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Patient Testimonials

Tiffanney Learn and Jennifer Calderon-Gwenigale

Engaging the Disengaged: Strategies for Promoting Behavior Change in Diabetes

William Polonsky, PhD, CDE, President and Founder of the Behavioral Diabetes Institute

• Discuss the latest research findings concerning poor motivation in diabetes and how psychosocial factors influence adherence to diabetes self-care behaviors. 
• Describe brief techniques for assessing diabetes self-management obstacles.
• Identify practical behavioral methods for promoting greater patient engagement and encouraging more effective self-care in diabetes clinical practice.

Breakout Session 1A - Health Inequities for People with Disabilities and Diabetes    

Anne Crotty, MPH, UIHC Center for Disabilities and Development, University of Iowa
Maggie Ferguson, MS, CRC, CBIS, Program Manager, Inclusive Health and Wellness Initiative for Iowans with Disabilities, Iowa Department of Public Health
Mike Hoenig, MA, Program Coordinator, State and Community Projects; UIHC Center for Disabilities and Development, University of Iowa 

People with intellectual disabilities are five times more likely to have diabetes than the general population. Despite a greater need for health care, people with disabilities are also less likely to receive preventative care, more likely to delay treatment, and tend to receive less adequate care in managing their diabetes. A collaboration between Iowa Department of Public Health and Iowa’s University Center for Excellence on Developmental Disabilities, Iowa is leading the way promote the inclusion of people with disabilities in public health and health care initiatives. This presentation will describe the multiple factors contributing to health inequities for people with disabilities and diabetes, as well as Iowa initiatives to address inequities, and examples of innovative community-based projects that are promoting inclusive health and wellness. 

• Explain underlying reasons for health inequities among people with disabilities and diabetes.
• Describe Iowa initiatives to address health inequities for people with disabilities as they relate to diabetes.
• List three community-based examples that are promoting inclusive health and wellness for people with disabilities and diabetes.

Breakout Session 1B - Legalizing Eating with Diabetes: An Intuitive Approach 

Alison St. Germain, MS, RD, LD, Iowa Academy of Nutrition & Dietetics    

Learn how weight stigma and bias hinders communication and causes patient harm. Explore the framework of Health at Every Size® and Intuitive eating and how to apply in diabetes education. Presenter will provide examples and handouts for practitioners to use with patients. Specific activities will be demonstrated to use with clients.

• Deconstruct weight stigma and learn how it hinders clinician-patient communication and how it increases the likelihood of poor health outcomes.
• Explore non-diet weight neutral approaches to well-being as an alternative to weight centered interventions with specific application to diabetes.

Breakout Session 1C - Iowa’s Innovative Dental, Medical, and Community Integration Activities

Katie McBurney, BSHM, RDH, Lifelong Smiles Coalition
Kate LaFollette, RN, Care Coordinator, Telligen
Joy Laudick, RN, CDP, Director of Clinical Quality Management, Senior Housing Management, Inc.

Health care transformation is changing the patient/client care landscape in Iowa. State and federal agencies, and public and private payers point to elements that guide providers from volume to value-based practices. Better care, better outcomes, and affordable cost is the goal and expectation. Iowa is becoming a leader in integrated oral and clinical care. Public health, community service organizations and clinicians are thoughtfully integrating and coordinating care practice. Evidence shows oral and dental care as preventing diabetes and other serious illness, containing costs and improving overall health. Partners in the LIFELONG SMILES Coalition are executing innovative programs. Their experiences and stories can provide your organization directions needed for integrated sustainable community health.

• Recognize the importance of oral care as part of a diabetes prevention and treatment plan while discussing the need to advance coordinated care among health disciplines.
• List two impacts of Mouth Care Matters training for healthcare professionals.
• Examine how social determinants of health (including access to oral care) impact overall quality of life and hospital re-admissions.

• Everyone with Diabetes Counts: Strategies and Accomplishments, Telligen
• Walk with Ease Program – A Diabetes Prevention and Control Intervention, Community Health Partners

Breakout Session 2A - The Med Talk: Strategies to Help People with Type 2 Diabetes Start and Stick to Their Diabetes Medications

Megan Muñoz, RN, MSN, CMSRN, CDE, Diabetes Educator, UnityPoint Clinic
Cynthia J. Fiester, RN, BSN, Linn County Public Health    

Medication safety and adherence have a well-recognized impact on medical outcomes, costs, productivity and quality of life for people living with Type 2 Diabetes. Medication safety and adherence was a Linn County Diabetes Subcommitte area of focus for the SIM grant (2017-19). This presentation builds on Linn County’s findings, and aligns with Iowa’s Diabetes Statewide Strategic Plan, and national movements by the American Diabetes Association, to close the gap between ideal diabetes outcomes and the current state. The presentation will highlight differences between practitioner and patient perceptions of Type 2 diabetes. A discussion on strategies for engaging and empowering patients to initiate and adhere to their medications will be included. The audience will walk away with tools and “real-world” methods to help them discuss new diabetes medications, maximize current regimens, modify glucose checking techniques, and overcome patient resistance to changes in care. All of these components address patient reported barriers to medication adherence and support public health efforts to improve diabetes outcomes.

• Identify the depth of the medication adherence problem in T2D.
• Overcome barriers to medication adherence in T2D.
• List two techniques that can be applied to practice to improve medication adherence.
• Identify one resource that can impact medication adherence outcomes.

Breakout Session 2B - Dental and Diabetes: A Bi-Directional Dilemma

Mary Kelly, MS, RDH, CDP, Trainer, Oral Health Connections

The relationship between dental and diabetes is well-documented and supported by research and data. By simply brushing one’s teeth a person with diabetes can realize improved glycemic control and oral health especially with periodontal disease which may eventually lead to tooth loss. This presentation will discuss opportunities for diabetes educators, clinicians and dietitians to understand the bidirectional relationship between oral health and glucose control, create shared outcomes through interprofessional practice, set oral health management goals that assist with diabetes management and create shared outcomes.

• Define the relationship between glycemic control and oral health.
• Perform an oral health screening.
• List common oral health diseases.
• Suggest oral hygiene management goals for their clients.
• Create shared overall health improvement goals through interprofessional practice.

Breakout Session 2C - A Collaborative Approach to Designing, Implementing, and Evaluating “Diabetes Management and Prevention at the Iowa City Free Medical Clinic”  

Mara Cheney, MPH, Johnson County Public Health
Estefany Guido, Iowa City Free Medical & Dental Clinic
Barbara Vinograde, Iowa City Free Medical & Dental Clinic

Johnson County Public Health (JCPH) and the Iowa City Free Medical Clinic (FMC) have a long-standing partnership to address the health needs of Johnson County’s uninsured and underinsured residents. FMC serves a population considered at high risk for diabetes, and while having offered a chronic disease Case Management Clinic for many years, FMC experienced barriers to sustained diabetes educational services due to reliance on volunteers. In order to address patient needs as an objective of the countywide Health Improvement Plan priority of Diabetes Screening and Education, JCPH and FMC collaborated to apply for grant funding through the American Medical Association Foundation (AMAF) to increase the scope of Case Management programming offered by the clinic. Utilizing AMAF funding, FMC has contracted a bilingual Community Health Worker (CHW) through JCPH to lead culturally relevant Motivational Interviewing-based diabetes management and prevention programming since May 2018. Participating patients receive quarterly on-site educational services, health metric checks, and guidance with goal setting. JCPH provided technical assistance to expand the previous programming utilized at the clinic and develop a program evaluation plan. To date, the CHW has worked with 85 patients (82.3% diabetic, 17.6% pre-diabetic) and data will continue to be tracked to determine patient retention and program sustainability. 

• Provide a framework for collaborative methods of developing, implementing, and evaluating diabetes prevention and management programming.

Breakout Session 3A - Treating Obesity in the Setting of Diabetes

Jamie Pitlick, PharmD, Associate Professor of Pharmacy Practice, Drake University and MercyOne Des Moines Diabetes and Endocrinology Care
Christine Langel, ARNP, MercyOne Des Moines Diabetes and Endocrinology Care 

Overweight and obese individuals should be encouraged to participate in a comprehensive lifestyle program with emphasis on adherence to a lower calorie diet, increasing physical activity, and behavioral modification as first-line weight loss strategies. Motivating and encouraging patients to participate in these lifestyle programs is a challenge. MercyOne Des Moines Diabetes & Endocrinology has an interprofessional collaboration of doctors, advanced nurse practitioners, dieticians, and pharmacists working to develop a comprehensive program for the treatment of obesity. The purpose of the presentation will be to review the treatment of obesity as a disease, and discuss the results (breakthroughs and barriers) of the clinic initiative.

• Describe the treatment of obesity as a disease, including evidence-based comprehensive lifestyle programs.
• Compare and contrast medical treatment options for patients with diabetes and obesity.
• Discuss the results(breakthroughs and barriers) of the interprofessional obesity clinic initiative.

Breakout Session 3B - Increased Access and Patient Success in a DPP Through Innovative Community Partnerships

Erin Raftery, RN, BSN, MPH, Care Manager, Eastern Iowa Health Center
Emmaly Fenton Renshaw, Certified Diabetes Prevention Lifestyle Coach and Chronic Disease Program Coordinator, YMCA of the Cedar Rapids Metropolitan Area

YMCA and Eastern Iowa Health Center in Cedar Rapids Iowa have worked together to refine and improve the referral process for primary care patients who are pre-diabetic to the YMCA Diabetes Prevention Program. Through staff education, motivational interviewing, patient education, working to reduce patient barriers, and building a model for referring outside the primary provider organization has both increased access and patient success in the program. With the addition of an electronic community referral option and the current trends of decreasing grant funding we will also discuss how we are tackling new opportunities and barriers in continuing to improve and enhance patient’s access to the diabetes prevention program.

• Apply innovative ways to reduce barriers for low income patients to the YMCA Diabetes Prevention Program.
• Prepare patients prior to DPP program enrollment for increased engagement and successful outcomes.

Breakout Session 3C - Reducing Health Disparities in the Pacific Island Culture: A Targeted Diabetes Intervention    

Heather Rickertsen, PharmD, Director of Clinical Pharmacy Services, Crescent Community Health Center 
Emma Kraayenbrink, PharmD, Infocus Pharmacy Services

Our presentation will briefly outline the history of the Pacific Island culture, emphasizing the prevalence for diabetes. We will share the structure of our program highlighting achieved successes through the use of a community health worker model. Lastly, we will share outcomes related to diabetes, ER use, visit compliance and more.

• Highlight the benefits of a community health worker model.
• Demonstrate how reducing barriers to healthcare can improve health outcomes.
• Emphasize how cultural sensitivity can enhance patient-provider relationships.
• Identify how community partnerships can contribute to healthier communities.