Community-Based Programs Can Improve Health Outcomes for Older Adults with Diabetes

By Kerz, Marcia M.; Lovegreen, Sarah | Aging Today, November/December 2016 | Go to article overview

Community-Based Programs Can Improve Health Outcomes for Older Adults with Diabetes


Kerz, Marcia M., Lovegreen, Sarah, Aging Today


Emelda Harris is 83 years old and has been dealing with diabetes for the past 20 years. That she is still active is a testament to her steadfastness and strength in coping with a challenging health condition.

Harris, a Creve Coeur, Mo., resident and a former elementary school teacher and college administrator, recently got a wellness boost by participating in a program called Better Choices, Better Health-Diabetes, a six-week workshop developed at Stanford University and offered by the Oasis Institute, a national nonprofit organization that promotes healthy aging. The program helps people implement strategies for coping with an illness that has had a devastating impact, particularly for the 25 percent of older Americans who have type 2 diabetes.

Harris is proud of her outcome. "The program was motivational and supportive," she said. Harris lost eight pounds over the course of the program and has lost seven pounds since, and improved her Ale level, a test that measures blood sugar over time.

Even more significant, she is one of thousands seeing benefits.

Workshop's Origins Based in Research

The Oasis workshop was part of an academic research study of the program's impact on more than 1,200 people. Oasis partnered with the National Council on Aging, with support from the Bristol Myers Squibb Foundation, to offer the workshops.

A study published in June in the Journal of Medical Internet Research (goo.gl/OxDuJd) concluded that participants showed improvement in key health indicators important to managing type 2 diabetes, including Ale blood sugar, depression, exercise frequency and taking medication.

The outcomes show that communitybased organizations can effectively deliver this approach in a real-world setting to improve health status for a people with a disease that is driving increased healthcare costs. Such outcomes also support Donald Berwick's Triple Aim-to improve the patient care experience and population health, while reducing costs.

Several studies have explored the impact of blood sugar control on costs. One study, published in 1997 in Diabetes Care (goo.gl/flBWUl), found that for every 1 percent increase in Ale, there was a 7 percent increase in healthcare costs over the next three years. Ongoing blood sugar control also is linked to fewer complications, such as neuropathy or kidney failure.

An Alternative Model for Success

The Oasis model for success is, in many ways, unusual. Typically, diabetes education programs are run out of hospitals or clinics and provide a lot of information at one time, with supporting reading material. That works well for some, but not all patients. Many adults do better processing smaller chunks of information, then applying it in their day-to-day activities. Successfully applying new information builds the confidence needed to manage diabetes daily. This model is effective with a wide variety of ages, ethnicities and reading levels.

Better Choices, Better Health-Diabetes provides participants with 15 hours of coaching over six weeks, using adult teaching methods and peer support. Facilitators use a standardized approach to help participants manage diabetes on a daily basis and create weekly action plans. Participants learn self-management tools that can help them eat well-balanced meals, exercise regularly, manage medications and deal with stress and depression.

Oasis offers workshops in comfortable neighborhood locations, such as public libraries and community centers, increasing the likelihood that participants will attend each week. …

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