Success Stories - Adirondacks

Taking Charge of Diabetes and Pre-Diabetes in Lewis County

Issue

Located in the northern region of the state, the population of Lewis County is 27,087, making it the fourth least-populated county in New York. Its county seat is Lowville. Roughly 1,275 square miles in size, Lewis County is known for its interesting topography, large windmill farms and outdoor recreational opportunities. Most of its residents arehealthy, and health indicators are generally close to or better than New York State averages. (2014-2017 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 diabetes and diabetes complications in the county: The mortality rate for diabetes in Lewis County is higher (10.4%) than that of NYS as a whole (8.5%) and diabetes mortality per 100,000 was double that of the state as a whole (29.5% versus 14.9%, respectively). In Lewis County, 27% of adults are physically inactive as compared with 25% in the State.

Based upon these statistics, the Lewis County Public Health Agency selected reducing obesity in children and adults as one of its priorities to prevent chronic disease in the population. One of the strategies chosen to meet this goal is to make the Chronic Disease Self-Management and its iterations (CDSMP/DSMP) and the National Diabetes Prevention Programs (NDPP) available to, and utilized by, Lewis County Residents (Community Health Improvement Plan).

Intervention

The Mission of Lewis County Public Health is to prepare and educate the people of Lewis County to ensure their health and safety; striving to be recognized as the leader in the Prevention of Disease, Preparedness for Disaster, and Promotion of Life-Long Health and the county’s Health Improvement Plan calls for the availability and use of evidence-based programs for its residents. Similar to that of the NYS Prevention Agenda, Lewis County provides the CDSMP/DSMP and NDPP community workshops as well as diabetes support groups on a regularly scheduled basis. This includes maintaining its program facilitator infrastructure by providing in-house training as needed.

In 2012, Lewis County Public Health began its efforts to provide evidence-based programming by sending two of its staff, to training for the Chronic Disease Self-Management Program (CDSMP) followed by the Diabetes Self-Management Program (DSMP) and the National Diabetes Prevention Program (NDPP). A natural fit with the ongoing diabetes support groups offered by the health department, the evidence-based programs were off to a great start through recruitment efforts directly with medical practices and Lewis County General Hospital to name a few; and, through partnering with the Office for the Aging and the Northern Regional Center for Independent Living to offer CDSMP classes in the community.

Reach And Impact

  • Since 2012, 9 programs, including CDSMP, DSMP and NDPP, offered to date; Of those, 3 are currently in process, with 2 scheduled to begin in fall 2015
  • Total of 58 people reached with the completed programs
  • For NDPP:
    • 82% attendance over the course of the programs
    • 36% retained a 7% weight loss
    • 59% reported 150 min/week of Physical Activity
    • Of the 37 that completed the 12-month program, 57% maintained a 5% weight loss

NDPP Lifestyle Coach and Lewis County Public Health Coordinator, Ellon Grunert, said that in one recent NDPP program, “a husband and wife partnered together to support each other, which helped both of them be more active and lose weight.” She went on to explain that they are now healthier and better prepared to care for their disabled son.

She also noted that their 2013 inaugural NDPP had 9 participants that collectively lost approximately 200 lbs. One participant in particular went from using a wheelchair to walking by the end of the year long program.

Importance of Impact

Grunert asks all of her participants to talk with their providers about the program if they like the results. This is important because it spreads the word about the program and the expected results. The Director of Public Health is also spreading the word, according to Grunert. Not only is she telling her colleagues and others about it but she has given Grunert and her co-worker and NDPP Lifestyle Coach, Mary Kimbrell, the flexibility to offer the programs in the early evening when the working population is available.

Resources Leveraged

Through their community connections and influence, the Lewis County Public Health Agency has worked tirelessly to establish a seamless referral and recruitment system for the evidence-based programs that it supports. Public Health staff have provided presentations and face-to-face meetings with providers and other professionals in the community.

In addition, Fort Drum Regional Health Planning Organization, located in the neighboring county, was developed to analyze the existing healthcare system available to Fort Drum Soldiers, their Families, and the surrounding civilian community, and to identify gaps and then leverage additional medical resources. The result is a strengthened, more adaptive healthcare system that provides a greater range of medical resources for all, including the support of Lewis County’s Priority Agenda on Health.

Contact Information:

Ellon Grunert, LCPH Coordinator

Lewis County Public Health Agency

7785 N. State Street

Lowville, NY 13367

(315) 376-5453

egrunert@lcpublichealth.org