This is part four of a four-part series on "Technical Assistance for Success" to provide a
high-level overview of becoming a CDC-recognized deliverer of the National Diabetes Prevention
Program lifestyle change program. This segment will discuss improving outcomes using data results.
Diabetes Prevention Recognition Program (DPRP). The Diabetes Prevention Recognition Program, or DPRP,
grants CDC recognition to organizations that have demonstrated their ability to deliver successful,
evidence-based Lifestyle Change Programs that help people prevent or delay type 2 diabetes.
Data Submission Results. You can use the results from your data submissions to improve your
outcomes. By comparing your organization's outcome measures to the requirements listed in the current
DPRP Standards and Operating Procedures, you can identify your strengths, weaknesses,
and opportunities for improvement. There are some tips to help you get the most out of your data.
Session Attendance. Keep up session attendance. This is a very important component of the
program, and if overall numbers are low, your organization may not achieve full recognition.
Participants who don't attend regularly are less likely to meet their weight loss goals,
which could also impact your progress in achieving full recognition. The program lasts
12 months, and organizations must hold a minimum of 16 weekly sessions during the first six months
and a minimum of six monthly sessions during the last six months. Attendance tends to fall
off during the last six months, so this is a critical time to keep participants engaged.
Program Intensity and Participant Retention. Organizations that offer more than 16 sessions
during the first six months and more than six sessions during the last six months
find participant retention and attendance improved significantly. Some organizations have found that
if they finish the weekly sessions early, offering sessions twice a month in months five and six
and then continuing this in months seven and eight can help ease the transition to monthly sessions.
Holding sessions more often can help to build continuity and cohesion among
participants, facilitating peer support and peer learning. Holding an introductory class,
or Session Zero, before the first session is another strategy that's worked well
for some CDC-recognized organizations. This gives the Lifestyle Coach an opportunity to
explain what the Lifestyle Change Program is and its value, describe the time commitment required,
and set expectations for potential participants during the 12 months. And, for some organizations,
creating participant non-binding contracts has worked in keeping up attendance because
it's a tangible way to help people stay accountable. As an incentive for retention,
organizations will be granted an additional two years of full recognition (for a total
of five years) if, at the time full recognition is achieved, certain retention criterion is met.
Make-Up Sessions. Offering make-up sessions for participants who miss a regular session
is also key to reaching your attendance goals. In addition, there's a proven relationship between the
number of sessions attended and success in meeting both increased physical activity and weight loss
goals. Every organization, class, and participant is different, so it's up to you to decide the
best way to deliver make-up sessions. They can be held over the phone, through distance learning,
or by using some other online method for the convenience of the participant.
No matter which method is used, makeup sessions must be at least five days apart to maintain
the intensity of the program, approximately one hour, and use a CDC-approved curriculum module.
If you have an emergency outside of the normal processes and procedures,
please contact the National DPP Customer Service Center for more guidance.
Participants can self-report their weight at make-up sessions and should be prepared to report their
physical activity minutes performed during the week leading up to the session that was missed.
Eligibility. Participant eligibility can be determined in a few ways: 1)
by a blood glucose test done within one year of participant enrollment, meaning one of the
following specifications a) Fasting glucose of 100 to 125 milligrams per deciliter, b)
Plasma glucose of 140 to 199 milligrams per deciliter, c) HbA1c of 5.7% to 6.4%,
or d) by a clinical diagnosis of prediabetes or history of gestational diabetes,
or 2) through a positive screening for prediabetes based on the Prediabetes
Risk Test online. Participants cannot be pregnant at the time of enrollment. Participants who enter
your program based on a positive score on their risk test should be encouraged to follow up with
their health care provider to get a diagnostic blood test, which is required for a firm diagnosis
of prediabetes, and report the results back to their Lifestyle Coach. You should strive
to have all participants get a blood glucose test before their last session. If someone enters on the
results of a risk test, as long as they receive a blood glucose test diagnosis of pre-diabetes
before the end of the program, your organization will get credit for a blood glucose test.
Documentation. Throughout your program, it's essential to document each participant's weight
and physical activity minutes at each session.
Keep in mind that some people are more comfortable being weighed privately.
And remember, weight can be self-reported if a participant is attending a make-up session remotely.
Documenting weight and physical activity minutes are important parts of the program. So, even if a
participant has a week with very little activity, encourage them to write it down, even if it's only
10 minutes. But if a participant has a week where they just couldn't do anything, make sure to record
that as zero. If your physical activity reporting is low, make sure you're entering minutes correctly.
Weight Loss. Meeting that overall weight loss requirement is important to achieve
full recognition and to help your participants meet their goal of preventing or delaying type
2 diabetes. Emphasize that people who attend class regularly and stay in the program have been shown
to reach those goals. It usually takes longer than six months to lose five to seven percent
body weight, and attending maintenance sessions is key! To help the larger group, ask participants
who are achieving their weight loss goals to share their experiences, with a special focus on
barriers and challenges they have encountered and what they have done to overcome them.
Individual Challenges. You're encouraged to devote time to exploring participants'
individual challenges when it may benefit the larger class. Use sessions for peer
learning and problem solving, and seek input from your organization's Lifestyle Coach.
Data Monitoring. Be sure to monitor and evaluate participants' data on a continuous basis between
each data submission. The DPRP Data Portal features evaluation reports that help with monitoring data.
By using data to identify areas for program improvement, adjustments can be made as needed,
leading to better outcomes. Reviewing data on an ongoing basis also helps you see trends
and identify any individuals who are having challenges meeting their goals. The Lifestyle
Coach can then provide additional needed attention and support. For instance, if you open your report
and your weight loss documentation numbers are low -- below four percent halfway through
the program -- individual counseling might be appropriate for participants who are struggling.
Data Evaluation. CDC evaluates each organization's data
against the requirements in the current DPRP Standards
to determine recognition status. All requirements must be met to achieve full recognition.
Evaluation Reports. Evaluation reports are generated after your organization
makes its regular data submission to CDC. In the guidance section of the DPRP Standards, you'll find
an example of the path to evaluation for one organization and calculations for weight,
physical activity, and HbA1c Reduction. Using this example to analyze your data before submitting to
the DPRP can help you address any data concerns, if there's time.
Continued Data Submission. Even after your organization has met all the requirements
in the DPRP Standards and achieves full recognition, you will continue submitting data
regularly according to the current DPRP Standards to be reevaluated for recognition status.
Be sure to refer to the DPRP Standards for more guidance
and tips on successful data submissions and ways to avoid common issues.
Your Successful Program. After all, the success of your Lifestyle Change Program
can encourage other organizations to participate, recruit more participants
for future classes, and ultimately help more people prevent or delay type 2 diabetes.
Whether you need technical assistance or guidance in making adjustments, or have questions about any
part of the DPRP, please reach out by visiting the Customer Service Center at nationaldppcsc.cdc.gov
and submitting a technical assistance request. To submit a request, you'll need to complete a
brief profile by selecting "Login" and then "Register." Once logged in, select "Contact Us/Contact Support"
on the home page. Thank you. And remember, CDC is always available to help guide and support you.