Project Diabetes: Changes for Life A Primary Care Based Prevention Program

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Project Diabetes Changes for LifeA Primary
Care Based Prevention Program

• Parinda Khatri, Ph.D.
• Director of Integrated Care
• Cherokee Health Systems

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Changes for Life Program

• Integrated Primary Care Based Prevention Program
• Target population is underserved children and
  adolescents who are overweight/obese
• Goal is to reduce risk for diabetes through
  positive health behaviors

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Multidisciplinary Approach

• Primary Care Providers
• Behavioral Health Consultants
• Nutritionist
• Nurses
• Fitness Counselor
• Partners
• St. Marys
• University of Tennessee

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Changes for Life Phase I

• Training to behavioral and primary care team
  members
• Identify children at risk for diabetes
• Interventions to prevent or impact obesity
• BMI at every office visit/red flag for additional
  interventions
• BMI gt 85 psycho-education and guidance
• At WCCs, BHCs provide info. on nutrition,
  activity, behavior changes
• At Risk clients will be offered specialized
  guidance by the health care team

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Changes for Life Phase II

• Assessment of At Risk patients
• BHC or PCP consultation
• Group Interventions
• Progress Evaluation
•  

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Group Sessions

• 3 age groups 2-6, 7-12, 13-18
• Parents for ages 2-12
• Monthly group sessions last 1 hour
• Each meeting included
• Healthy lifestyle education/information
• Nutritional ideas/tips and snacks
• Physical activity interventions

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Focus of Interventions

• Healthy Eating
• Choosing healthy foods, healthier recipes, better
  fast food choices, shopping on a budget
• Physical Activity
• Increasing physical activity daily, decreasing TV
  and screen time
• Behavioral changes
• Goal setting, self-management, stress management,
  maintaining positive changes

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Phase II Outcomes

• 69 had a decrease in zBMI
• 53 ate more fruit
• 30 ate more vegetables
• 29 increased at least one step in readiness to
  change
• 35 increased physical activity
• 39 decreased time spent watching television on
  school days

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Challenges

• Group participation
• Limited motivation
• to change

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Parinda Khatri, PhDCherokee Health Systems

• Parinda.khatri_at_cherokeehealth.com