thanks goes to Debbie Childers, a certified diabetes educator, for. providing expert information on diabetes management at the Lunch and Learn. meetings. …
Dallas-Fort Worth Business Group on Health Diabetes Management Worksite Program
Project Report February 2004
Underwritten by GlaxoSmithKline with additional support from Bayer Corporation and Roche Diagnostics
DFWBGH S-E-T for Success Diabetes Management Demonstration Project February 2004
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Dallas-Fort Worth Business Group on Health Diabetes Management Worksite Program
Project Report February 2004
Underwritten by GlaxoSmithKline with additional support from Bayer Corporation and Roche Diagnostics DFWBGH S-E-T for Success Diabetes Management Demonstration Project February 2004 2
The Dallas-Fort Worth Business Group on Health is grateful to GlaxoSmithKline for its generous support of this project and to Bayer Corporation and Roche Diagnostics for additional in-kind contributions
The Dallas-Fort Worth Business Group on Health is a 110-member coalition of Dallas and Fort Worth employers committed to market-based health care reform Members include American Airlines, Bell Helicopter-Textron, EDS, ExxonMobil, JC Penney, Neiman Marcus, RadioShack, Southwest Airlines, Texas Instruments, TXU, Verizon, Federal Reserve Bank of Dallas and others DFWBGHs goals are to empower employers
to make informed, value-based health care purchasing decisions and to encourage health care providers to continuously improve their clinical performance and quality of care
2004 by the Dallas-Fort Worth Business Group on Health, Dallas, TX All rights reserved No part of this publication may be used or reproduced in any manner without permission in writing from the Dallas-Fort Worth Business Group on Health, except in the case of brief quotations embodied in news articles, critical articles or reviews
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Acknowledgements
None of what follows would have been possible without the dedication of the team members of TXU and FRBD TXUs team members included: Michele Hawkes, Meredith Okruhlik, Denise Moltzen, and Linda Borisky FRBDs team members include: Ginger Cole, Mary Kinman, Shashi Mathews, and Bob Queyrouze An additional thanks goes to Debbie Childers, a certified diabetes educator, for providing expert information on diabetes management at the Lunch and Learn meetings We also thank the diabetes associates at the Ruth Collins Diabetes Center of Baylor University Hospital System for their assistance
DFWBGH would also like to thank John Hilyer and Mande White who as project managers contributed time and effort to making the project a success
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Table of Contents
The Problem: A Super Sized Nation 56 S-E-T for Success Project Overview 80 Goals and Objectives 109 Project Phases 125 Program Components 162 Project Component Pyramid 209 Implementation 213 Outcomes 270 Lessons Learned 276 APPENDIX 1: Resource Audit Worksheet 307 APPENDIX 2: Diabetes Prevalence Worksheet 331 APPENDIX 3: Prevalence of Diabetes by Special Populations 349 APPENDIX 4: Diabetes Burden of Illness Worksheet 381 APPENDIX 5: Communication Checklist Worksheet -FRBD 407 APPENDIX 6: Sample Waiver 442 APPENDIX 7: Weekly emails-Sample week 2 482
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The Problem: A Super Sized Nation
No matter how successful or profitable a business is, it cannot afford bad health Businesses
everywhere are ready to put an end to soaring health care costs But the silver bullet isnt higher premiums, decreased benefits, capitated services or more drugs The real solution requires changing our focus and tackling the real problem unhealthy employees Experts estimate that nearly two-thirds of the United States population is overweight Since 1991, the incidence of obesity has risen from 12 percent to more than 25 percent While some call it an epidemic, US Secretary of Health and Human Services Tommy Thompson calls obesity the fastest growing disease in America Now, imagine what will happen to employer health care costs over the next three to five years when many of those who are now simply overweight become diabetic Then look ahead five years when these diabetics develop kidney failure requiring dialysis, and coronary artery disease requiring complex heart surgery Consider these staggering facts from the American Diabetes Association ADA: q Each day, approximately 2,700 people in the US are diagnosed with diabetes About 1 million people aged 20 years or older will be diagnosed this year Nationwide, 17 million people have diabetes q Diabetes is the fifth leading cause of death
in the US q More than 1 of every 10 spent on health care services in the US is attributable to diabetes q Heart disease is the leading cause of diabetes-related deaths q The risk for stroke is two to four times higher among people with diabetes q 73 percent of adults with diabetes have high blood pressure q Diabetes is the leading cause of new cases of blindness among adults 2074 years old q Diabetes is the leading cause of treated end-stage renal disease q About 60 to 70 percent of people with diabetes have mild to severe forms of nervous system damage q More than 60 percent of nontraumatic lower-limb amputations in the US occur among people with diabetes As the graying of America continues and the population grows in size and becomes more racially and ethnically diverse, the diabetic population will grow, even if current diabetes prevalence remains unchanged Using diabetes prevalence rates applied to Census Bureau population projections, the national costs of diabetes could grow to 156 billion by 2010 in 2002 dollars and to 192 billion by 2020, according to the ADA
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S-E-T for Success Project
Overview
Give diabetes an inch and it will take a foot, the highway billboard simply stated Its graphic, yet true Diabetes is a complex disease and its management is more than just control of blood glucose Employees with diabetes must be extra vigilant They must monitor their levels of blood glucose, blood pressure, cholesterol and watch for symptoms of diabetes while remaining productive at work Employees with diabetes are at greater risk of temporary incapacity, permanent disability, and premature mortality The economic impact of temporary incapacity due to diabetes can be measured by both workdays lost and number of inpatient bed days Direct medical and indirect expenditures attributable to diabetes in 2002 were estimated at 132 billion, according to the ADA Attributable indirect expenditures resulting from lost workdays, restricted activity days, mortality, and permanent disability due to diabetes totaled 398 billion Per capita medical expenditures totaled 13,240 for people with diabetes and 2,560 for people without diabetes Although diabetes is incurable, it can be prevented in many employees For diabetic employees, it may be controlled through multi-faceted diabetes
management programs provided at the worksite Diabetes management programs can drastically reduce a companys skyrocketing health care costs Controlling diabetes translates to controlling health care costs Based on data from the ADA, employers could save 21,360 annually, by keeping just two at-risk employees from developing diabetes Managing Diabetes in the Workplae Millions of people spend the largest part of their waking hours at work As a result, employers are in a unique position to help employees with diabetes gain a better understanding of their disease and find ways of managing it Employees at-risk for diabetes can be educated in the prevention of the disease and avoid unnecessary complications In an effort to empower employees to self-manage their risk for diabetes, the Dallas-Fort Worth Business Group on Health DFWBGH initiated a nine-month multi-faceted worksite diabetes management program for its employer members: S-E-T for Success Screening, Education, Treatment Diabetes Education and Management Program This program also provided employers tools to control diabetes-related health care costs and improve day-to-day worker productivity DFWBGH S-E-T for Success 9 Diabetes
Management Demonstration Project February 2004
The purpose of this innovative program was to: ü Provide a health-management tool to help employers build a framework for prevention and treatment programs ü Develop and customize a screening, education and follow-up program for employees that could help reduce diabetes risk factors and improve treatment ü Help employers take action toward reducing the threat of diabetes in the workplace Supported by an unrestricted educational grant from GlaxoSmithKline, with additional support from Bayer Corporation and Roche Diagnostics, this demonstration grant was successful in creating greater awareness of diabetes risk factors and self management tools and potentially saving millions of dollars in future health care costs Although this study initially began with two large Metroplex employers, TXU and the Federal Reserve Bank of Dallas FRBD, the findings in this report primarily reflect those of FRBD TXU was unable to complete the program
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Goals and Objectives
DFWBGHs worksite diabetes management program provided a road map for improved client counseling and
prevention to help employees take steps toward healthier living and change the lifestyle behaviors of those at greatest risk The overall goals: q Determine the prevalence and cost of diabetes among project participants q Develop a model worksite diabetes education and management program to provide disease management planning, screening, education and interventions q Evaluate program impact on employee health status, diabetes management and health care costs The following objectives were accomplished to meet these goals: q Calculate direct and indirect costs of diabetes for employer participant q Determine current diabetes risk for each employer participant q Implement promotion, screening and education resources for employees of each participating company q Implement a diabetes intervention program to include: glucose HbA1c monitoring, monthly group educational sessions and personal coaching by certified diabetes educators, weekly email self-management reminders see Appendix 7: Weekly emails-Sample week 2 q Conduct a process, outcome/behavior change and cost/benefit evaluation for each participating company
Project Phases
The worksite Diabetes Education and Management Program
consisted of five phases: v Phase I: Employer Education Selection Identified and recruited DFWBGH members for participation Federal Reserve Bank of Dallas was selected Educated benefits manager regarding the prevalence and financial burden of diabetes in the workforce v Phase II: Participation Selection Worksite awareness and diabetes blood glucose screenings HbA1c and glucose were offered to employees at a worksite health fair Employees were selected as participants based on results of their blood screenings and invited to participate Participants signed a participation agreement acknowledging risks and permitting DFWBGH access to personal health information DFWBGH S-E-T for Success Diabetes Management Demonstration Project February 2004 11
v Phase III: Worksite Educational Activities Monthly Lunch Learn group educational sessions with various diabetes-related topics and speakers Web-based tools eg, wwwdiabetesatworkorg Participants were encouraged to seek proactive diabetes management by their personal physicians Incentives were used to encourage employees to participate and stay involved, including: ü FREE diabetes supplies throughout course of program ü FREE
Glucometer ü FREE glucose and HbA1c blood tests, ü FREE diabetes risk assessments, ü Personal coaching by professional diabetes educators, ü Weekly email reminders and tips see Appendix 7:Weekly emails ü Newsletter articles ü FREE S-E-T for success T-shirts Self-report health tracking forms were provided v Phase IV: Evaluation Participation rates and self-report health-tracking forms were evaluated Follow-up HbA1c and glucose results were compared with baseline blood tests Employees were surveyed regarding satisfaction with program, usefulness of diabetes management tools and improvements in health status and on-the-job productivity v Phase V: Reporting Project results, including changes in employee risk factors, were summarized in a written project report and in a PowerPoint presentation
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Program Components
Awareness Communications Employer Planning Guide with manual and forms on CD ROM including Communications Checklist Worksheet See Appendix 5: Communication Checklist Information/promotion about DFWBGH Demonstration Project Employer-based Assessments Employer Resources Audit See
Appendix 1 ü Internal project coordinator/staff support ü Employee demographics See Appendix 1 ü Formulary evaluation ü Medical pharmacy claims analysis Diabetes Burden of Illness calculation direct and indirect cost estimates See Appendix 4 Worksite Activities Diabetes Risk Assessment web-based print Blood Screenings glucose and HbA1c Education ü Educational brochures, posters, newsletter articles, e-mails, etc ü Internet health information website link ü Group education sessions with certified diabetes educator ü List of endocrinologists in company health plans Targeted Interventions ü Free glucometers to employees with diabetes ü HbA1c blood tests: pre post-intervention ü Glucose blood tests: pre post-intervention ü Self-management tracking form ü Weekly email reminders see Appendix 7: Weekly Emails ü Monthly coaching sessions with certified diabetes educator Incentives Awards Employee incentives ü Free snacks and meals, t-shirts, glucometers, educational materials provided by DFWBGH ü Other optional incentives as determined/provided by employer eg free diabetes testing supplies and medications Employer award presentation Press releases
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Program Evaluation Employee feedback satisfaction survey Medical pharmacy claims analysis compared to baseline data Impact analysis Summary report for employer incl aggregate data, impact analysis, etc Project report ü Written report ü PowerPoint presentation
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Project Component Pyramid
Project Report Cost-Benefit Analysis Incentives Awards
Reporting
Rewards
Repeat Blood Tests
Repeat HbAICs
Repeat HRAs
Repeat Lipid Profiles
Weekly Glucose Tracking
Targeted Interventions Baseline Blood Tests Risk Screenings Employer Audit
Monthly CDE Sessions Glucometers HbAIC Tests
Weekly E-mail Reminders Lipid Profiles Glucose Screening Burden of Illness Calculation In-network Endocrinologists
Diabetes Risk Assessments Employer Planning Guide Employee Demographics
Employee Educational Materials Formulary Evaluation Med/Pharm Claims Analysis
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Implementation
With a diabetes management worksite model developed, the first step was to identify
participating employers Federal Reserve Bank of Dallas met the criteria, including workforce demographics that suggested a high incidence of diabetes, and medical and pharmacy claims that indicated frequent use of the health care system for diabetes-related treatments Federal Reserve Bank of Dallas FRBD-As one of 12 regional Reserve Banks in the Federal Reserve System, the FRBD serves the Eleventh Federal Reserve District, which consists of Texas, northern Louisiana and southern New Mexico FRBD has 2,030 employees, LTD, retirees and survivors eligible for medical coverage, of which 1,037 are female and 993 are male 1,000 employees are DFW-based and these were invited to participate in this project Employee demographics are shown in Appendix 2: Resource Audit Worksheet Through DFWBGH, the FRBD was able to provide its employers a complete suite of diabetes management options that included education, online tools, and one-to-one personal support Employee compliance and incentives Each employee participant had to agree to the terms of the program and sign a waiver permitting DFWBGH access to confidential personal health information 35 employees volunteered to participate in the
six-month program This waiver was adapted for use and approved by the FRBD prior to use See Appendix 6: Sample Waiver As an incentive to participate in this program, FRBD participants were provided diabetic supplies through Liberty Direct Supplies without a co-pay Supplies were provided for a 30-day prescription If it was determined by the company nurse that a participant was not complying with the terms of the program, he/she was deleted from Liberty Directs eligibility file and did not receive free supplies Claims data provided information on the process used for Liberty Direct Supplies eligibility files and payment of invoices From January to June 2003, FRBD purchased 13,41525 from Liberty Direct Supplies for 30 employees, averaging 5589 per employee a month January 2003 expenditures from Liberty Direct for diabetic supplies totaled 1,32813 compared to Junes expenditures of 74255 suggesting that the program was having a positive impact on participants A longer period of tracking such data would be needed to determine if continued use of the program would reflect a sustained downward trend in costs for diabetic supplies A longer trial period could provide better measures of
DFWBGH S-E-T for Success 16 Diabetes Management Demonstration Project February 2004
employee adherence to treatment protocols and behavior changes, which should reduce the use and exp 
ense of medical supplies over the long term Glucose Screenings A total of 262 employees at the FRBD were initially screened for diabetes Of these, 17 were determined to either have diabetes diabetic or be at risk positive screen for the condition, representing 7 percent of the screened participants This falls in line with the trend of 6 percent being diabetic within the general population An additional 216 employees showed a tendency for diabetes However, according to Liberty Medical claims data, 100 to 150 FRBD employees have been diagnosed with diabetes, which is somewhat higher than the general population Glucometer Each FRBD participant with diabetes was given a free Bayor Elite glucometer and was required to maintain a Diabetes Self Management Tracking Form developed by FRBD The glucometer readings were downloaded to the company coordinators computer via Glucofacts software provided by Bayer Corporation At each monthly meeting, participants were provided charts showing their glucometer readings
with a report of their progress Lunch Learns Six Lunch Learns were provided to participants during the six-month project FRBD continued the program for an entire year FRBD employees could purchase lunch through food vouchers provided by the program in the bank cafeteria Held monthly, these educational meetings, conducted by certified Diabetes Educators were used to teach nutrition, exercise and healthy lifestyle habits Topics included: Jan 16: Introduction and Monitoring Blood Glucose Feb 20: Medical Nutrition Therapy Mar 20: Benefits of Increasing Activity Levels April 17: Medical Management of Diabetes May 15: Prevention Complications July 12: Wrap-up and Long-term Goal Setting During the final meeting in July, participants completed a feedback and satisfaction questionnaire Fourteen surveys were completed Here are some of their comments
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Q Please let us know about any significant changes or observations you made while enrolled in the program? Answers: - I am no longer a potential candidate for Type II diabetes because of lifestyle changes I have made based on information I obtained in
this program I have lost a significant amount of weight Also my blood sugar has dropped to normal ranges almost every day I have learned what to eat and how much I am paying more attention to my glucometer readings I know/understand more about how diabetes works and how medication affects it
-
Q Please describe how valuable you felt this program was to you Answers: - This program has helped to alter my life by changing the impact diabetes could have on it I have started to check my blood sugar level everyday Getting the free supplies from Liberty has been a real plus The motivation and encouragement is priceless
-
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FRBD Survey Results All the topics of the FRBD Lunch Learn meetings ranked very favorably Eleven of the 14 respondents attended at least three or more of the 6 Lunch and Learn Sessions Medical Nutrition Therapy garnered the most 5 favorable votes Benefits of Increasing Activity Levels was ranked the most enjoyed topic by 7 respondents Twelve of the 14 respondents ranked the program very useful and 2 ranked the program useful No one ranked the program not useful Twelve of the
14 respondents stated they were very likely to participate in Phase II and 2 ranked likely No one voted not likely to participate in the continuation of the program As modeled by the program, lifestyle modification remains a cornerstone for diabetes management Strong evidence that diet, walking and other types of activity can go a long way in reducing mortality and other diabetic complications Federal Reserve Bank of Dallas participants wanted to continue the program and DFWBGH agreed to extend the program for another 6 months The same Lunch and Learn topics were repeated with more coverage on areas of concern among participants
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Outcomes
DFWBGHs S-E-T for Success Diabetes education and management program at the FRBD was successful in providing a health-management tool to help employers build a framework for diabetes prevention and treatment programs at the worksite FRBD had 35 participants complete the program December 31, 2003 and 35 have opted to continue the program with funding through other sources Employee participants are still offered free diabetic supplies through Liberty Direct
Lessons
Learned
DFWBGHs worksite program proved that employers could make diabetes management work at work Moreover, onsite educational programs go a step further by enhancing employee moral and loyalty Such worksite programs hold enormous potential for reducing diabetes among employees, enhancing worker productivity, decreasing diabetes-related costs and reducing other health problems The program definitely increased awareness of Diabetes management and probably improved the health of employee participants As we explore expanding this successful program to other employers, these additional ideas will be considered for future initiatives: To make the program the most successful, the benefits, wellness and fitness departments must collaborate to ensure a program synergy There must be a commitment from senior management to ensure that resources are allocated appropriately and sufficiently to support the program within the company The corporate culture must emphasize wellness and prevention A 12 to 18 months commitment by the employer is needed Six to nine months is not long enough to generate needed behavior changes among participants Readiness to change surveys should be completed before
participants are accepted into the program
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A weight management component, such as Weight Watchers, should be included since obesity and diabetes are often linked A psychologist should be involved for behavior modification issues Actual application lessons are needed at the worksite, not just educational classes For example, companies should make changes in their employee dining room and vending machines to support healthier eating and provide facilities for employees to exercise Incentives must be directly tied to participant involvement, ie free diabetic supplies to participants Ideally, different topics should be taught by the most appropriate member of the healthcare team, provided they have experience in diabetes management The team can include physicians, nurses, dietitians, exercise physiologist, pharmacist, psychologist, podiatrist etc
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APPENDIX 1: Resource Audit Worksheet
Employee Demographics-FRBD
Number of Employees by the following AGE groups:
Sex Both Male Female
20-39 604 319
285
40-49 499 218 281
50-59 400 185 215
60-74 527 271 256
TTL People 2030 993 1037
Number of Employees by the following ETHNICITY groups:
Ethnicity TTL People Percentage Caucasian 1186 58 African American 426 21 Hispanic 369 18 Asian American Native American 47 2 2 0
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APPENDIX 2: Diabetes Prevalence Worksheet
The Third National Health and Nutrition Examination Survey, 1988-1994 NHANES III Data, is one of several sources for calculating prevalence of diabetes in the United States NHANES II is a representative sample of more than 18,000 adults surveyed within the general population to determine the percentage with a known diagnosis of diabetes Use the prevalence rates listed in the NHANES III Data chart below to calculate the number of employees between 20 and 64 who are at risk for diabetes
Percentage By Age
20-39 years
SEX
Both Sexes
of Employees 11 x_________ 11 x_________ 11 x_________
40-49 years
of Employees 39 x__________ 33 x__________ 44 x__________
50-59 years
of Employees 80 x__________ 96 x__________ 66 x__________
60-74 years
of Employees 126 x_________ 118 x_________ 128
x_________
General Population of Employees 59 x__________ 59 x__________ 59 x__________
Men Women
Prevalence of Diabetes by AGE and GENDER-FRBD
Sex Both Male Female 20-39 7 4 3 40-49 19 7 12 50-59 32 18 14 60-74 66 32 33 TTL People 120 59 61
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APPENDIX 3: Prevalence of Diabetes by Special Populations
Some populations have a higher incidence of diabetes These include African American, Mexican American, Asian/Pacific Islander and Native American Use the prevalence ratios for special populations in the NHANES III chart below to calculate the number of employees who are at risk for diabetes, based on age, gender and ethnicity
Percentage By Age
20-39 years
of Employees
40-49 years
of Employees 33 x_________ 30 x_________ 35 x_________ 62 x_________ 55 x_________ 67 x_________ 73 x_________ 55 x_________ 92 x_________
50-59 years
of Employees 75 x_________ 99 x_________ 53 x_________ 138 x_________ 130 x_________ 145 x_________ 160 x_________ 155 x_________ 165 x_________
60-74 years
of Employees 113 x_________ 109 x_________ 117 x_________ 209 x_________ 168 x_________ 239 x_________ 244
x_________ 188 x_________ 290 x_________
Ethnicity/Gender
White
Both Sexes Men Women
10 x_________ 12 x_________ 09 x_________ 16 x_________ 16 x_________ 16 x_________ 08 x_________ 05 x_________ 12 x_________
African American
Both Sexes Men Women
Hispanic
Both Sexes Men Women
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Prevalence of Diabetes by AGE and GENDER and ETHNICITY-FRBD
20-39 Both Male Female 20-39 Both Male Female 20-39 Both Male Female 1 0 1 2 1 1 4 0 1 Caucasian 40-49 50-59 10 18 4 11 6 7 African American 40-49 50-59 6 12 3 5 4 7 Hispanic 40-49 50-59 7 12 2 5 5 6 60-74 35 17 17 60-74 23 10 13 60-74 23 8 13 TTL People 65 32 31 TTL People 43 18 24 TTL People 43 16 25
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APPENDIX 4: Diabetes Burden of Illness Worksheet
Once you have determined an estimated number of employees at risk for diabetes, you can calculate the costs associated with these risks According to the ADA, estimated medical costs including diabetes-related and non-diabetesrelated costs for a person with diabetes is 13,240 each year, while the medical costs for a person
without diabetes or other chronic condition is 2,560 FRBD
Estimated Medical costs per Employee: -Without diabetes or other chronic condition -With Diabetes 2,560 13,240
More per diabetic employee
10,680
Total Employees NHANES III estimate of diabetic employees Total Cost of Care
2,030 x 120 x 1,910
2,56000 10,68000
5,196,80000 1,281,60000 6,478,40000
Projections based on know number of covered plan members purchasing diabetes supplies in 2002 Total Employees Number of covered employees or dependents purchasing diabetic supplies in 2002 Total Cost of Care 2,030 x 2,56000 5,196,80000
150 x 1,880
10,68000
1,602,00000 6,798,80000
Total number of employees with diabetes for the FRBD-120 was determined by adding total numbers for each ethnicity from Figures of Appendix 4
Source: American Diabetes Association
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APPENDIX 5: Communication Checklist Worksheet FRBD
Availability of communication tools: _____Intranet _____Internet Access _____Bulletin Boards _____Payroll Stuffers ______Other_____________
Health Promotion/Wellness Checklist Worksheet Availability of staff and resources listed
below: ____Part or full-time wellness coordinator ____Worksite health screening
____Workplace Internet-based health information program Name of Wellness Coordinator ___________________________________
Medical/Pharmacy Claims Data and Contact Worksheet Availability of claims data and coverage as indicated below: Medical and pharmacy claims data related to diabetes for 12 months prior to program ü Medical claims inpatient and outpatient with ICD-9 diagnosis codes 250xx diabetes-related ü Pharmacy claims for diabetes medications and supplies Medical and pharmacy claims data related to diabetes for 6 months during program ü Medical claims inpatient and outpatient with ICD-9 diagnosis codes 250xx diabetes-related ü Pharmacy claims for diabetic medications and Supplies Pharmacy plan coverage for diabetes testing equipment and supplies
Medical Plan Contact:_________________________________________________ Pharmacy Plan Contact:________________________________________________
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APPENDIX 6: Sample Waiver
Federal Reserve Bank of Dallas FRBD Diabetes Program Consent, Release, and Waiver
The Diabetes
Education Program at FRBD is a joint project between Dallas Ft Worth Business Group on Health DFWBGH, Roche Diagnostics, GlaxoSmithKlein, Bayer Corporation, Schering-Plough, and FRBD The purpose of the project is to determine if providing diabetes education in the work place leads to improved health behaviors and outcomes Please read the terms of this agreement and sign below if you agree to give your consent to participate in the diabetes Program project What FRBD Health and Wellness will provide participants: 1 2 3 4 Monthly one-hour meetings may include lunch with a diabetes educator 6 months Each meeting will cover educational information for self-management of diabetes Full participation participants will each receive a blood glucose monitor for home testing, including a finger sticking device, and lancets for the duration of the program No copay for diabetic supplies obtained through Liberty Direct Services Corporation as prescribed by the participants physician
What the Participant commits to participate:
1 2 3 4 5 6 7 Agree to attend all 6 monthly meetings Agree to test blood sugar with equipment supplied at the intervals prescribed in the course Agree to test HgA1c lab
pre_____ and post____ course Agree to complete an HRA pre_____ and post____ course Complete diabetes pre-course knowledge assessment ____ Complete diabetes post-course knowledge assessment ____ Consent to sharing the above pre and post program labs and information: a Baseline HRA b Post course HRA c Baseline HgA1c d Post course HgA1c e Pre and post course knowledge assessment
I consent to participate fully in the diabetes program as described in the participant commitment section of this agreement provided by FRBD Health and Wellness Management unit I understand that all participant information will be kept confidential, in aggregate format, with individual identities concealed for confidentiality Your name will not be released in any form, other than eligibility for benefits through Liberty Direct Corporation The blood glucose values, HgbA1c, and HRA information will be used as the values/numbers only, without any names associated I understand the purpose for this program is to provide information and resources to each participant that is beneficial for disease management in exchange for inclusion of my data gathered to demonstrate that diabetes education at the work sites can
improve health outcomes I have had the opportunity to ask any questions pertaining to my participation and agree to participate ___________________________ __________________ __________ Participant Name Participant Signature Date
__________________________ Witness
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APPENDIX 7: Weekly emails-Sample week 2
Get S-E-T for Success This weeks email topics include: ü Exercise Planning Guide ü Diabetes in the News ü Helpful Hints Encouragement EXERCISE PLANNING GUIDE What to do? Almost any physical activity that you enjoy can serve as a form of exercise Ideally, choose low-impact activities that use large muscle groups rhythmically such as swimming, biking, walking, dancing or weight training Add recreational activities throughout the day such as shopping, yard work, and extra walking to burn more calories and raise your metabolism When to do it? Choose a time that is convenient for you, preferably after a meal or snack Morning exercise is usually best, but mid-day or early evening is OK as well Avoid late-night exercise, as this may lead to nighttime hypoglycemia or keep you from falling asleep How
often to do it? Remember, exercise is like taking medicine for your diabetes You will get the most consistent benefits through daily exercise Aim for 5-7 days per week DIABETES IN THE NEWS http://wwwdiabetesorg/main/health/exercise/faqjsp This site answers some of the frequently asked questions regarding diabetes and exercise HELPFUL HINTS ENCOURAGEMENT Create a reward system for yourself Set a goal this week of measuring your glucose 3 times per day At the end of each day, give yourself a small reward, ie 10 minutes alone with a magazine, a pat on the back At the end of the week, if you have achieved your goal, reward yourself with something larger ie a trip to the movies, a new shirt, a book Set rewards that is encouraging and motivational to you You deserve them youre doing a great job of learning to take care of someone important YOURSELF Remember to download your glucometer information
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If you would like additional information regarding the Dallas-Fort Worth Business Group on Health please visit: wwwdfwbghorg or call us at 2143823036
If you would like additional information on providing a
worksite diabetes management program at your company, please call Mande White at 2143823036
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Source:dfwbgh.org
