Implement a Serious 7-Step Strategic Plan to Reduce the Prevalence of Diabetes in Your Community Today

As an upstream health professional, are you looking for effective ways to address diabetes in your community?

Blip-Zip Executive Summary

This short guide equips upstream health professionals with a strategic planning framework to reduce diabetes prevalence in local communities. It’s not just a plan, it’s a roadmap to a healthier future. By leveraging strategic planning, communities can create a lasting impact on diabetes prevention and improve the overall health of their residents. The power is in your hands.

Blip-Zip Takeaways

• Strategic planning is not just a process; it’s a powerful tool that empowers public health professionals like you to develop effective interventions for reducing diabetes prevalence in your communities. It’s a way to take control and make a real difference in your community’s health.
• Addressing the social determinants of health and creating a more supportive environment for healthy living are key components of successful planning.
• Remember, you are not alone in this journey. Community engagement and resident empowerment are not just important; they are the key to achieving long-term success in diabetes prevention initiatives. Your role in fostering this engagement is crucial.

Key Words and Hashtags (#)

#PublicHealthLeadership #CommunityDiabetesPrevention #StrategicHealthPlanning #SocialDeterminantsofHealth #HealthEquity

Introduction On Need for a 7-Step Strategic Plan

Diabetes is a serious chronic condition that continues to be a significant public health burden. In the United States alone, 38.4 million people, or 11.6% of the US population, have diabetes, 29.7 million people, including 29.4 million adults, have been diagnosed with diabetes, and 8.7 million people, or 22.8% of adults, have diabetes but are undiagnosed. 97.6 million people aged 18 years or older have prediabetes (38.0% of the adult US population), and 27.2 million people aged 65 years or older (48.8%) have prediabetes. These statistics underscore the critical need for effective population health strategies and plans to address this growing challenge.

The following image outlines a structured approach to strategic planning, featuring key steps. These steps include defining the vision and mission, analyzing the current state, setting strategic objectives, identifying differentiators, developing a tactical plan, implementing KPIs and feedback loops, and reviewing and adapting the plan.

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As a diabetes-related plan, Michigan’s Diabetes Improvement Plan 2021-2025 plan was developed in response to key informant interviews with partners in diabetes care and prevention around the state. It includes healthcare systems, providers, diabetes professionals, community organizations, and people with diabetes and their families.

It is a comprehensive guide for health leadership professionals who want to develop strategic plans for diabetes prevalence and effect change in their communities.

Case Study: West Virginia Ranks #1 in the USA for Diabetes Prevalence

According to the Robert Wood Johnson Foundation Rankings, diabetes prevalence has increased in most West Virginia counties since 2015. The number of West Virginians diagnosed with diabetes ranks number one in the United States at 15%.¹ The direct and indirect economic and emotional burdens of diabetes on individuals, employers, and communities are enormous.

According to the American Diabetes Association, 219,000 West Virginians, or 15% of the population, have been diagnosed with diabetes. An additional 45,000 West Virginians don’t know they have diabetes. Approximately 502,000 or 34.8% of the adult population have prediabetes with higher than normal blood glucose levels but yet high enough to be diagnosed with increased health risks and present increased burdens on their families, employers, and communities.² 

Each year, 14,000 West Virginians are diagnosed with diabetes. Their medical expenses are 2.3 times higher than those without diabetes.²  The total indirect annual lost productivity costs due to diabetes in the US are estimated to be $640 billion.^2,3 The total diabetes-attributable productivity losses–morbidity, presenteeism, household productivity, inability to work, absenteeism–totaled an estimated $880 million in West Virginia.³ Direct costs related to diabetes include costs from the condition itself and related complications such as heart disease, stroke, blindness, kidney disease, and lower-limb amputations.³ West Virginia’s total direct annual medical costs are about $1.8 billion. Medical costs per patient are $9,595 for patients with diabetes.^2,3

States, counties, and communities struggle with diabetes and the affordability of prescription drugs, supplies, and equipment. In 2020, the West Virginia Legislature enacted WV Code §16-1-21. The code required the development of a West Virginia Diabetes Action Plan.⁴  As part of development, survey results identified three needs: education, programming, and coverage. The top barrier to obtaining insulin medication to manage diabetes was high out-of-pocket costs. The plan contains four long-term goals and five specific recommendations.

Now is the time to act to reverse this costly trend! While West Virginia has developed a Virginia Diabetes Action Plan, it is up to counties and local communities to develop and implement a strategic plan to reduce the prevalence of diabetes. Otherwise, West Virginia leaders will pass up the opportunity to reduce healthcare costs and improve the lives of individuals and families.

Need for Community-Wide Strategic Plan at County and Community Levels

Strategic planning offers a systematic and data-driven approach to curbing the prevalence of diabetes within a local community. For example, Los Angeles County developed a practice-grounded framework for implementing the National Diabetes Prevention Program. The framework consists of three domains: expanding outreach and education, improving healthcare referral systems and protocols, and increasing access to and insurance coverage for the National Diabetes Prevention Program.

By applying a framework, community stakeholders and health professionals can establish a comprehensive plan that tackles the root causes of diabetes and empowers residents to adopt healthier lifestyles. The seven-step process outlined in the table can be a helpful roadmap for guiding this initiative.

Table: Strategic Planning Phases for Reducing Diabetes Prevalence in a Local Community

Phase of Strategic Planning Cycle	Examples: Reducing Diabetes Prevalence in a Local Community
Define Vision and Mission	Vision Statement: A community where residents thrive with healthy lifestyles and minimal diabetes burden. Mission Statement: Empower residents to make healthy choices and create a supportive environment that promotes diabetes prevention.
Analyze the Current State	Conduct a community health assessment to identify diabetes prevalence rates, demographics, and risk factors. Analyze social determinants of health (SDOH) impacting diabetes risk, such as access to healthy food, safe physical activity spaces, and quality healthcare. Evaluate existing resources and partnerships for diabetes prevention initiatives.
Set Strategic Objectives & Key Results	Objective 1: Reduce the overall prevalence of diabetes in the community by 10% within five years. Key Result 1.1: Increase participation in diabetes prevention programs by 20% within two years. Key Result 1.2: Reduce the number of residents with prediabetes by 15% within three years.
Develop a Tactical Plan	Develop a project plan outlining specific interventions:  Partner with schools to implement healthy eating initiatives and physical activity programs. Collaborate with grocery stores to increase access to affordable fruits and vegetables. Organize community walks, bike rides, and fitness classes. Launch social marketing campaigns promoting healthy lifestyle choices and diabetes prevention resources.
Implement Key Process Indicators (KPIs) & Feedback Loops	Identify key performance indicators (KPIs) to track progress:  Number of residents participating in diabetes prevention programs. Changes in diabetes prevalence rates and prediabetes diagnoses. Resident satisfaction with healthy food access and physical activity options. Establish feedback mechanisms to gather community input and adapt strategies as needed.
Review Balanced Scorecard	Consider developing a balanced scorecard to assess progress across various domains:  Community health outcomes (diabetes prevalence), Resident engagement in healthy behaviors, Effectiveness of interventions and partnerships, and Sustainability of the program.
Adjust Strategic Plan	Regularly review data and metrics to assess progress toward objectives and identify areas for improvement. Adapt strategies based on community feedback and emerging trends in diabetes prevention. Be prepared to adjust resource allocation or explore new partnerships to address unforeseen challenges.

The 7-step strategic planning process emphasizes the importance of analysis, goal setting, implementation, and review in strategic planning. It provides a comprehensive framework for organizations, ensuring continuous improvement and alignment with their vision and mission. The process also highlights the importance of feedback and adaptability in achieving strategic objectives. Tools like systems thinking, SWOT analysis, Gantt charts, and balanced scorecards are recommended for effective planning and implementation.

Successful Community-Wide Diabetes Prevention Initiatives

Strategic planning empowers upstream health leaders to tackle complex challenges like diabetes and innovation. By proactively learning or benchmarking from others, addressing the root causes of disease, and fostering healthy environments, upstream health leadership can significantly improve community health outcomes. For example, community health workers can be precious in diabetes management and prevention. A Community Health Worker model to mitigate disparities in access to diabetes education can provide evidence to support the efficacy of this approach.

This table showcases successful community-wide initiatives that reduced diabetes prevalence through strategic planning.

Table: Success Stories on Community-Wide Diabetes Prevention

Title/Vision	Approach	Outcome
Viva Salud! (San Antonio): Create a culture of health in underserved communities	Multi-pronged approach: community health assessments, partnerships for healthy food access, “Salud en las Calles” events, culturally-tailored diabetes programs	16% reduction in diagnosed diabetes in intervention areas
Project Namaste (Chicago): Empower South Asian immigrants to manage diabetes	Culturally-sensitive interventions: workshops in Hindi/Urdu, traditional food practices, exercise routines	1.4% decrease in HbA1c, increased knowledge and self-management skills
YMCA Diabetes Prevention Program: Increase access to evidence-based programs in diverse communities	Partnership with CDC to offer National DPP, focus on affordability and accessibility	58% reduction in risk of developing type 2 diabetes among participants
Kaiser Permanente: Healthy Housing Initiative: Address link between unhealthy housing and diabetes risk	Pilot program offering home repairs, improved indoor air quality, partnerships for resident support services	Positive impact on blood sugar control and asthma management highlights importance of addressing SDOH for diabetes prevention

These successful initiatives demonstrate the power of strategic planning in reducing diabetes prevalence. By addressing social determinants of health, tailoring interventions to specific populations, and fostering collaboration, these programs empowered residents, improved health behaviors, and achieved significant health outcomes. This model provides valuable insights for upstream health leaders aiming to create healthier communities through strategic planning.

Conclusion and Call to Action

Strategic planning empowers public health professionals to develop and implement effective programs to reduce diabetes prevalence within local communities. West Virginia serves as an example of why and how to move forward. However, regional planning is required at the county and community levels. By systematically addressing the underlying social determinants of health and promoting healthy behaviors, communities can create a healthier environment for all residents.

Diabetes is a significant public health challenge, but it is not insurmountable. By working together and taking a strategic approach, communities can make significant progress in reducing the burden of diabetes.

Discussion Questions

1. What SDOH most significantly contribute to diabetes prevalence in your community?
2. What resources and partnerships are currently available to support diabetes prevention initiatives in your community?
3. How can you leverage data and metrics to track progress toward your community’s diabetes prevention goals?

References and Resources

1. “Diabetes Management: Interventions Engaging Community Health Workers” discusses interventions that engage community health workers to help people manage their diabetes
2. “A Framework for Implementing the National Diabetes Prevention Program in Los Angeles County” provides a framework for implementing the National Diabetes Prevention Program (NDPP).
3. “The Role of the Community Environment in Managing Diabetes Risk” discusses the National Diabetes Prevention Program (DPP) from the Centers for Disease Control and Prevention.
4. “Chronic Disease Prevention Strategic Plan – Santa Clara County, California” provides a comprehensive strategic plan that guides the approach to chronic disease prevention and advances health equity for all County residents.
5. “A Community-Wide Collaboration to Reduce Cardiovascular Disease Risk: The Hearts of Sonoma County Initiative” describes outcomes and lessons learned from a successful multi-sector collaborative effort to reduce cardiovascular disease risk in Sonoma County, California.
6. “Health Systems Approaches to Preventing Chronic Disease: New Partners” discusses evolving approaches, including coordinating care for people with complex illnesses, extending the scope of healthcare systems to new settings, and addressing health behaviors and social determinants of health in healthcare settings and partnerships with community organizations.
7. “How We Prevent Chronic Diseases and Promote Health | CDC” suggests increasing the use of effective community-delivered interventions—such as chronic disease self-management programs, the National Diabetes Prevention Program, and smoking cessation services—through clinician referrals and health insurance coverage.
8. “Managing Chronic Conditions Optimizing Health Throughout Life—FHI 360” presents strategies to enhance chronic care in resource-limited settings. It considers the following basic components of healthcare: patient, healthcare provider, health service delivery, community, and policy environment.

Citations

1.         n.a. Behavioral risk factor surveillance system. In. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2019.

2.         n.a. Fact Sheet: The Burden of Disease in West Virginia. In: Association AD, ed2017.

3.         Sundar S. Shrestha AAH, Wenya Yang, Ping Zhang, Olga A. Khavjou, Diana C. Poehler, Simon J. Neuwahl, Thomas J. Hoerger. Economic Costs Attributable to Diabetes in Each US State Diabetes Care. 2018;41(12):2526-2534.

4.         n.a. West Virginia Diabetes Action Plan 350 Capitol Street – Room 514, Charleston, West Virginia: Division of Health Promotion and Chronic Disease, West Virginia Bureau for Public Health, Department of Health and Human Services (DHHR);2021.