteen community programs were delivered in the past year, potentially affecting over 16,000 people with diabetes Enhanced relationships among patients, providers, and educators results in improved patient outcomes such as reduction in A1c level and increased staff satisfaction after implementation of the program, one educator stated that staff are, all speaking the same
language
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MINNESOTA DIABETES PLAN 2010
Plan Goals Addressed: Fostering community-based collaboration and communication Promoting professional development for the entire clinic staff nurses, dietitians, front office, medical assistants Improving diabetes services to rural populations Improving the collection, quality, and scope of Minnesotas population-based diabetes data examples: system in place to review data at regular intervals, increased documentation of eye exams and foot exams
EXAMPLE 3: Anishinaabe Center Young Warriors Diabetes Program
Program Purpose: To teach American Indian youth to help their people by being a warrior against diabetes Lead Organizations: Anishinaabe Center and Office of Minority and Multicultural Health at the Minnesota Department of Health Target Audience: Anishinaabe Ojibwe youth aged 8-18 years old, as well as the general community and people with diabetes Activities: Developed a culturally appropriate animated video for children about diabetes Teach the Young Warriors how to be presenters and lay health educators Young Warriors present the video to other youth and answer questions about diabetes Monthly Defeat Diabetes community
screening and education days Accomplishments To-Date: Development of an animated video and plans to develop a second video 4 Young Warrior presenters trained to-date Monthly Defeat Diabetes Days ongoing since May 2003 375 people screened for diabetes since 2002 Plan Goals Addressed: Encourage healthy lifestyle behaviors for youth Raise public awareness about diabetes Foster community-based collaboration and communication Stimulate diabetes awareness and action Make diabetes education accessible and culturally appropriate
Anishnaabe Center Young Warriors - Mycal Rock, Winnie Lindstrom front row, and Director Carol Guinn 2nd row
EXAMPLE 4: Minnesota Diabetes Collaborative
Program Purpose: To reduce duplication, stretch resources, and gain greater impact by providing consistent diabetes messages and promoting best diabetes practices to providers and consumers statewide Lead Organizations: American Diabetes Association, Blue Cross and Blue Shield of Minnesota, HealthPartners, Institute for Clinical Systems Improvement, Medica, Metropolitan Health Plan, Minnesota Department of Health, South Country Health Alliance, Stratis Health and UCare Minnesota Target Audience: Adults
with diabetes or its risk factors, health professionals, community organizations, public health
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YEAR ONE PROGRESS REPORT
Activities: Sending common messages about diabetes and risk factors to consumers and providers Stimulating and supporting quality improvement and professional development related to diabetes care Networking and sharing diabetes-related resources, data and experiences Accomplishments To-Date: This joint effort involving nine of the states leading health organizations is gaining greater impact by providing consistent diabetes messages and promoting best diabetes practices to providers and consumers statewide Meeting monthly since June 2000 Produces key diabetes communications pieces for use by health plans, providers, community organizations, the media and many others http://wwwmn-dcorg Created an award winning exam room poster, recently revised in bilingual format Spanish/English Plan Goals Addressed: Raise public awareness about diabetes Foster community-based collaboration Stimulate diabetes awareness and action Improve diabetes services Make diabetes education accessible and culturally appropriate Maximize and effectively use diabetes
resources
EXAMPLE 5: Promoting Uniform Indicators for Monitoring the Diabetes Burden and Evaluating Programs
Program Purpose: Build capacity to conduct diabetes surveillance and program evaluation and promote consistency in defining and tracking diabetes indicators Lead Organizations: Centers for Disease Control and Prevention CDCs National Diabetes Prevention and Control Program NDPCP Target Audience: Stakeholders interested in monitoring the diabetes burden or evaluating diabetes programs Activities: Article published reviewing the status of diabetes surveillance: Desai J, Geiss L, Mukhtar Q, Harwell T, Benjamin S, Bell R, Tierney E Public health surveillance of diabetes in the United States Journal of Public Health Management and Practice, November 2003; S36-S43 Interactive web-based tool developed, which provides comprehensive information on commonly used diabetes indicators and their associated data sources Accomplishments To-Date: The NDPCP and five state Diabetes Prevention and Control Programs DPCPs formed a work group to develop the Diabetes Indicators and Data Sources Internet Tool DIDIT DIDIT was completed and launched for use by DPCPs; other diabetes stakeholders
may access the tool by visiting the following website and completing a short request form: http://wwwcdcgov/diabetes/statistics/indexhtm Training on DIDIT was conducted among DPCPs Article on DIDIT submitted to Preventing Chronic Disease http://wwwcdcgov/pcd/indexhtm
Plan Goals Addressed: Improve the collection, quality and scope of Minnesotas population-based diabetes data
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MINNESOTA DIABETES PLAN 2010 F Evaluation
From the evidence presented throughout this progress report, it is clear that the Plan requires significant investments of time and resources from the Minnesota diabetes community The following is a brief overview of the draft Plan Evaluation Design A final, more detailed, Plan Evaluation Design will be released separately
Purpose
CentraCare supports the Minnesota Diabetes Plan 2010 because there is a critical need for the public to be aware of the long-term effects and costs that the diabetes epidemic will present With decreasing reimbursement and the increasing numbers of people with diabetes it is crucial for health care and government leaders to be made aware of this crisis - CentraCare Diabetes Center
The primary purpose of the Plans evaluation is
to assess the effects of a statewide strategic plan for diabetes A secondary purpose is to improve the practice of statewide strategic planning for diabetes, including plan implementation and plan evaluation
Stakeholders and Users
An evaluation stakeholder is any individual or organization that has invested resources including time in the Plans development, implementation or evaluation The primary users of the evaluation are the MDP and MDSC Other stakeholders include Plan Champions, Action Network members, Dialog newsletter subscribers, the CDC, and other State Diabetes Prevention and Control Programs DPCPs
How Results Will Be Used
Evaluation of the Plan will yield results related to Plan processes and progress, and also contribute to a small but growing body of knowledge about designing, implementing and evaluating statewide strategic plans Evaluation results will be used to: Improve Plan marketing and implementation strategies Guide the mid-point review of the Plan and make needed additions or improvements Guide future strategic planning around diabetes in Minnesota Contribute lessons learned to fellow state DPCPs and other chronic disease programs Begin developing best
practices based on accumulated experiences of state DPCPs and other chronic disease programs Document progress on Plan receommendations Demonstrate the value of the Plan to stakeholders
Evaluation Questions
The evaluation questions are summarized below The use of the word how is intended to move this evaluation beyond simply counting activities, to achieving an understanding of the types of activities being undertaken, their effectiveness, sustainability, and scope Evaluation of the Plan will take place at three levels, as summarized in Table 5
Colleagues networking at the Kickoff Celebration left: Joe Nelson, right: Dr Richard Berganstal
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YEAR ONE PROGRESS REPORT
Table 5: Levels of Plan evaluation, and relevant questions at each level
Level 1: Evaluation questions related to marketing promotion of the Plan 1 What is being done to market and disseminate the Plan? 2 Are stakeholders aware of the Plan? 3 How do stakeholders understand their role in the Plan? 4 Are stakeholders taking action on the Plan? If not, why not? Level 2: Evaluation questions related to use action on Plan recommendations 5 How is the Plan being used and implemented? 6 How is the Plan helping
to coordinate action on diabetes? 7 How does the Plan promote partnership among diabetes stakeholders? 8 Do stakeholders feel the Plan promoted communication, action, coordination and partnership? Level 3: Evaluation questions related to statewide progress on Plan recommendations Public Health goals 9 How has progress been made on the Minnesota Diabetes Plan for 2010? How has progress been made in each of the five Theme areas? How has progress been made in each of the Goals within each Theme area? How has progress been made for each Recommendation in the Plan? 10 How has progress been made in areas not directly covered within the Plan ? 11 What progress is directly attributable to Plan activities? 12 What progress is indirectly attributable to Plan activities? 13 How has progress in Plan areas impacted diabetes public health objectives? 14 How has progress in non-Plan areas impacted diabetes public health objectives?
Methods
Evaluation methods will be observational, and measurement will occur at multiple levels The MDP will lead the effort of collecting data to track indicators and will answer these evaluation questions through a variety of methods
Evaluation Roles and
Responsibilities
Organizations undertaking activities to address the Plan will be responsible to evaluate those activities The MDP will invite these organizations to share success stories and evaluation results via Plan CENTRAL The MDP is responsible for accomplishing the work of coordinating Plans overall evaluation, including planning, implementation and analysis, but they will rely on two other groups for feedback: the Evaluation Advisory Group EAG and the Minnesota Diabetes Steering Committee MDSC The role of the EAG is to provide expert advice and feedback on evaluation planning, implementation, evaluation, interpretation and reporting The role of the MDSC is to make judgments and recommendations based on the results Members of MDSC will be integral in promoting and sharing the results with the Minnesota diabetes community at large
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MINNESOTA DIABETES PLAN 2010 Progress on Plan Evaluation
In the first year of Plan implementation, significant progress was made in developing a comprehensive, statewide Plan evaluation Accomplishments include:
Convening the Evaluation Advisory Group EAG to review and improve the Plan Evaluation Design, and assist with the resulting
evaluation Presenting to a national audience on Minnesotas groundbreaking efforts to evaluate a statewide strategic plan at the 2004 CDC Diabetes Translation Conference Developing a draft Plan Evaluation Design to be released Developing and testing the Action Network, an online database to collect and share Plan-related activities to be released
The Plan Evaluation Design will be posted on Plan CENTRAL for review and comment beginning in 2005 All Plan partners will be asked to consider their role and what unique perspectives and contributions they can bring to the evaluation process
5 PRIORITIES FOR THE FUTURE
Implementation of the Minnesota Diabetes Plan 2010 is guided by the philosophy that it is the responsibility of each individual or organization within the Minnesota diabetes community to determine how they can best contribute to the success of the Plan It is up to each of us to select the goals, recommendations, and activities we have the capacity to address It is through this voluntary, but coordinated and collaborative effort we will, dramatically reduce the impact of diabetes in Minnesota The first year has been very successful, but there is still much that can be done
to raise awareness of the Plan and bring new and diverse partners to the table A thoughtful, coordinated and statewide approach to evaluation will be needed to demonstrate the Plans impact Therefore, through the guidance of the Minnesota Diabetes Steering Committee, continued Plan promotion and initiation of evaluation have been selected as key priorities for Year 2 A few specific, measurable objectives for making progress on these priorities are listed below 1 2 3 4 5 A minimum of 15 presentations given on the Plan, at events, trainings, and meetings, by December 2005 A minimum of 800 potential stakeholders, or Plan partners, reached through presentations by December 2005 Increase the number of registered Plan Champions by 50, or to a total of 75 by December 2005 Increase the number of Dialog Newsletter subscribers by 50, to a total of at least 420, by December 2005 Collect data on Plan-related initiatives through the Action Network Increase the number of Action Network program examples from 0 to 100 by December 2005
A What You Can Do
To help accomplish these objectives, there are simple and important things we can each do to help make progress on this important initiative See
Table 6
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YEAR ONE PROGRESS REPORT
Table 6 Suggestions and tips for accomplishing Year 2 objectives Outreach Promotion Give a brief presentation on the Plan to your organization or partners at your next steering committee meeting, annual conference, staff retreat or other event Describe how the Plan relates to the mission, vision or expertise of your organization Share at least one of your organizations programs or activities that address one or more Plan goal using the online Action Network Tip: Download and customize the Introduction to the Plan PowerPoint presentation It can be found on Plan CENTRAL under Promote
Tip: Enter your Minnesota specific program information on Plan CENTRAL, under Participate or contact the MDP for assistance
Tools Resources Develop a fact sheet or issue brief that highlights important programs and activities occurring in your organization and describe which goals or recommendations of the Plan your activities are helping to address Create a link to Diabetes Plan CENTRAL on your organizations website Share your useful diabetes tools or resources through Diabetes Plan CENTRAL, or browse the existing resources Tip: Download the Fact
Sheet Template, or use the Issue Briefs as models Both can be found on Plan CENTRAL under Promote
Tip: If you need help making the link, contact the MDP for assistance Tip: Submit your tools and resources using the entry form, or search the current Resource List found in Plan CENTRAL under Participate
Partners Plan Champions Endorse the Plan become a registered Plan Champion Encourage your partner organizations to become a registered Plan Champions Tip: Endorse the Plan confidentially and electronically on Plan CENTRAL under Participate
Media Coverage Recognition Include a story on the Plan in your organizations newsletter Describe your efforts in addressing a particular goal or recommendation or share why youve decided to endorse the Plan Subscribe to the Diabetes Plan Dialog Newsletter Submit a story idea or upcoming Plan-related event to Plan CENTRAL Tip: Download the Media Talking Points It can be found on Plan CENTRAL under Promote
Tip: Subscribe electronically on Plan CENTRAL; go to Dialog Tip: Enter your ideas electronically through Plan CENTRAL, go to Events or email the MDP
Visit Plan CENTRAL at: http://wwwhealthstatemnus/diabetesplancentral to
share information about your tools, resources, products, activities, and success stories If you dont find a way to share on Plan CENTRAL that works for you, please contact the MDP directly at diabetesplan@healthstatemnus or 651 281-9849
B Give Us Feedback on this Report
The MDP will strive to keep the Minnesota diabetes community informed of the Plans progress through regular reports Please let us know how this report can be improved to better meet your needs In addition, we seek your assistance in monitoring activities and evaluating the impact of the Plan Whenever you become aware of key diabetesrelated milestones or achievements, please enter them into the Diabetes Plan CENTRAL Action Network or contact us, so we can include them in future reports
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Minnesota Diabetes Plan 2010 Kickoff Celebration set-up at the Landmark Center in St Paul, Minnesota
Source:ncbde.org
