National Snapshot of State Health Department Outcomes and Lessons Learned from Implementing Diabetes Self-Management Education and Support Programs and National Diabetes Prevention Programs

In 2013, CDC developed the State Public Health Actions to Prevent Obesity, Diabetes, and Heart Disease and Stroke, a five-year cooperative agreement which combined the efforts of four divisions to fund 50 state health departments (SHDs) to implement strategies to work through health systems and communities to prevent chronic disease and reduce complications from multiple chronic diseases. The Division of Diabetes Translation recommended several strategies to support type 2 diabetes prevention and diabetes management. The strategies focused on 1) increasing referrals to CDC-recognized lifestyle change programs operating under the National Diabetes Prevention Program (National DPP); 2) securing the program as a covered benefit for state or public employees and Medicaid beneficiaries; and 3) increasing referrals to, coverage for, and availability of diabetes self-management education and support (DSMES) programs. Quantitative analysis of SHD performance measures data shows that from baseline to year 4, there was an increase in access to and participation in DSMES and the National DPP. Qualitative analysis of SHD workplans identified program accreditation, technical assistance, partnerships, reimbursement for DSMES, and flexible scheduling for patients as key facilitators for increased DSMES program utilization. SHD grantees reported reimbursement availability, practice/provider referral policies, and having standard curricula as facilitators to implementing the National DPP lifestyle change program.