Dahl Memorial Healthcare Association





Dahl Memorial Healthcare Association in Ekalaka, Montana truly understands the value of academic progression for their nurses. The management staff goes above and beyond to support and ensure that their nurses are reaching their highest academic potential. Dahl Memorial Healthcare knows that more education equals better care for patients.

Check out this video created by The Robert Wood Johnson Foundation’s National Academic Progression in Nursing (APIN) Office, spotlighting all the great work that Dahl Memorial is doing! 

Dahl Memorial Healthcare Association is a great example of forward thinking and academic progression, as their goals align perfectly with the Institute of Medicine’s recommendation to increase the proportion of nurses with a baccalaureate degree to 80% by 2020, double the number of nurses with a doctorate by 2020 and ensure that nurses engage in lifelong learning.

To learn more about what Montana is doing to promote academic progression in nursing, please visit the Montana Center to Advance Health through Nursing (MT CAHN) website:


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 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 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.