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Bright Spot: Road to Health Toolkit (Kit El camino hacia la buena salud)

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Photo by Arek Adeoye on Unsplash


This bright spot was originally published in the 100 Million Healthier Lives Change Library and is brought to you through partnership with 100 Million Healthier Lives and the Institute for Healthcare Improvement.

Overview

Detailed Description

The Road to Health Toolkit was developed by the National Diabetes Education Program (NDEP), a partnership of the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and more than 200 public and private organizations. NDEP wants to help community health workers (CHWs) share with their communities, that type 2 diabetes can be prevented or delayed in people at high risk for the disease.

This bi-lingual toolkit is for CHWs in African American/African Ancestry and Hispanic/Latino communities. The Road to Health Toolkit was mainly designed for African American/African Ancestry and Hispanic/Latino communities, but it can appeal to any audience. In the United States, these two communities are at higher risk than the general population for developing type 2 diabetes. In creating this toolkit, NDEP looked at findings from the Diabetes Prevention Program (DPP) study. The DPP study showed that type 2 diabetes can be prevented or delayed in people at high risk for the disease.

The DPP study has three main messages on how to prevent or delay type 2 diabetes. Lose 5 to 7 percent of their weight, if they are overweight (10 to 14 pounds /4.5 to 6.3 kg for a 200 pound/90.6 kg person). Lose and maintain the weight loss by making healthy food choices by eating a variety of foods that are low in fat and reducing the number of calories they eat per day. Get at least 30 minutes of moderate-intensity physical activity five days a week. This could be brisk walking, yard work, and actively playing with children, for example, riding bicycles or playing soccer.

NDEP also asked CHWs who are working in African American/African Ancestry and Hispanic/Latino communities what tools they would need to teach their neighbors about type 2 diabetes prevention. Their answers helped shape The Road to Health Toolkit, which has three types of materials: resources, activities, and teaching aids. The basic toolkit components include: a Flipchart, User's Guide, Activities Guide, Resource Guide, Photo Journal, and The Road to Health Supplemental CD-ROM. Also available are The Road to Health Training Guide and Video, designed for those who offer train-the-trainer workshops.


Expected Outcomes

The Road to Health Toolkit provides community health workers/ "promotores de salud", nurses, health educators and dietitians with interactive tools that can be used to counsel and motivate those at high risk for type 2 diabetes. These tools will help reduce their risk for type 2 diabetes by encouraging healthy eating, increased physical activity, and moderate weight loss for those who are overweight. After this training, the participant will have the knowledge, skills, and competency to: Define types, symptoms, and complications of diabetes. List at least three major findings of the Diabetes Prevention Program (DPP) study. Explain how type 2 diabetes can be prevented or delayed. Identify at least five risk factors for type 2 diabetes. Explain the importance of making small lifestyle changes to prevent or delay the onset of type 2 diabetes. Define serving and portion size for common foods. Demonstrate how to use the Road to Health Toolkit. Conduct a role play activity by using the Road to Health Toolkit Flipchart. Identify serving size, total calories, and saturated fat on Nutrition Facts labels. Use the National Diabetes Education Program (NDEP) Food and Activity Tracker to record food and drink intake and physical activity. Use the NDEP Fat and Calorie Counter to demonstrate how to determine the grams of fat and calories eaten. Use the poster Step by Step - The Road to Health to introduce, summarize, and end the training workshop. Communicate the three key prevention messages to help prevent or delay the onset of type 2 diabetes - 5 percent to 7 percent weight loss, if overweight by: making healthy food choices and following a low fat, low calorie meal plan and increasing physical activity for a minimum of 30 minutes at least five days a week. State the role of CHWs in helping people learn how to prevent or delay type 2 diabetes by explaining the roles CHWs have in the community, learning tips from CHWs. Develop and strengthen a partnership with the NDEP.


Cost Details

The cost involved is of implementing the intervention.

Key Steps for Implementation

The basic toolkit components include: a Flipchart, User's Guide, Activities Guide, Resource Guide, Photo Journal, and The Road to Health Supplemental CD-ROM. Also available to order is The Road to Health Training Guide and Video.

The Training Guide and Video are designed for those who offer train-the-trainer workshops. The Road to Health Training Guide uses an active learning (participatory) method that focuses on "learning by doing." The activities developed in the Training Guide include questions that actively involve participants. By the completion of this training, participants' skills and knowledge of primary prevention of type 2 diabetes is expected to increase.

Participants are then expected to have the knowledge and skills necessary to relay to others a clear and precise presentation of the various health messages and tools of the Road to Health Toolkit. The guide is written in an easy-to-read format. It contains activities that are based on different educational strategies and reference tools such as the Flipchart, Resource Guide, Activities Guide, and Photo Journal, which are part of the Road to Health Toolkit.

Required Staffing (FTEs)

One trainer and one co-trainer are required.

Special Infrastructure

The training location should preferably be free of distractions, well lit, and at a comfortable temperature. The room should be large enough to accommodate at least 30 participants and have enough open space to allow for easy movement, for the physical activity component of the training.

Materials:

  • Flipchart on a tripod
  • Colored markers
  • Different colored pieces of paper
  • Colored paper foot cutout
  • Adhesive tape
  • Blank paper or notepads
  • Pens/pencils
  • Training agenda
  • Sign-in sheet
  • Name tags and tents
  • Participant profile form
  • Pretest & Post-test
  • Colored cards for each area (red, blue, yellow)
  • Elastic stretch bands (three types and colors-red, green, and yellow)
  • DPP Study Prompt Questions Cards
  • Training Evaluation Form and
  • Certificate of Attendance

Road to Health Toolkit Tools:

  • Flipchart
  • User's Guide
  • Activities Guide
  • Resource Guide
  • Photo Journal
  • Training Guide
  • Training Video
  • CD/DVD Step-by-Step: Moving towards prevention of Type 2 Diabetes
  • CD/DVD Movimiento Por Su Vida
  • VHS copy of the music videos Movimiento
  • Step-by-Step NDEP Fat and Calorie Counter
  • NDEP Food and Activity Tracker
  • Road to Health Training Guide
  • Road to Health Training Video
  • Road to Health Supplemental CD-ROM 

Five PowerPoint presentations:

  • Training Guide's Goals and Objectives for the Toolkit
  • Introduction to the National Diabetes Education Program (NDEP) Road to Health Toolkit
  • Introduction to Prevention of Type 2 Diabetes
  • The DPP Study
  • The Basic Concepts of Diabetes Posters: A future without type 2 diabetes- can you see it?
  • Step-by-Step-The Road to Health
  • Welcome to the City of Excuses
  • Nutrition Facts Labels
  • The Traffic Light Method

Depending on availability, use the following equipment: Laptop computer and LCD projector, white screen, overhead projector, television and a VCR to play a VHS and a CD/DVD Player.

Training

The Road to Health Training Guide which is a component of the Road to Health Toolkit, is designed for people who develop or offer train-the-trainer workshops and for community health workers who work with people who are Hispanic/Latino or African American/African Ancestry. Other health care professionals, diabetes educators, health educators, nurses, dietitians, and community educators can also be trained or provide training to others by using the Road to Health Toolkit. Each training workshop can last up to 8 hours.

Return on Investment Details

The following community partnerships are desirable:

  • Community health workers,
  • Community based organizations,
  • Community coalitions,
  • Faith-based organizations,
  • Health care systems,
  • Government officials and elected representatives
  • Funders


Evaluation Strategies and Data Collection Tools

The Road to Health Toolkit Evaluation Guide was created to help community health workers (CHWs), diabetes educators and health educators in their evaluation efforts and for those who want to know how the Road to Health Toolkit is making a difference in the lives of their participants who are at risk for type 2 diabetes, and how well they have conducted their own educational activities while using the Road to Health Toolkit.

Outcome Measures

The key outcome measures are:

  • Did the participant change their behavior in order to reduce the risk of type 2 diabetes (i.e., making healthy food choices, increasing physical activity, and losing weight)?
  • Participant satisfaction (how well did today's session go?)

Process Measures

The key process measures are:

  • Number of sessions conducted
  • Length of each session
  • Topics covered in each session
  • Parts of the toolkit used in each session

Resources


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Road to Health Toolkit
Resource - Website/webpage
Brought to you by CDC
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Road to Health Toolkit: Evaluation Guide
Resource - Guide/handbook
Brought to you by CDC
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