Located in the west central region of the state, the population of Tompkins County in 2010 was 101,564. Ithaca, the largest city, acts as the county seat. The county is subdivided into 9 towns and 6 villages. There are 3 institutions of higher education that call Tompkins County home: Cornell University, Ithaca College and Tompkins Cortland Community College. Cornell and Ithaca College campuses are within or just outside the City, and Tompkins Cortland Community College’s campus borders the Village of Dryden. The schools have a combined population of roughly 27,000 students (2010-2013 Community Health Assessment).
The county chose Chronic Disease prevention as a top priority from the New York State Department of Health’s Prevention Agenda because of a high level of the diabetes and pre-diabetes in the county and surrounding areas: The mortality rate for diabetes in Tompkins County is in the middle of all Upstate NY counties and elevated blood levels among adults (10 mg/dL) per 100,000 employed persons (aged 16 and older) equaled 12 for 2007-09 (per 53,750 employed – 2008), for a rate of 7.4% (http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/docs/challenges.pdf).
The county views chronic disease prevention as rooted in the modification of risk factors such as physical inactivity, poor nutrition, and the prevention of tobacco use. Policy change and changes in individual and community environments help to support healthy behavior and, thus, lead to primary prevention of chronic diseases like diabetes.
The mission of the Human Services Coalition of Tompkins County is to enhance the delivery of health and human services in the Tompkins county area of New York State. The Health Planning Council is a program of the Human Services Coalition. A goal of the Health Planning Council is to educate the community about good chronic disease management in the form of the National Diabetes Prevention Program (NDPP).
In 2012, the Human Services Coalition of Tompkins County was awarded a 3-year Community Health Improvement Grant from Excellus Blue Cross Blue Shield to establish the NDPP in Tompkins County. The NDPP is an evidence-based, CDC recognized program for adults who are at risk of developing Type 2 diabetes, or who are pre-diabetic. The year-long lifestyle change program was offered by the Human Services Coalition staff and NDPP Lifestyle Coach, Susan Olmstead. Since then, another organization, the Cayuga Center for Healthy Living, has joined the effort.
Recruitment for the initial three NDPP groups came from two practices in the county: The first, Olmstead’s previous employer, provided their office setting as the weekly meeting site and used their EMR to target patients with impaired fasting glucose. The identified population would then receive a NDPP recruitment letters from their provider. The same provider is now a champion of the NDPP and continues to identify patients at risk for diabetes and send out bi-annual recruitment letters.
The second practice came on board because of connections established through the provision of another evidence-based program for people with diabetes. Currently, the Human Services Coalition and its county-wide partners have expanded the NDPP to the community at large partly due to the foresight that they had to train additional NDPP coaches as part of the grant’s sustainability mechanisms.
Reach and Impact
- Since 2012, 11 programs offered to date; Of those, 3 are currently in process
- 85 people reached
- 78% maintained a 5% weight loss throughout the 12 month program
- 69% retained a 7% weight loss
- 78% reported 150 min/week of Physical Activity
- As a result of the initial efforts, there are now 6 Lifestyle Coaches spanning across the 4 agencies
Importance of Impact
As a result of the NDPP activities in the county, all of the collaborating organizations are now working together to support and promote the NDPP throughout the county by adopting and offering a unified approach as “The Diabetes Prevention Program of Tomkins County” in the media coverage that they receive, and by charging the same rate for eligible NDPP participants (note that sliding scale and scholarships are available). Each promotes the others’ programs, using the same marketing forms and documents, which were adapted from the Common Ground NDPP Lifestyle Coach website including a customizable poster, brochure and use of the guide/fact sheet. In addition, the Human Services Coalition of Tompkins County received CDC recognition of its NDPP efforts in March 2015.
Offering the NDPP has united Tompkins County organizations to work together around diabetes. The partnership has raised the awareness and diagnosis of pre-diabetes. Both the community and the area health care providers can see these four organizations working in concert to lower the risks of diabetes.
As a result of the activity and outcomes documented in this article, the Human Services Coalition has secured additional grant resources from the NYS Health Foundation, receiving a grant award to connect the NDPP with employers. The Diabetes Prevention Program of Tompkins County has collaborated on development of a business engagement plan. The Health Department is working with Cornell University to host NDPP, market it to employees and to include fees as part of the flex benefits spending program.
Susan J. Olmstead, Chronic Disease Program Coordinator
Human Services Coalition
171 East MLK Jr./State Street, Ithaca, NY 14850-5543