Small Steps Diabetes Campaign - United States

The theme of this campaign is that big change is easy; even small steps lead to big rewards. The campaign promotes the following messages:

• To health care providers: assess your patients for pre-diabetes, help them initiate lifestyle modifications and refer them for help, and discuss treatment options with them.
• To people at risk: ask your health care providers if you have pre-diabetes, ask what you can do to prevent diabetes, make modest changes in diet, and increase physical activity to reduce weight by 5 to 7%.

To reach health care providers, the campaign uses:

• Journal and trade publication articles to build awareness
• Tools to assess patients' risk for type 2 diabetes
• Lifestyle intervention "GAME PLAN" toolkit for counseling patients at risk
• Presentations at scientific and professional meetings
• Continuing medical education units on diabetes prevention
• Strategic partnerships with the private sector

The campaign uses mass media and community outreach methods to communicate with people with "pre-diabetes", including:

• Public service announcements (PSAs) and public relations media campaign - for example, 60-second radio PSAs have produced in English and Spanish. One begins "Dancing is a great first step. Cooking more vegetables for the family is another good step" and ends with a question: "What's your first step going to be?"
• Promotion of the patient education brochure "Your GAME PLAN for Preventing Type 2 Diabetes"
• National event to introduce the campaign's call to action
• Tie-ins with radio stations and networks to programme "small steps/big rewards" segments
• Tie-ins with celebrity chefs, syndicated food editors, and cooking magazines
• Strategic partnerships with the food and fitness industry and non-profit groups to promote diabetes prevention
• Community outreach partnerships with departments of health and recreation
• Collaborations with faith-based communities
• Lifestyle intervention kits for social, service, and religious organisations to facilitate their own diabetes prevention, weight loss, and physical activity programmes.

Online materials, including various resources available on the NDEP website, are central to this programme's strategy. Fact sheets and education materials are provided here, many of which are detailed in NDEP's publications catalog. In addition, the 32-page toolkit for health care providers [PDF] includes details about how to talk to patients about reducing behaviours that contribute to diabetes, and an office poster. Any health care provider may reproduce these materials free of charge and without permission. The toolkit written for those at high risk of experiencing diabetes (click here to view the PDF version) emphasises that "diabetes prevention is possible, powerful, and proven." Pre-diabetics are encouraged to keep track of their progress using the charts provided in this booklet.

Health.

About 16 million adults ages 40 to 74 have pre-diabetes, a condition in which blood glucose levels are higher than normal, but are not yet diabetic. NDEP claims that having blood glucose levels in the pre-diabetic range puts a person at a 50% higher risk of having a heart attack or stroke.

The Diabetes Prevention Program (DPP) was a clinical trial that showed that moderate changes in diet and exercise can delay and possibly prevent type 2 diabetes in a diverse population of overweight people with pre-diabetes. The DPP found that modest weight loss - 5 to 7% of body weight - and increased physical activity, such as brisk walking for 30 minutes a day 5 days a week, can cut a person with pre-diabetes' risk of developing diabetes by more than half. The DPP also found that the oral diabetes drug metformin reduces diabetes risk, although not as effectively as lifestyle changes. DPP showed that the lifestyle intervention worked equally well in men and women and in all the racial/ethnic groups represented in the study - and was most effective in people ages 60 and older.

NDEP is a national initiative jointly sponsored by the National Institutes of Health and Centers for Disease Control and Prevention. To order NDEP materials (single copies are free) call 1-800-438-5383 or visit the NDEP website. To learn more about the NDEP Partnership Network and how it works, the various NDEP workgroups, and policies regarding reproducing NDEP materials, click here. NDEP also provides 2 other websites geared toward specific audiences: one for business and managed care and one on health systems change and quality improvement.