Florida Diabetes Prevention Program

Summary

The Florida Diabetes Prevention Program is an effort to encourage and ease the creation of new DPPs in the state of Florida and to strengthen the programs that already exist. The Florida DPP is based on the simple belief that there is no need to reinvent the wheel; the original DPP study, along with many replication and translation studies, has demonstrated that development of diabetes can be significantly reduced and delayed through a standardized curriculum. Instead, the challenge is to recruit more people into DPPs in the first place. The Florida DPP increases the availability and efficacy of individual DPPs throughout the state by: providing resources to help new DPPs get started, supporting existing DPPs so that they become more successful, and working to raise awareness about diabetes prevention with clinicians, employers, and residents of Florida. An immense collection of resources is available for free on the Florida DPP website, including guides on how to start a DPP, advice on marketing programs, multi-media advertising materials, information on cost effectiveness for employers and payers, and tools for clinicians to communicate more effectively about prediabetes and risk factors. In addition, the Florida DPP establishes partnerships to make prediabetes screening and DPP enrollment more accessible.

Keys to Success

Evidence-based intervention, focus on access

The Florida DPP operates on a simple but powerful philosophy; rather than trying to reinvent the wheel by creating new programs and strategies, it takes a proven intervention and works to expand it to reach more people. The use of a pre-existing program model is a highly efficient strategy for coordinating interventions on a state level. Attention and resources can instead be focused on building partnerships, improving marketing, and increasing awareness. This strategy is particularly useful given reliance on state-funding. Using an intervention with strong evidence of outcomes and known measures of cost-effectiveness can make it easier to justify and sustain funding.

Free information and resources

As a government-funded initiative, the Florida DPP can provide many of its benefits entirely free of charge—including a huge variety of free resources on its website.^[1] These resources include:

An operations guide that contains everything from a week-by-week lesson plan, a recommended budget for materials, suggestions for marketing and advertising, strategies for identifying lifestyle coaches, and tips for collecting and reporting data for CDC recognition.^[2]

A best practices manual with guidance on five key focus areas to set up a DPP for success.^[3]

The “Business Case” for diabetes prevention, which outlines statistics on the prevalence of prediabetes and the return on investment
in prevention.^[4]

Advertising materials to recruit participants through business websites, clinicians’ offices, social media, print publications, and press releases.^[5]

Advertising materials to encourage employers, clinical practices, and health plans to focus
on screening and prevention.^[6]

Focus on marketing and awareness

The Florida DPP’s model recognizes that one of the biggest remaining challenges is getting people with prediabetes involved in the first place, let alone engaged for the long term. As such, the Florida DPP recognizes that strong marketing is critical. Beyond offering the free advertising materials mentioned above, the Florida DPP also focuses more broadly on the concept of “social marketing”—thinking about how marketing strategies can be applied to influence lifestyle and motivation, rather than just consumer behavior.^[7]

Easy entry into programs

Even small barriers are likely to greatly reduce involvement in prevention programs. The more screenings that patients need, the more visits they must attend; moreover, the more time or money required to determine eligibility, the less likely patients will be to even start the process. The Florida DPP has taken many actions to make it as easy as possible for people to earn eligibility for DPPs. Most notably, the program uses a prediabetes risk-assessment quiz, available on-line, to determine eligibility.^[8] As a result, participants are not required to complete clinical tests of their A1c, Fasting Plasma Glucose (FPG), etc., and instead can determine their eligibility online in just minutes.

Ability to Inspire

The Florida DPP network has well over 100 brick-and-mortar DPP programs throughout the state.^[9] Patients can locate and connect with all of these locations through the Florida DPP website. At least one other state, California, has reached out to program coordinators in Florida about the possibility of replicating the Florida DPP’s model.

Cost Effectiveness

The Florida DPP program has a strong argument for cost effectiveness, as DPPs have been shown to lead to returns on investment by individual studies and by actuarial review from the Centers for Medicare & Medicaid Services (CMS). In turn, the Florida DPP makes a strong case for the cost effectiveness of prevention to employers, health plans, and the state itself—indicating that the possibility for savings is, in many ways, one of the Florida DPP’s keys to success.

Drawbacks and Limitations

By focusing its statewide initiative specifically on pre-diabetes, Florida potentially overlooks other possible avenues for long-term prevention through social and environmental change. Of course, these two prevention approaches (targeting at-risk populations versus the general public) are not mutually exclusive, and the “social marketing” approach of the Florida DPP carries great promise for wide-reaching social change, which will hopefully be realized in the future.