Diabetes Self-Management Education Empowers Mississippians

In the United States, 18.8 million people are diagnosed with diabetes, and an estimated seven million people remain undiagnosed, according to the 2011 National Diabetes Fact Sheet.

Educating diabetics about how to manage their disease allows them to better control and understand the potential complications such as amputations, blindness and kidney failure.

In 2012, the Centers for Medicare & Medicaid Services (CMS) selected Meridian, Miss. for a special innovation project focusing on the high prevalence of diabetes and associated complications, particularly within the African-American community.

atom Alliance partner, Information & Quality Healthcare (IQH) coordinated this effort with the goal of reducing amputation rates and improving care through diabetes self-management education (DSME) classes provided at no cost to African-American Medicare beneficiaries. Other Alliance partners are expanding the program to Alabama, Indiana, Kentucky and Tennessee.

IQH recruited Meridian-based providers to participate in the project. Participants referred their eligible Medicare patients to DSME classes using tools provided by IQH, including sample standing orders for referrals to DSME classes, chart sticker reminders, monofilaments (for detecting neuropathy), and personal health records that encourage foot and eye exams for people with diabetes.

The Project Leaders, Lisa Camel, RN, BSN, and Willie Ann Thomas, RN, BSN, made a point to get involved in the community and reach out to anyone who comes into contact with beneficiaries.

They recruited 54 providers to participate.

The DSME classes, were conducted at a variety of meeting sites throughout the city and taught by nurses trained in a curriculum based on the Diabetes Empowerment Education Program (DEEP), a participatory model that simplifies complex medical concepts using props, pictures and interactive learning to engage beneficiaries, and makes a point of incorporating culturally-sensitive materials.

The program covers topics such as medications, nutrition and monitoring foot and eye care. The interactive learning sessions include fun demonstrations such as a fast food meal as a visual aid illustrating the amounts of unhealthy ingredients using sugar, lard and salt.

Camel and Thomas taught DSME classes in a variety of non-traditional settings such as senior housing apartments, activity centers, churches, Housing and Urban Development (HUD) sites and parks.

“Because of their age and barriers to transportation, beneficiaries can’t always come to the classes, so we take the classes to them,” Camel said. “That’s one of the unique things about the DEEP model – you can take the props anywhere.”

A graduation was held to celebrate the completion of each DSME class. Every participant received a certificate and appeared in a photograph featured in a local newspaper reaching more than 20,000 homes in the Meridian area. This increased interest in the meetings.

To track participants’ progress and the impact of DSME classes, staff conducted follow-up calls at two-month intervals after graduation. As of June 30, 2013, foot exams increased 21 percent, and eye exams increased 15 percent.

“It’s truly rewarding to see that the beneficiaries understand the information from our class and are applying it to their everyday lives,” Thomas said. “This project has helped improve the health of Meridian residents and may serve as a model program to improve diabetes self-management nationwide.” The program graduated 178 African-American Medicare beneficiaries with diabetes.