District Nominee – Fallbrook Regional Health District

To address this pressing need and quickly launch this program, the District researched organizations that could provide the program at the FRHD – Community Health & Wellness Center. This led to a relationship with the J. Moss Foundation - Skinny Gene Project and guidance on creating our program as well as assistance to bill insurance. Ongoing funding for the initiative is achieved through a combination of District funds and our partner’s ability to bill Medicare and private insurance plans. This strategic funding approach ensures that the program can be accessible to all, eliminating potential barriers to participation. This initiative is innovative in its holistic approach, weaving together evidence-based strategies from the Centers for Disease Control (CDC) to prevent type 2 diabetes through lifestyle changes and our own staff’s ability to create a fun community-centric approach to the education, activities, and camaraderie. For the District to offer this program, our staff gained Lifestyle Coach certification in this curriculum; which required 16 hours of training from our accredited training entities – The Skinny Gene Project, and 2 hours of advanced training each year to keep the certification.

Community stakeholders played a crucial role in shaping and achieving the goals of this initiative. FRHD collaborated closely with the J. Moss Foundation’s Skinny Gene Project, County of San Diego, healthcare providers, local organizations, and community leaders to raise awareness, gather insights, and mobilize resources effectively. This collaborative effort fostered a sense of ownership and engagement within the community, ensuring that the program's impact was widespread and sustainable.

The impact of diabetes on healthcare costs is substantial and multifaceted. Prediabetes alone incurs significant expenses, with individuals spending an additional $8,941 five years before a diabetes diagnosis. Diabetes, being the costliest chronic condition nationally, results in a staggering $327 billion in total annual healthcare costs, with one in every four US healthcare dollars allocated towards diabetes care. Recognizing the dire financial implications, federal and state health agencies have collaborated to establish reimbursement mechanisms for the National Diabetes Prevention Program (National DPP), safeguarding its sustainability. This strategic approach ensures that the National DPP remains a covered benefit for most insurance plans and is considered an entitlement for Medicare beneficiaries, highlighting its crucial role in averting potential healthcare system bankruptcy.

The success of the Lifestyle Change Program is quantifiable through several milestones and achievements. The milestones achieved in our program include participants attending their first class, progressing to 4 classes within 6 months, further advancing to 9 classes within the initial 6-month period, and ultimately attending 16 classes while successfully meeting the 5% weight loss goal. Moreover, our District's program has earned Full Plus Recognition from the CDC, symbolizing adherence to rigorous standards and the effective delivery of proven diabetes prevention strategies. Our first cohort completed the program. We saw that 50% of participants who stayed in the program for at least 6 months experienced a 5% weight loss, reducing their diabetes risk by an impressive 71%. These outcomes not only enhance quality of life and overall health but also lead to notable improvements in triglycerides, apnea, knee pain, fatty liver disease, and depression. Additionally, there are direct healthcare savings costs of $8,015 per participant over 3 years.

In addition to the significant weight loss and diabetes risk reduction, participants in our program have reported improvements in various areas such as stress reduction, improved sleep quality, increased mobility, enhanced attention to meal planning, and positive changes in food purchasing habits. These transformations contribute to a holistic improvement in overall well-being and highlight the program's comprehensive approach to health. The participants’ stories further underscored the program’s impact on their' lives beyond physical health. One participant stated: “As my cardiologist told me, by addressing my overall health, I cannot let my heart get any worse and even improve it. This Lifestyle Change Program is helping me achieve this goal! At my last visit, he let me know that all my blood panels had come into normal range and asked exactly what I was doing differently.” This program impacts more than just the participants but their spouses, families, co-workers, and community.

In conclusion, the Lifestyle Change Program implemented by Fallbrook Regional Health District stands as a beacon of success, showcasing an effective model for addressing prevalent health concerns within communities. By emphasizing evidence-based interventions, securing strategic funding, nurturing community partnerships, and prioritizing holistic wellness, this initiative has demonstrated its potential for replication and lasting impact on public health. As districts across the nation seek innovative solutions to combat chronic conditions like diabetes and obesity and reduce health care costs the lessons learned from this program can serve as a roadmap towards healthier, more resilient communities.