1. 1
SUPPORTING HEALTHY
LIFESTYLESYMCA’S DIABETES PREVENTION PROGRAM SEMI-ANNUAL UPDATE | JUNE 2015
The Semi-annual Update is designed for Y leaders and Program Coordinators to learn about the work happening at
YMCA’s Diabetes Prevention Program locations around the country.
FORGING A NEW PATH
On May 18th, Matt Longjohn, National Health Officer, and Heather Hodge,
Director Chronic Disease Prevention Programs held a national update
webinar for all Ys delivering the YMCA’s Diabetes Prevention Program. The
purpose of the call was to announce some changes coming to the business
relations with DPCA over the next 2 years, how the primary change in
2015-2016 will be in Y-USA’s business relationship with DPCA, and how Y-
USA and the YMCA’s DPP team will support you as the program continues to
evolve. The call also introduced some future transitions beyond 2016.
Many of the questions received during the webinar and immediately
following the call have been developed into a Frequently Asked Questions
(FAQ) document included here with this semi-annual program update.
Some transitions have already begun and the most immediate ones are
outlined below.
 5/11/2015: updated Lifestyle Coach training certification integrated
into LCDC system
 5/18/2015: webinar for program providers – CEOs and program staff
on upcoming transitions
 5/31/2015: new contract in place with UHS for continued work with
DPCA through 12/31/16
 6/30/2015: business requirements for new technology RFP finalized
and RFP released
 7/1/2015: we can begin promoting a new category 3 CPT tracking
code (billing code that accurately describes the DPP intervention) that Y-
USA applied for and received approval on with the final code descriptor
 12/31/2015: new data solution determined for implementation 1/1/17
Though the coming changes might prove challenging at times, the end
results will make the YMCA’s Diabetes Prevention Program a stronger, more
effective and sustainable program. We are working with industry leading
consultants to help us prepare for 2017, when YMCAs will receive claims-based
reimbursements and must comply with federal and state regulations as
“Providers”. If we’re to achieve true payor agnosticism in the evolving health
care landscape, a new way of working will allow for Ys to connect with
reimbursement mechanisms independent of the current TPA system. We’ve
learned a lot over the last five years and the road ahead won’t be easy, but
together we can forge a new path. Our commitment to you is that you’ll always
know what’s ahead and when you can expect to hear from us.
IN THIS ISSUE
NATIONAL NEWS AND UPDATES
Raising Awareness
DATA AND TRENDS
Risk Test Vs. Blood Value
HIGHLIGHT
Unlimited Support
Laura Aden, Program
Coordinator
PROGRAM PRACTICE
Using Success Stories to Build
Your Program
Meeting Participants Where
They Are
Expanding the Program’s Reach
PROGRAM SPOTLIGHT
YMCA EXPO
MAKING IT HAPPEN
Supporting Lifestyle Coaches
Working Collaboratively as a
State
Questions, comments or
suggestions? Please contact us at
YMCADPP@YMCA.NET.

2. 2
Sue:
Michele Adney:
Lifestyle Coach
HIGHLIGHT
UNLIMITED SUPPORT
The small group component of the YMCA’s Diabetes Prevention Program is the heart of its success. For
participants, the support they receive from their class and Lifestyle Coach is akin to a steady blood flow.
It sustains them through their journey of self-awareness, growth and transformation. For many, it is their
lifeline.
In Minnesota, neighbors Sue [68] and Darlene [72] shared many conversations about family and health.
Sue’s husband struggles with diabetes and Darlene, a widow, is adjusting to life on her own. The women
were committed to healthy aging and leaned on each other for support, so when they each learned they
were at risk for type 2 diabetes they knew something to change. A postcard from the local Y—offering
Medicare beneficiaries the opportunity to participate in the YMCA’s Diabetes Prevention Program at no
cost—would point the friends in the right direction. They joined the program at the YMCA of the Greater
Twin Cities with varied expectations but with the same overall goal—to prevent type 2 diabetes.
The neighbors began the program as “buddies,” but soon grew to love and depend on the genuine
support of their entire group. The format of the program—the Lifestyle Coach, the accountability, and
most of all the open discussions—helped keep the women motivated and
on target to meet their goals. Darlene says, “During the class we were all
very supportive of each other.” Sue adds, “Interacting with the people in
my group—listening to them, learning about what did and didn’t work for
them—was my favorite part [of the program]. We just had a really good
group of people.”
Dedicated Lifestyle Coach Michele Adney’s positive energy and direction
was the key to creating an open and accepting learning environment.
“Michele was really good about supporting us and not making you feel bad
if you did go over,” recalls Darlene. “She [Michele] was tremendously
supportive. She led our group wonderfully—it was great,” says Sue.
Michele is one of 2,775 Lifestyle Coaches trained by Y-USA. Her ability to
help lay the foundation for successful and positive outcomes was
especially helpful for Sue and Darlene as they worked toward learning this
new approach to achieving weight loss and a healthier lifestyle. “Sue and
Darlene were part of my first group teaching and I felt so privileged having
such a fantastic group of participants,” shares Michele. She adds, “I feel
blessed to be able to help people with making lifestyle changes that will
help them to live longer, healthier lives.”
Both women met their weight loss goals, lowered their glucose levels, and
improved their overall health. The experience has had a lasting impact on
their lives and their relationship. They are looking toward their futures
with the renewed optimism that comes with improved health, but Sue
admits that the reality of not meeting with the group she has grown to rely
on is a little frightening. “Accountability is very helpful to me, and I’ve
heard this reiterated by many people in the group,” she says. “It’s just
that little check that you know you have coming down the road that helps
keep you on track. I’ll miss our group. Maybe they’ll let us attend and
weigh in down the road.”
By the end of April 2015, the YMCA’s Diabetes Prevention Program served
nearly 34,000 adults. They came to the Y hoping to prevent a life-altering disease, but they quickly
learned that the program offers something more, something that had been missing from many of their
lives—a supportive community and a blueprint for healthier future.

3. 3
MAKING IT HAPPEN
SUPPORTING LIFESTYLE COACHES
In October 2014, YUSA conducted a focus group with Lifestyle Coaches of various levels of experience.
Across the board, they said, as newly trained coaches they wished they had been given more
opportunities to observe experienced Lifestyle Coaches facilitate a session, co-facilitate with an
experienced coach and receive more feedback about what they’re doing well, what they can improve on
and ideas for how to enhance their facilitation. Several Ys who have incorporated this type of support for
Lifestyles Coaches are highlighted below:
Observation
The YMCA of Delaware provides mentorship opportunities for their team of coaches. Tricia Jefferson says,
“We want them to feel supported, they are remote and not always sure of themselves so this helps build
their confidence and gets the group off to a positive start.” When a new coach is hired, they are required
to observe between one and four sessions depending on how they did in the training, their experience
level and confidence. The Program Coordinator ensures the new coach observes a strong Lifestyle Coach
facilitate and, after the session, can ask questions and get ideas for activities or how to handle group
dynamics. Then, when the newly trained coach begins his/her own class, the Delaware Y ensures they
have a mentor (often the Program Coordinator or an experienced Lifestyle Coach) observe between 1 and
4 sessions, provide constructive feedback, troubleshoot issues that come up, and help input data and
answer questions around the data collection system. Many Ys also use the Observation Assessment Tool
when doing Lifestyle Coach-to-Lifestyle Coach observations in addition to the Program Coordinator
conducting the observation.
Co-facilitation
The YMCA of Central Ohio uses a co-facilitation model with newly trained Lifestyle Coaches to provide
support. Caroline Rankin says, “The beginning of the program is so critical for the participants, we want
to ensure the group is engaged and give the coach the opportunity to gain experience facilitating, to see
what its like.” This Y typically has a newly trained Lifestyle Coach co-facilitate with a branch coordinator
or other experienced Lifestyle Coach for the first four sessions. The co-facilitation model might vary
depending on the Lifestyle Coach’s training evaluation, but typically works like this: The newly trained
Lifestyle Coach is introduced as the “lead”, conducts weigh-ins, collects and reviews trackers and the
mentor Lifestyle Coach is the “co-facilitator” and will be with the group for the first 4 sessions and may be
back to sub if needed. Week 1 is shared facilitation; both the mentor and the new coach facilitate
different sections of Session 1. Week 2, the mentor facilitates, setting the stage for group dynamics.
Week 3, the newly trained coach builds on the previous week to facilitate and is closely observed by the
mentor. Week 4, they facilitate as a team, the newly trained Lifestyle Coach applying what has been
learned and the feedback that has been given. By Session 5, the newly trained coach is often ready to
facilitate solo, but has a strong foundation and a mentor to offer support and guidance.
Lifestyle Coach Connections
Several Ys have created internal, closed Facebook pages as a forum for Lifestyle Coaches to connect. In
Delaware, Program Coordinator Terri Borkland noticed that she received frequent questions from Lifestyle
Coaches, many of them situational. The coaches requested a Facebook group where they could post
questions or issues that come up within their groups. Terri says, “It’s working so well, it has evolved
organically, our more experienced coaches have stepped up and are the ones responding to the questions
and sharing ideas. Unless it’s related to a policy, I try to encourage the Lifestyle Coaches to own the
process.” Similarly, in Columbus, the program staff meets every two weeks for “huddles” to surface
questions and issues that come up from Lifestyle Coaches and to review data to monitor program quality.
Caroline says, “I don’t want coaches/coordinators to feel like they’re on an island, I want them to feel
supported and to know we can work together to improve program outcomes.” Through these huddles,
the branch coordinators are able to take back the ideas, best practices and recommendations to their
team of Lifestyle Coaches.

4. 4
PROGRAM PRACTICE
USING SUCCESS STORIES TO
BUILD YOUR PROGRAM
Does your Y regularly collect success stories or testimonials
from YMCA’s Diabetes Prevention Program participants? While
Y-USA continues to seek out success stories that can be
shared nationally, your Y should also regularly collect and
share stories of local participant success. Developing systems
for identifying participants and diversifying opportunities to
share success stories can lead to increased recruitment and
partnership development. The following steps can be
considered as you develop or strengthen these systems.
 Integrate success story recruitment into regular
meetings and broaden your scope. Lifestyle Coach
meetings are a great opportunity to discover potential
success stories. When thinking about participants to
highlight, consider not only those who have achieved the
highest percentage weight loss, but also those who have
struggled but still found success. Participants will share their
stories throughout the program; prompt your Lifestyle
Coaches to be cognizant of stories that can be shared. Use
the end of year participant evaluation and MYnetico to
identify other participants, but always ensure the Lifestyle
Coach agrees with your request. When you share articles and
stories with your Y leadership, connect the Lifestyle Coach so
they can be a part of the celebration.
 Meet participants where they are when collecting
stories. Some YMCAs have developed a standardized form
for collecting testimonial through their marketing department
which also includes the necessary release forms for sharing
this personal information more broadly. Questions to ask
during the interview may be the following:
a. Why did you decide to participate in the program?
b. Why do you feel you had success with this program?
c. What makes the YMCA’s Diabetes Prevention Program
different from everything else you’ve tried?
d. What would you tell people who are thinking about
participating in the program but are unsure?
Always ask participants how they’d like their story shared.
They may give you carte blanche, but they may ask for some
level of anonymity or restriction.
 Be creative on how you use success stories. How can
you use testimonials outside of printed marketing materials?
Are there opportunities for a participant to share their story
in person? The YMCA of Snohomish County (WA) had a
participant speak at a local medical practice meeting with
over 60 providers. The Y emphasized its value as a
community resource that should be utilized, and ended with
the participant sharing her story. She received a standing
ovation, and the opportunity led to additional payor
conversations.
Developing systems to regularly collect and share
testimonials can promote the program in many ways. Local
stories are powerful, and integrating their collection into your
program operations can ensure that stories are always
available. Being creative about how you share these stories
can promote recruitment and partnership development.
HIGHLIGHT
LAURA ADEN,
PROGRAM
COORDINATOR
KEARNEY FAMILY YMCA – KEARNEY,
NEBRASKA
Laura Aden has been the Program Coordinator
for the YMCA’s Diabetes Prevention Program
for just over two years. Laura works at the
Kearney Family YMCA, and says, “As a part-
time employee at the Y with numerous
responsibilities, it’s always challenging to
balance time and priorities, but our Y is
committed to the YMCA’s Diabetes Prevention
Program and very proud of it and our
participants.” The Kearney Family YMCA
average
weight
loss is
6.9% at
the end
of the
year
program based on CDC standards as of
December 2014.
“I truly believe we are helping in a small way
to change people’s lives,” she says. “We get to
see how they are continuing to make changes
in the way they’re eating and moving.” She
points out they know participants are reducing
their risk for diabetes, and participants are
getting additional benefits from the program
as well. They’re making new friends, they walk
and go to classes at the Y together, and
they’re eating better which is positive for them
and their families.
“Our program team is very collaborative; our
group of Lifestyle Coaches meets before class
ahead of time and we talk about what’s
working, what challenges have come up, and
we share best practices and ideas. I welcome
the Lifestyle Coach’s suggestions; we have an
open door policy,” Laura says. “Our leadership
is incredibly supportive, our board and CEO
and branch staff are very proud of the impact
the program is making, they are continually
asking for updates.” Laura states she is
“looking forward to meeting our goal to enroll
30 participants each year who meet the
program goals and reduce their risk for
diabetes. We’re also looking to expand our
partnerships in the community and develop
direct payor partnerships.”
Kearny, NE

5. 5
MAKING IT HAPPEN
WORKING COLLABORATIVELY AS A STATE
YMCA State Alliances are organizations that can communicate with and convene all YMCA associations
within a given state. Though each state alliance is unique in structure and capacity, they all offer an
opportunity to advance efforts to strengthen community through shared legislative and programmatic
priorities and a unified approach for supporting youth development, healthy living, and social
responsibility.
As the YMCA’s Diabetes Prevention Program continues to grow and scale throughout the country, the role
for state alliances in increasing access to this program for adults at high risk can also grow. Alliances can
leverage resources to ensure quality and consistent program delivery, and develop partnerships with
health care providers and payors for the purposes of participant recruitment and third party program
coverage.
Here are just a few of the many real-world examples where state alliances have offered support to
ongoing delivery of the YMCA’s Diabetes Prevention Program:
Indiana
One of the 2014 legislative priorities for the State Alliance of Indiana YMCAs was to encourage the
development and expansion of evidence-based programs, such as the YMCA's Diabetes Prevention
Program, aimed at reducing obesity and preventing the onset of diabetes in adults and children. The
YMCA’s DPP providers also hold a monthly conference call, attended by a state alliance representative,
where they discuss topics such as health care provider referral sources (and crossover between
communities), and consistency around program practices. The Ys are also working on developing a “talent
sheet” to share self-identified strengths in various program areas to facilitate outreach when Ys are
looking to connect with one another for program delivery strategies and best practices.
Massachusetts
The Alliance of Massachusetts YMCAs hosts regular conference calls, and devotes a portion of the agenda
to discussions around the YMCA’s Diabetes Prevention Program. The Executive Director of the state
alliance plays an active role in supporting the program, and together with the YMCA’s DPP providers, is
working to streamline efforts for payor engagement and develop standard processes that represent the
interest of all Ys. A first step in moving in this direction is to review each Y’s payor matrix to identify
shared priorities and partners where local Y relationships overlap.
Michigan
The YMCA’s DPP providers in Michigan connect regularly as members of the Michigan Diabetes Prevention
Network, and with support from the State Alliance of Michigan YMCAs, have recently starting meeting
monthly via phone so Program Coordinators can coordinate their efforts related to payor engagement,
marketing and promotion of the program, strategies for working with health care providers and the health
care community, and pursuit of other sources of funding to maintain capacity for this work. The State
Alliance of Michigan YMCAs also publishes a monthly newsletter which regularly features updates on the
YMCA’s Diabetes Prevention Program.
Wisconsin
Wisconsin recently began engaging in efforts to work collaboratively, meeting for the first time in person
in December 2014 with a representative from the Wisconsin State Alliance of YMCAs to discuss strategic
approaches for payor and health care provider engagement. Since that time, the Wisconsin Ys have
established a recurring conference call to continue program work and have also developed statewide
marketing collateral to help partners better understand the network and locations of providers throughout
the state. The Wisconsin State Alliance of YMCAs has helped connect the Ys to opportunities for program
promotion, including a statewide physician conference earlier this year, and created shared tools for the Ys
to contribute information on local payor engagement activities so the Ys can stay updated and minimize
duplication of outreach efforts.

6. 6
South Carolina
In 2014, the South Carolina Alliance of YMCAs incorporated the YMCA’s DPP into its strategic plan,
motivating many of the Ys in the state to initiate the process for becoming a program provider. Guided in
part by the Executive Director of the South Carolina Alliance of YMCAs, the Ys now convene regularly to
share strategies for building capacity for program delivery, and to pool resources when possible related to
workforce development, support of health seekers, and partner engagement. The state alliance is also
providing marketing support to the Ys and information on funding opportunities.
If you’re considering connecting with your state alliance about the YMCA’s Diabetes Prevention Program,
here are some strategies to get started:
 Reach out to your state alliance to provide them information and updates on the program.
 Schedule a call with other YMCA’s DPP providers in your state, and invite your alliance to
participate. Carve out time on a call agenda for the alliance to share information on current
statewide priorities.
 Become familiar with your alliance’s strategic plan and how chronic disease prevention
programming is addressed.
 Work with your alliance to identify chronic disease prevention programming as a legislative priority.
 Invite your alliance to attend a Community Advisory Board meeting or community stakeholder
meeting.
 Determine if it’s possible to devote some space to the YMCA’s DPP on your alliance’s web page.
 Ask your alliance how they’d like to be involved!
PROGRAM PRACTICE
MEETING PARTICIPANTS WHERE THEY ARE
ONE Y’S APPROACH TO FULLY EMBRACING HEALTH SEEKERS WHILE STRENGTHENING CLINIC TO
COMMUNITY LINKAGES
When interviewed, there was one thing that Nancy Gildersleeve, Director of Healthy Living at the Capital District YMCA
said multiple times that really hit home: in order to truly meet the needs of health seekers—physically, mentally, and
emotionally—and have an impact on health, a comprehensive approach must be taken. Collaboration between the Y,
health partners, and other stakeholders must be approached with this common goal in mind and to be truly
successful, each organization must focus on what they are good at so the “whole package” is provided to the
community seamlessly.
In October 2013, the Healthy Living Center in Albany, NY was born by way of a unique partnership formed between
the Capital District Y, Hannaford Supermarkets, and Capital District Physician’s Health Plan (CDPHP) to create a
wellness facility (located inside a supermarket) that supports the community’s efforts to make healthy choices through
shared resources and expertise around:
 Health seeker getting started and chronic disease prevention programs—led by the Y);
 Nutrition services—led by the Hannaford dietician; and
 Health promotion/education courses and health insurance enrollment and support—led by CDPHP.
With the Capital District Y overseeing operations, the center was designed with the Gulick Collaboration in mind,
supporting health seekers by fostering a welcoming environment in a state of the art facility. The goal is to meet
people where they are, remove barriers (such as cost and transportation) and provide a wide, extensive range of high
quality resources in health education, nutrition, and wellness activities in an underserved community where the
estimated median household income is $24,950.
The Healthy Living Center has helped increase satisfaction and confidence among members, as evidenced by the
frequency of their visits and their participation in the programs offered. Since opening, 1,400 members have joined
with 68% of these members actively utilizing programs and services. The increased access to programming, as well as
the interpersonal relationships formed among individuals, has resulted in improvements in activity levels, reductions
in challenges related to chronic illness, and greater success in attaining a healthy weight. When asked about the long-
term vision for the center, Nancy shared that she sees a lot of potential for continued innovation around this model
and looks forward to what’s to come. For more information, visit www.healthyalbany.com.

7. 7
PROGRAM SPOTLIGHT
YMCA EXPO
Sharing your program practices and success can give your Y an opportunity to spotlight your efforts and help
other Ys learn from what you’re doing. There was no better place to see this on display than during the Circle
Talks at EXPO 2015 in Anaheim, CA in February. The Circle Talks were a great way for Ys to showcase their
experiences around chronic disease prevention programs, specifically the YMCA’s Diabetes Prevention Program,
and for others to learn from those experiences.
 Anne Graves from the YMCA of Greater Indianapolis, in her presentation “Strategic Partnerships for
Improved Health,” shared her Y’s strategic approach to creating win-win relationships with partners in
order to bring awareness and resources to the Y’s chronic disease prevention programs.
 As more and more Ys work with FQHCs and other organizations supporting low-income populations,
there was lots of value in Meghan Merritt’s presentation titled, “YMCA’s Diabetes Prevention Program in
Low-income Communities.” From the YMCA of Western North Carolina, Meghan shared how her Y
adjusts implementation and ensures coaches have the support they need to reach the participants who
need the YMCA’s DPP the most.
 “Connecting Health Care to Community Based Programs” was the title of Tricia Jefferson’s presentation.
Tricia, from the Delaware YMCA, shared how Ys can assert themselves in the health care arena by
bridging the gap in healthcare and linking the clinical setting to community based programs. Tricia
shared ways the Y can work with providers to establish sustainable referral systems.
 “Plan, Implement & Evaluate: Success for the Diabetes Prevention Program” was the topic shared by
Chrissy Sebald from the YMCA of Waukesha, WI. Chrissy discussed the importance of program quality
and fidelity and how to achieve these through use of tools from Y-USA, and others, by garnering senior
leadership support, evaluating performance and quality, and supporting your team.
 A large crowd joined Caroline Rankin from the YMCA of Central Ohio to discuss, “Free Does Not Keep the
Lights on: Balance between Wanting to Serve All & Providing Programs that are Self-Sustaining.” She
shared how her Y has been able to remain relevant during changing and challenging times by providing
quality programs, specifically those program which address chronic disease, which meet community
needs. In addition she shared how her Y has been able to cover costs for these programs and potentially
make a profit!
 Nancy Gildersleeve of the Capital District YMCA shared on their “Healthy Living Center,” a collaboration
among the Y, a local supermarket, and a health insurance provider. Now in its second year, the center
has opened the door to medical partnerships, gained important financial and media support, and
attracted health seekers. This all helps to address the nation’s serious chronic health challenges.
 “Innovative Chronic Disease Prevention” was the topic covered by Chelsey Bowermaster of the Two
Rivers YMCA in Illinois. When a health care provider in her community was no longer able to financially
support and provide important services to individuals suffering from chronic disease, the Y stepped in to
fill a need. Chelsey shared interactive health assessments to incorporate in all wellness programming.
 Wendy Bart of the YMCA of Greater Seattle presented “Creating Communities of Practice.” In this
session, she shared how these communities, such as regional and/or statewide coalitions, offer staff the
opportunity to learn and grow from each other, to share ideas, and to create a support network that can
leverage resources resulting in improved chronic disease prevention program efficiency and expansion.
 Kristin Magnant from the Greater Burlington YMCA discussed how her Y worked with the state health
department on an initiative call, “Blueprint for Health” which allows eligible participants to join the
YMCA’s Diabetes Prevention Program at no cost. This session shared ideas on how to develop a
statewide “Blueprint for Successful Health Management Partnerships.”
Although sometimes the YMCA’s Diabetes Prevention Program team at local Ys might feel like a department of
one, you are not alone. As you can see, your colleagues across the country have wonderful ideas to share. You
can reach out to your Technical Advisor to assist you in making connections to other Program Coordinators.
Also, be sure to join the National Provider Calls, the Lifestyle Coach Open Forum Calls, and utilize the discussion
board on the YMCA’s DPP web community. These are all great ways to share learning across the program!

8. 8
PROGRAM PRACTICE
EXPANDING THE PROGRAM’S REACH
In the fall of 2013, 7 Ys received a Community Transformation Grant (CTG) to address health disparities
by focusing on the health and well-being of African-American/Black and/or Hispanic/Latino populations.
The Y’s focused part of their efforts on expanding the reach of the YMCA’s Diabetes Prevention Program.
Below are key learnings from four CTG Ys around expanding the reach of the program:
 Involve the right people: Each CTG Y created an advisory board comprised of local stakeholders
that helped advance the group’s shared vision for addressing health disparities, similar to your Ys
Community Advisory Board for YMCA’s DPP. Several Ys cite the importance of identifying leaders
from the communities they wanted to reach. It helps build trusting partnerships, credibility, and
allows the Y to learn more about perceptions that may impede involvement in the program. It also
serves as an inroad for establishing formal referral systems with local health care partners. The
YMCA of Greater St. Petersburg (FL) elicited the support of the outgoing Head of Primary Care
Physicians of a local health system to participate in their advisory board, and also accompany the Y
to meetings at physician offices. Likewise, having representation from a Federally Qualified Health
Center helped the YMCA of Central Ohio expand their referral networks to their target population
and the YMCA of Greater St. Louis (MO) integrate the program as a referral option into a Center’s
electronic medical records.
 Stay focused and patient: The YMCA of Greater Charlotte (NC) stressed the importance of
keeping the advisory board focused on one or two clearly definable objectives. Otherwise there are
too many agendas to cover and less will be accomplished. It is also important to understand that
building credibility in communities in which the Y has previously been less engaged takes time;
sometimes up to a year. To help advance the process, engage volunteer stakeholders and faith-
based institutions from the community to participate in your advisory board. The YMCAs of Central
Ohio and Greater St. Petersburg found that relationships with churches provided inroads to raising
awareness about the program and the Ys general commitment to addressing health disparities.
 Anticipate barriers: All four Ys interviewed emphasized that their target populations already
encounter many barriers on a daily basis, and the Y must be prepared to remove barriers for entry
into the program. Utilize the insights and expertise of your advisory board members to learn about
those barriers. If the cost of the program is a potential barrier, consider how your Y’s financial
assistance policy can increase accessibility, how you will frame the cost of the program, and the
messages you want your partners providing about the program to minimize confusion and
efficiency. Additionally, ensure your Lifestyle Coaches are prepared to facilitate problem-solving
around the barriers that participants may encounter, such as access to health and affordable foods,
transportation, or finding services in their spoken language.
Diabetes is a community level problem and to address it effectively, your Y must enlist the help of
partners. Those partners will inform the strategies you devise and implement, and can advance the
specific tasks that are important for expanding the program’s reach.
DATA AND TRENDS
RISK TEST VS. BLOOD VALUE
DIFFERENCES IN OUTCOMES BASED ON PARTICIPANT QUALIFICATION METHOD
Participants can qualify for the YMCA’s Diabetes Prevention Program based on a risk test score indicating
they are at high risk for developing type 2 diabetes or a blood value that places them in the prediabetes
range.
Analysis of program-to-date data through March 2015 shows some differences in outcomes exist based on
qualification method.

9. 9
Participants who qualify for the program based on blood value tend to attend more program sessions
during both the weekly and monthly portion of the program:
In addition, these participants lose more weight on average than participants who qualify based on risk:
This data supports the CDC’s Diabetes Prevention Recognition Program, which require at least 50% of
participants to qualify for the YMCA’s Diabetes Prevention Program based on blood value in order for Ys to
meet recognition criteria. It also supports the idea that modifying recruitment and enrollment practices to
increase the number of participants who qualify based on blood value may lead to improved participant
outcomes.
Here are a few strategies for increasing percentage of participants who qualify based on blood value:
 Encourage participants who initially qualified based on risk to also get a blood test – a blood value
can be added even after a participant has started the program
 When talking to potential direct payor partners, encourage them to include support around testing
events if they are receptive – for direct payor partners particularly motivated by employee
outcomes, this could be a helpful talking point in making the case for testing event
12.1
12.8
0
5
10
Risk test Blood test
Average weekly session
attendance by participant
qualification method (n=21,923)
42.6%
46.0%
0%
10%
20%
30%
40%
50%
Risk test Blood test
Percent of participants attending
at least one monthly session based
on qualification method (n=15,486)
4.4%
5.3%
4.6%
5.7%
0%
2%
4%
6%
Weight loss at end of weekly sessions (n=18,230) Weight loss at end of year (n=6,923)
Average weight loss by participant qualification method
Risk test
Blood test