Community Health: FCS Extension Educators Deliver Diabetes Education in PA
Cox, Jill N., Corbin, Marilyn, Journal of Family and Consumer Sciences
For decades, family and consumer sciences (FCS) Extension educators have provided health related education to consumers through Cooperative Extension programming at land grant universities. However, offering diabetes education can be extra challenging due to the complicated nature of the disease and the multi-faceted treatment required. Faced with an increasing prevalence of type-2 diabetes and pre-diabetes, public health advocates are turning to nontraditional programming to help reverse this trend.
In 2006, the Governor of Pennsylvania recognized the necessity of developing a more comprehensive approach to diabetes prevention and treatment. In keeping with the Chronic Care Model of healthcare, the Pennsylvania Diabetes Action Plan (http://www.dsf.health.state.pa.us/ health/lib/health/diabetes/PADiabetesActionPlan. pdf) was developed. Community resources are recognized as a valuable component of the Chronic Care Model. To strengthen the availability of these resources, the Pennsylvania Department of Health approached Penn State Cooperative Extension to develop a statewide diabetes education program to be delivered in community settings.
Led by an Extension Associate Specialist, a team of eight FCS educators began the planning phase of the diabetes education program. Many of the Extension educators and the associate were registered dietitians; one was also a certified diabetes educator.
Selection of an appropriate curriculum was the first step; top priority elements were:
* Focus on food preparation and menu planning
* Adaptable to Pennsylvania populations
* Inclusion of physical activity promotion
Following a review of several curricula, the Dining with Diabetes program (West Virginia University) was selected and modified for use in Pennsylvania.
Recognizing that difficult questions related to diabetes would likely arise during group sessions, FCS educators who were not registered dietitians or certified diabetes educators were required to partner with a healthcare professional with those credentials to deliver the class. The healthcare partner delivers the teaching portion related to diabetes and the FCS educator organizes class sites, conducts interactive food demonstrations, and helps with administrative issues.
Findings from the pilot study revealed the success of the program on many levels. Objective measures obtained at the first and last classes revealed significant improvement in several biomarkers. Participants showed decreases in their AlC levels (blood test reflecting blood sugar control over previous months), systolic blood pressure, and waist circumference. Additionally, responses to questions regarding awareness of important knowledge and behavior items to manage participants' diabetes indicated significant improvement upon completion of the program.
Feedback from the participants yielded greater insight to factors contributing to the success of the program. Since the FCS educators live and work in the counties in which they provide programs, they are able to select sites that are familiar and comfortable to the participants. Most programs are held in non-medical facilities, which is a more relaxed atmosphere for learning.
Often when people are first diagnosed with diabetes, they are overwhelmed with the many lifestyle changes prescribed. Medications, diet changes, physical activity recommendations, and blood glucose monitoring techniques all may be presented at the outset. Depending on the amount of time and resources available to their healthcare provider, this information can be imparted in various ways and in varying lengths of time.
One of the reoccurring comments related to the program is that it focuses more on what the participants can do in managing their diabetes as opposed to what they can no longer do because of their diabetes. With interactive food demonstrations, the participants have the opportunity to prepare and taste healthy versions of familiar foods. …