MT CVD and Diabetes Prevention Program logo

Montana Cardiovascular Disease and Diabetes Prevention Program

Diverse Montana Communities Deliver Lifestyle Change Program to Prevent Diabetes

Since 2008, Montana communities have been helping prevent type 2 diabetes and cardiovascular disease among adults at high risk through the Montana Cardiovascular Disease and Diabetes Prevention Program (CVDDPP).  The 10-month CVDDPP is based upon research evidence that intensive lifestyle change can prevent or delay the development of diabetes by 58% among adults at high risk.1

Lifestyle coaches educate and motivate participants to develop and maintain healthier eating and physical activity habits, which lead to weight loss and control.  These lifestyle coaches are registered dietitians, registered nurses, cardiac rehabilitation nurses, and exercise specialists trained to deliver the CVDDPP.

Eligibility criteria for the CVDDPP are based upon risk factors for type 2 diabetes and cardiovascular disease.  Adults aged 18 years and over with a Body Mass Index (BMI) ≥25 kg/m2, medical clearance from a doctor, a commitment to lifestyle change, and one of the following may participate:

  • History of pre-diabetes, impaired glucose tolerance, or impaired fasting glucose
  • History of gestational diabetes or birth to a baby weighing >9 lbs
  • High blood pressure (≥130/85 mmHg or treatment)
  • Dyslipidemia (triglycerides >150 mg/dL, LDL cholesterol >130 mg/dL or treatment, or HDL cholesterol <40 mg/dL for men and <50 mg/dL for women)
  • A1C between 5.7% to 6.4%

 

In Montana, an estimated 185,000 adults over age 20 have pre-diabetes.3 The rate of diabetes reported by adult Montanans increased from 2.8% in 1990 to 7.0% in 2010.4  Based on these rates, it is estimated that nearly 70,000 adult Montanans have diagnosed diabetes.5  Over 8% of deaths in Montana are diabetes-related.6

 

Participating in the program is an effective way to slow these trends.  Over 2,000 Montanans have participated in the prevention program since it began in 2008.  Here are the average 10 month program results:

  • Weight loss of 15.4 lbs
  • Blood pressure reduction from 133/81 mmHg to 127/78 mmHg
  • LDL cholesterol reduction from 123 mg/dL to 119 mg/DL
  • HDL cholesterol increase from 49 mg/dL to 51 mg/dL
  • Fasting blood glucose reduction from 102 mg/dL to 97 mg/dL

 

Fourteen sites and four telehealth sites currently deliver the CVDDPP in communities designated8 as

  • Urban: Billings
  • Rural: Missoula, Kalispell, Great Falls, Helena, Butte, Bozeman
  • Frontier: Libby, Choteau, Dillon, Baker, Colstrip, Ekalaka, Forsyth,  Miles City

 

Go to www.mtprevention.org to contact the site near you, read news and journal articles, and learn more.  For more information, contact Diane Arave, the Montana Diabetes Project Quality Improvement Specialist in Prevention, at darave2@mt.gov or (406) 444-0593.

 

References and Data Sources

1. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393–402.

2. Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.

3. National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007 fact sheet. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

4. Montana DPHHS, Behavioral Risk Factor Surveillance System.

5. U.S. Census Bureau: State and County QuickFacts.

6. Montana DPHHS, Office of Vital Statistics.

7. Vanderwood KK, Hall TO, Harwell TS, Butcher MK, Helgerson SD. The Montana Cardiovascular Disease and Diabetes Prevention Workgroup. Implementing a state-based cardiovascular disease and diabetes prevention program. Diab Care 2010;33:2543–2545.

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Southwest Montana YMCA

Dillon is one of many rural communities working hard to help create a healthier Montana. The Southwestern Montana Family YMCA has partnered with many Dillon organizations to increase the health and wellness of their residents through a variety of programs.


In November 2008, the SW MT Family YMCA launched their first four month Biggest Loser campaign with thirty-six participants. This campaign included both educational and physical activity programs. Participants were weighed and measured each week; kept a daily food record; and were able to use the YMCA facilities for four months at no extra charge. The campaign also offered a variety of workshops with topics ranging from stress management to healthy eating with a variety of guest speakers. The SW MT Family YMCA received a positive response to this program including a participant losing fifty pounds. They plan to begin their next Biggest Loser campaign in March of 2009.

The SW MT Family YMCA is working with the Barrett Hospital on a program aimed at lifestyle changes. Dillon was one of four sites in Montana to receive a grant for prevention. This program began in February, 2009. There was a one hundred dollar registration fee for this program. The fee included membership to the YMCA through the duration of the program. Individuals who were at high risk for chronic diseases were eligible to participate. There were forty participants for this program. The participants are tracked for one year with blood tests taken twice per year. The program includes fifteen education programs, trained lifestyle coaches, and sponsored group exercise programs.


Dillon’s local public schools and the SW MT Family YMCA have collaborated to create a sixth grade program. This program began in November, 2009. Eighty-two sixth grade students participated in an orientation visit per month during school hours for six months. During these visits, students were able to exercise or swim. They also received a free one year membership, and the student’s families were offered a discount membership.
The SW MT Family YMCA will be working with the County Commissioner’s Office on improving Dillon’s walking/biking path. This year, the biking and walking path by the North end of town will be increased by two miles. Next year, they plan to work on the path behind the YMCA.

Barrett Hospital & HealthCare’s Diabetes and Heart Disease Prevention Program

Barrett Hospital & HealthCare provides compassionate care, healing and health-improving services

 to all community members throughout life’s journey.

 

Barrett Hospital & HealthCare’s Diabetes and Heart Disease Prevention Program

The Diabetes and Heart Disease Prevention Program (DPP) at Barrett Hospital and HealthCare is now in its fourth year.  The proven program assists with lifestyle changes that promote weight loss and encourage routine exercise. This 10-month program is taught by a variety of healthcare professionals providing education on nutrition, exercise, behavior change, motivation, and coping skills.  The classes originally meet weekly for the first 4 months and then monthly the final 6 months.  Self-monitoring is stressed, which includes keeping daily food and exercise logs.  Bi-weekly exercise classes are also offered.

Classes include instruction and group exercise. The cost is a one-time fee of $150, which includes instruction for the entire 10-month period. The DPP coordinators are Deanna Nelson, RN, ACSM and Jill Pulaski, RD.

An individual is eligible for the DPP if they are overweight (a Body Mass Index or BMI of 25 or greater is the criteria) and one or more of the following:

  • Impaired blood glucose (A1c of 5.7-6.4% or fasting blood glucose >100 mg/dL)
  • Abnormal cholesterol lab values OR  taking cholesterol-lowering medication
  • Elevated blood pressure OR taking medication to control blood pressure
  • History of gestational diabetes
  • Had a baby weight 9 lbs. or more

Several patients of the program have given positive testimonials about their experience with the DPP:

“There are many things that I am thankful for.  On the very top of that list is the 10 month Diabetes Prevention Program that I joined back in March of 2010. This program is aimed at healthy lifestyle options through food choices and exercise.”

“Before the class I had a BP of 199/98 and high blood sugar.  I was overweight and seldom exercised.  My wife can attest to my overall “mood!”  I was on blood pressure medication and going onto cholesterol medications.  I slept poorly and had more aches and pains than I care to recall. After finishing the program I am no longer on BP or cholesterol prescriptions.  My weight is down significantly and I exercise daily.  I’ve begun to play tennis in the summer and racquetball and skiing in the winter along with being a member of the YMCA.  Every blood draw through the program showed improvements in everything from triglycerides to blood glucose and everything in between!”

“I want to thank so many people for literally changing my life!  Special “thanks” to Jill, Deanna and Dr. McIntyre at the hospital. Most importantly to my wife Lynne for her support through all phases of change that I went through and especially her help in cooking great low fat meals for me.”

“This community of people and organizations is unlike anywhere else I’ve lived and I am thankful.  For anyone thinking that it is time for a resolution this season that includes a healthy lifestyle, I highly encourage you to consider this life-changing program!”

For more information about the Diabetes and Heart Disease Prevention program or Barrett Hospital & HealthCare please visit:  http://www.barretthospital.org 

 

 

 

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Montana FoodCorps & Grow Montana

Montana’s FoodCorps is a team of young leaders fighting the childhood obesity epidemic by helping K-12 schools serve more locally grown food, grow school gardens, and conduct hands-on nutrition education. The 2011-2012 team is focused on Montana’s rural communities, especially those with high levels of poverty or food insecurity.

In the summer of 2006, Grow Montana partnered with Montana Campus Compact to launch Montana’s FoodCorps, the nation’s first statewide team of VISTA volunteers trained to create and grow farm to cafeteria programs. Each FoodCorps member was trained, provided with mentors, and dispatched to a partnering institution. Since then, the six original Montana FoodCorps institutions have returned over $2.5 million dollars to local farmers and ranchers. This year the growing Montana FoodCorps team will work in a dozen communities state-wide to help schools serve local, healthy foods; build and tend school gardens; and educate kids about how and why to eat food grown closer to home.

 

In FoodCorps’ first year alone, Salish Kootenai College purchased 10 percent (up from 0) of its total food budget from seven tribal reservation-area vendors, Montana State University launched a diversified student-run vegetable farm, UM-Western bought so much local beef that a county commissioner is proposing to build a processing plant in the region, and Missoula County Public Schools actually saved money stocking local produce. Now, Montana’s FoodCorps is a model for a national FoodCorps, which launched this summer with 50 members in 10 states.

Montana’s FoodCorps depends on the hard work of many, starting with the host communities who In Ennis, Dillon, Red Lodge, Boulder, Livingston, Ronan, Glendive, Forsyth, Kalispell, Somers, Sheridan, and Potomac, we collaborate with community foundations, extension agencies, local colleges, school districts, non-profits, after-school programs, and more. In addition, FoodCorps members enjoy broad statewide support from the Grow Montana coalition, which aims to create a sustainable Montana-based food system.

While the emphasis of Montana’s FoodCorps is on K-12 students, our impact reaches far beyond. For example, on a recent sunny fall day in Dillon, middle school students jogged one mile to the UM Western Campus Garden, enjoyed a quick hands-on lesson on the benefits of fresh fruits and vegetables from a UM Western student, then harvested a bounty of produce to share with the senior center down the road. This one simple project gets healthy food into the lives of sixth graders, college students, and retirees all at once.

But do the kids like it? According to teachers in Kalispell, even the pickiest eaters are gobbling up the local produce now being offered in the Fresh Fruits and Vegetables Snack program. And in Red Lodge, students so enjoyed the fresh veggies offered on a special meal day that they went to the farm to help harvest more. The fruits of our labor are disappearing into kids’ bellies, and that’s just the way we like it.

The key factor in our ability to create such innovative programs is our community-building process: All FoodCorps members share the same mission—to improve the health of children through Farm to School, school gardens, and nutrition eduction—but the strategies for achieving the mission is tailored to the unique strengths and opportunities of the local community.

Results:  Previous FoodCorps members have returned over $1 million to Montana’s farmers
and ranchers through local food buying programs, and reached thousands of
community members through educational programming.

Findings:  Evaluation data on FoodCorps for Rural Montana is still pending. Initial
summary of progress to date will be developed in fall/winter of 2012.

Farm to School programs across the state would benefit from:

                -Increased number of farmers and ranchers with the capacity to sell locally

                -Increased opportunities for community-based food processing

                -More opportunities to work with teachers on how to incorporate school gardens and farm-based education into their already full schedules

                -More research on which types of school gardens, farm-based education, cooking and nutrition classes have greatest impact, so that we can tailor our programs accordingly

Current Funding Sources: USDA Community Food Projects (NIFA) & Corporation for National and Community Service

Partner Organizations: Grow Montana, National Center for AppropriateTechnology, Alternative Energy Resources Organization (AERO), Montana Campus Compact VISTA, Montana Team Nutrition’s Farm to School Program, National FoodCorps, Mission Mountain Food Enterprise Center, Community GATE, Montana
Farmers Union

For more information please visit : www.montanafoodcorps.blogspot.com

 Or Contact:

Crissie McMullan, FoodCorps Project Director, National Center for Appropriate Technology and Grow Montana

406-531-5162 crissiem@ncat.org

or

Kevin Moore,  Grow Montana Project Director, Alternative Energy Resources Organization

406-443-7272  kmoore@aeromt.org