1 PEEPS Diabetes Training Program - PowerPoint Presentation

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PEEPS Diabetes Training Program

Angella White, RN, BSN.

Teachers College, Columbia UniversitySlide2

Mission

of the PEEPS program is to empower persons with and at risk for diabetes, through education and support, to equip them with the knowledge and tools that will enable them to make healthier choices in any given situation.

Goal

: To reduce disparities in diabetes care in rural Native American communities and improve diabetes-related health outcomes.Objectives:To increase self-management skillsTo facilitate sustainable behavior changeTo reduce diabetes risk factors; amputations, renal failure and CVDTo manage the psychosocial aspects of diabetesTo increase awareness and knowledge of diabetes prevention and care

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PEEPS Mission Statement and GoalsSlide3

Target Population and Rationale

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Most AIAN communities are disproportionately affected by diabetes heart disease, and stroke. About 45% of our target population comprises households with at least one person living with diabetes. Slide4

Needs Assessment

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American Indians/Alaska Natives frequently contend with issues that prevent them from receiving quality medical care. These issues include cultural barriers, geographic isolation, and low income (Office of Minority Health).

Riverside San Bernardino County Indian Health Inc (RSBCIHI) operates five health clinics in the more densely populated areas and four facilities in the rural areas that provide supportive services. These rural health facilities are not staffed with fulltime healthcare personnel and the diabetes team only visits each rural site once per month. RSBCIHI manages a comprehensive network of services, which many of these community members find services hard to access, due to issues with transportation. Many of these communities are populated with families having low parental educational levels, high unemployment and high levels of poverty. .Besides the single monthly visits from the diabetes team, there were no more additional diabetes education resources or DSME programs serving the community. Slide5

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Stakeholders

Related Interests

Roles as a Partner Adult residents with type 2 diabetes and their families. Improved self-managementReduced barriers to access(convenient time and location)Identify diabetes self-management needs,Serve as Peer MentorHelp recruit new participants

Community Leaders/Elders

Community health promotion

Recognition for role in supporting

program

Provide material resources to

support DSME program

Help to promote the DSME program

Serve on program advisory board

Local and

State and National Diabetes Organizations and Health Departments.

Diabetes prevention and ManagementImproved Public HealthProvide resources and leadershipRefer people to DSME program and provide supporting education servicesServe on program advisory boardExisting diabetes education programs & health professionalsOngoing program improvement Participant satisfactionQuality diabetes educationAdequate program fundingContribute staff time to DSME program Sponsor DSME programProvide educational resourcesServe on program advisory boardPhysicians and other Health Professionals including Diabetes EducatorsPatient implementation of self-care regimens and achievement of targeted clinical outcomes Improved patient healthRefer patients , monitor outcomesReinforce value of participation in DSMEOversee curriculum developmentOrganize or teach DSME classesSupervise or train other staff

An Action Guide. The Community Health Promotion HandbookSlide6

Cultural Considerations

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Healing is considered sacred work and in many Indian traditions cannot be effective without considering the spiritual aspect of the individual.

In many Indian traditions, healing, spiritual belief or power, and community were not separated, and often the entire community was involved in a healing ceremony and in maintaining the power of Indian “medicine.” The term “medicine” is often used to denote actions, traditions, ceremony, remedies, or other forms of prayer or honoring the sacred. In some tribes/nations causes of illness were considered to be an "imbalance" between the spiritual, mental, physical, and social interactions of the individual and his family or clan.Many contemporary Indians use "white man's medicine" to treat "white man's diseases," such as diabetes, and use Indian medicine to treat Indian problems (pain, disturbed family relationships resulting in physical symptoms, or sicknesses of the spirit, which may include mental illness and alcoholism). Slide7

Peer Education and Support/Rationale

Training

: Provide training that is practical and easy to understand for professionals and paraprofessionals. Training should give new tools, techniques, and terminology.

Outreach: Go to where the people in need are to be found in their own communities and engage in community outreach.Acceptance: Accept individuals in the condition, state of readiness to change, or state of change in which you find them. Provide respect, empathy, hope and foster enhanced motivation for whatever steps community members decide to take toward change and transformation.Self-efficacy: Facilitate practical and personal experiential learning (via methods and materials) that increases the self-efficacy of all participants; and that facilitates the delivery of prevention, intervention and treatment to others, in turn.Empowerment: Support the empowerment of community health workers and community members to engage in the determination of their own community’s health.Cultural Competence: Provide culturally sensitive training that produces workers in the trenches who possess cultural competence and can engage in that which is culturally appropriate. Guiding Principles for Community Health Promotion (Wallace, 2008).7Slide8

Format

Education curriculum designed to engage community residents in self-management practices for prevention and control of diabetes (using the AADE7 curriculum as a guide). – 2 days/week for 2 hours over 6 weeks

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Based on Empowerment Principles Encourage involvement of family and friends of persons living with diabetes.Outline of Patient Empowerment Education ProgramEducator assesses current patient status Educator provides relevant diabetes educationEducator acknowledges patient’s responsibility for self-carePatient identifies barriers and strengths related to achieving self-carePatient assumes problem-solving responsibilityPatient establishes plan with assistance from Peer EducatorPatient caries out planPatient and Peer Educator evaluate and review plan periodically Training of Peers Educator Curriculum – One week course.

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Funnell et al., 1991.Slide9

Feasibility of Creating Program

Cost of implementing program will be less than the cost of care from reduced or preventable diabetes risk factors .

Tremendous benefits to overall health of community

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Likelihood of Program Implementation

Given that there has been no record of similar program within the Native American population, the anticipation that this would be accepted by the community members

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Current placement and visibility in community contributes to the formation of trusting partnerships.Personal passion for and commitment to program implementation.Investment in Program Logo and application for Trademark of “PEEPS”.Acquisition of Domain: “bemypeeps.org” to create program website.10Slide11

Potential Challenges and Solutions

Anticipated difficulty in recruiting Peer Educators

Lack of trust for healthcare providers

There might be difficulty finding cultural competent, motivated educators, preferential will be for people of Native American ethnicity.Cost/funding to run program.Transportation to and from meetings for participants.Involve Stakeholders and community Elders Community members as Peer EducatorEngage stakeholders to secure financial support11Slide12

References

American Indian/Alaskan Native Profile, retrieved July 4

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, 2016 from http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=62Diabetes among American Indians and Alaskan Natives, retrieved july4th, 2016 from https://www.cdc.gov/media/matte/2011/11_diabetes_Native_American.pdfFunnell, M. M., Anderson, R. M., Arnold, M. S., Barr, P. A., Donnelly, M., Johnson, P. D., . . . White, N. H. (1991). Empowerment: An Idea Whose Time Has Come in Diabetes Education. The Diabetes Educator, 17(1), 37-41.Partnership for Prevention. Diabetes Self-Management Education (DSME): Establishing a Community-Based DSME Program for Adults with Type 2 Diabetes to Improve Glycemic Control— An Action Guide. The Community Health Promotion Handbook: Action Guides to Improve Community Health. Washington, DC: Partnership for Prevention; 2008.Pollack, C.D. (1994) Planning for success: The first steps in new program development. Journal of School Nursing 10 (3), 11 – 15.Wallace, B. C. (2008). Toward equity in health: A new global approach to health disparities. New York: Springer

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