As part of a class that helps them prevent type 2 diabetes and heart disease, these women at the Amma Senior Center traded ideas about ways to cope with a high-calorie church dinner or the heart-attack buffet at a local restaurant. (photo: Kate Long)

The text for the Chronic Disease self-management classes covers nutrition, physical activity, and stress management. As one participant said, “It’s a textbook for living a healthy life.”

How do you keep yourself from pigging out at a church dinner or a buffet? How can you exercise when the weather’s bad? What can you do to lower your stress level at work? In the picture above, Roane County seniors are trading answers at a six-week class at the Amma Senior Center that helps them better manage their own health. The class is free. They were learning practical, low-cost, non-medication ways to lower blood pressure and blood sugar, thereby controlling/preventing  heart disease, Type 2 diabetes and a range of chronic diseases. Several said their blood pressure and blood sugar had dropped since they started the class. The state is trying to spread free or low-cost classes statewide, in which West Virginians help each other learn new ways to avoid or control chronic illness.  Solid research says these kinds of face-to-face programs work. The West Virginia feedback is good. “I can’t think of anything that would do more to reduce West Virginia’s bad numbers than to spread these classes all over the state,” said Perry Bryant, director of West Virginians for Affordable Health Care.

How can such classes be offered regularly in your community?

During this self-management session at St. Albans’ Hansford Senior Center, participants report back on their weekly goals. A lot of laughing and encouragement.

Self-management programs teach you what you can do for yourself to: (1) control your chronic disease and keep it from getting worse and/or (2) keep yourself from getting those diseases in the first place. People in the classes support each other. Both kinds of classes encourage people to move more and eat smart. All the classes and programs recommended here are based on research that proves the work if people use them. The Bureau for Public Health especially recommends programs that have been proven, by research, to work. These programs are called “evidence-based.”

There are three kinds of evidence-based programs:

 (1) programs that help people control heart disease, type 2 diabetes and a range of other diseases:

• Chronic Disease Self-Management (CDSM) classes are for people who already have diseases such as diabetes (including Type 1) and heart disease. Developed at Stanford University, these classes help people develop ways to weave better nutrition, exercise and stress reduction into busy lives.
•  The classes apply to all chronic disease, but can also provide information specific to, for instance, type 2 diabetes.
• Here is research showing the effectiveness of this program.

• Here is a list of existing CDSM leaders and regional coordinators as of 2014:   Marshall
  

  Many Senior Centers, like this one in Pocahontas County’s Hillsboro, are running classes.

  University organizes trainings for CDSM leaders.  Contact: Dr. Richard Crespo at Marshall University. crespo@marshall.edu

(2) Programs for people at high risk of Type 2 diabetes, who want to avoid getting it:

• The National Diabetes Prevention Program (NDPP): http://www.cdc.gov/diabetes/prevention, teaches people how to avoid getting Type 2 diabetes or heart disease in the first place. If you would like to start an NDPP program in your community, contact Jessica.g.wright@wv.gov.
• Here is research that shows that the NDPP program is highly effective when followed.
  • Are you at risk of diabetes? Check and see:  www.wvdiabetes.org

(3) Programs for anyone who wants to improve flexibility and general fitness:

• Walk with Ease program, the Arthritis Foundation: This one is easy to adopt. http://www.arthritis.org/living-with-arthritis/tools-resources/walk-with-ease/

The Fitness and Fellowship group at Mingo County’s Little Dove Baptist Church has a lot of fun and can show the results in their numbers.

Other possibilities:

Thousands of diabetics take part in the Public Employees Insurance Agency’s Face to Face program, which pairs a diabetic with a pharmacist, here pharmacist Kate Dotson with retired teacher Mary Ann Wilder.  Photo: Kate Long

• Paid classes. Many West Virginia hospitals and clinics and social service agencies offer diabetes counseling. It is often excellent, but they may charge hundreds of dollars. Insurance will often cover most of it. In that case, it may be a good option.
• The Face to Face program. Thousands of West Virginia public employees with Type 2 diabetes keep their diabetes under control through a Public Health Insurance Agency program that pairs them up with a pharmacist who advises them about exercise, diet and good medication management. State employees and their families are eligible. PEIA waives co-pays for prescriptions and labs for participants.
  • People who are not public employees can establish a relationship with their local pharmacist and ask for help as needed. This has been proven to be effective and most pharmacists are glad to help.
  • Program description: https://www.peiaf2f.com/.
  • For a list of qualifying providers, go to https://www.peiaf2f.com/DbResources.aspx and click on Participating Providers.

How can a community get started?

Participants in the classes often provide a strong support system for each other.

• What agency or people might naturally offer such classes? You will need two trained leaders for CDSM. One person for Walk with Ease or National Diabetes Prevention Program. They can be lay people, but must be trained.
• An excellent local goal: Get your own local people trained to offer these classes so you can offer them again and again. Look at employees of the senior center, library or other local agency that might see this as part of their mission. Classes have been offered at libraries, churches, schools, community health centers, fire halls and other public buildings. Between 2009 and 2013, the Bureau for Public Health funded CDSM trainings in West Virginia. In 2014, their federal funding was cut. Still, there are more than 200 trained leaders in West Virginia. Classes can be scheduled.
• Contact the programs listed above about scheduling a training. You may need to contact surrounding counties to get together enough people to bring a class to your area.

Learn more about West Virginia’s Chronic Disease Self-Management classes:

Sometimes classes meet at libraries, like this class at Logan County’s Mann library.

• Facebook page: https://www.facebook.com/pages/Chronic-Disease-Self-Management/103171089721203
• The Marshall University CDSM Web site: http://livewell.marshall.edu/SelfManagement
• Video that explains self-management classes:
• From Stanford University, where CDSM was created: https://www.youtube.com/watch?v=v3Sz8kyHVwY
• National Council on Aging description of CDSM: https://www.ncoa.org/news/resources-for-reporters/get-the-facts/chronic-disease-facts/
• Research proves CDSM works: http://www.ncbi.nlm.nih.gov/pubmed/11606875

Learn more about National Diabetes Prevention Program classes:

Regina and John Elza swear by what they learned from the class. “We’re both diabetic, and we drag that book out when we’re trying to decide what to do about something having to do with our health.”

• These West Virginia agencies are authorized to offer these classes: https://nccd.cdc.gov/DDT_DPRP/City.aspx?STATE=WV&CITY=ALL
• Here’s a video about NDPP: http://www.cdc.gov/diabetes/prevention/features.htm
• Pocahontas doing a version of it: http://www.publicbroadcasting.net/wvmr/news.newsmain/article/1/0/1950148/AMR.Newsroom..and..Archive/Pocahontas.diabetes.program.got.early.start

Useful resources for diabetics:

Classes can be held anywhere you can pull together some tables and a flip chart. This group met at Lincoln County’s Mud River Volunteer Fire Department.

• Assess your risk for prediabetes: http://www.wvdiabetes.org
• The American Diabetes Association Web site: http://www.diabetes.org/
• Heart 360: An online blood pressure control program: Here
• A lot of practical help here: http://win.niddk.nih.gov
• Guidelines for diabetes self-care:
  • http://www.diabetes.org/diabetes-basics/type-2
  • American Association of Diabetes Educators
  • National Library of Medicine
• Also see the Try This diabetes coalition page

Have something to add to this page? Write it in “reply” below, with your contact info, in case we have questions.