Diabetes Care
Qualis Health Leverages Community Relationships to Build a Sustainable Diabetes Self-Management Program in Rural Idaho
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Although nearly 29.1 million people in the United States—approximately 9.3 percent of the general population—have diabetes, many patients are not aware of the best ways to manage and treat the disease. Diabetes Self Management Education (DSME) is an evidence-based intervention for empowering individuals with diabetes to take an active role in managing it.  

In summer 2014, the state of Idaho had no community-based DSME program. Qualis Health—the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Idaho and Washington—saw the opportunity to fill this care void and build a platform through which Idaho residents with diabetes could learn how to better manage their health and maintain fulfilling lives.

With a desire to build on the existing chronic disease program in the state, Qualis Health evaluated top evidence-based programs and decided that Stanford University had the best DSME model to meet the state’s needs. On top of Idaho’s want for an established DSME program, its rural communities were in need of better and more accessible care. Qualis Health recognized that diabetes management programs were primarily supporting urban areas via clinics and that Idaho’s rural communities should be a focus as its DSME program expanded over the next year. 

Building strong relationships with community members and organizations, and training local volunteers were Qualis Health’s top priorities as it launched the program. After kicking off its first master training, the QIN-QIO was able to provide effective education of local workshop leaders by assimilating four master trainers and 24 active leaders serving various regions of the state.

Qualis Health also was able to significantly improve self-management skills in people with diabetes and prediabetes by facilitating 36 six-week DSME workshops, 20 of which took place in 2017, primarily in rural communities. Nearly 300 Idaho residents completed a DSME workshop, including 164 total residents in 2017 (105 of whom were Medicare beneficiaries with diabetes and prediabetes).

Workshop participants have seen a 46 percent increase in knowledge of healthy ways to handle stress related to diabetes; a 30 percent increase in asking for support on how to live with and take care of their diabetes; and a 36 percent increase in feeling they can make a plan with goals that will help control their diabetes.

Sustainability was the most notable goal of 2017, as Qualis Health transitioned from an active leadership role to a support one. As the DSME program grew and became established throughout Idaho, the QIN-QIO used sustainability as its foundation by finding partners that can train leaders and become leaders themselves. The purpose is to have members continue to take the program forward and keep it viable.

Over the course of 2017, Qualis Health strengthened its partnerships, resulting in another DSME license (for a total of five) and three DSME grants to community organizations, including a tribal group in Eastern Idaho, which is planning to have its first workshop in 2018. In October 2017, Qualis Health held a DSME cross-training for the tribal group and other community associations. The QIN-QIO also held three leader trainings in February, March and December 2017, bringing it closer to its goal of creating a new and sustainable community-based DSME program across the state.

In addition to the success of the DSME program in Idaho, Qualis Health has started an accreditation path for a Federally Qualified Health Center (FQHC). In preparation for this path, two of the FQHC Community Health Workers (CHW) attended a four-day DSME leader training. The plan is for the CHW to use the training to offer the DSME program to their patients, and then the FQHC will use the DSME program to work toward meeting accreditation requirements. This will provide their staff with the knowledge and skills to better serve their patients with diabetes.