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BETHESDA NEWTRITION & WELLNESS SOLUTIONS LAUNCHES A “HEALTHCARE TO COMMUNITY” PROGRAM.

Diabetes is a chronic disease and a growing concern across the United States. The Centers for Disease Control (CDC) estimates the number of adults with diabetes is nearly thirty million, and the prevalence in Maryland is repeatedly among the top twenty-five states.

The Maryland Department of Health is taking this seriously and collaborating with partners across the state to help reverse the trend and get the numbers down. The program involves partnering with hospitals, local health departments, and private care providers.

Bethesda NEWtrition & Wellness Solutions (BNWS) is proud to be a part of this collaboration and has developed a four-week Healthcare to Community program that includes diabetes education, access to community classes, and medically tailored meals for qualified participants. The goal is to improve diabetes self-management, reduce social isolation and lessen rehospitalizations.

Participants may be referred to BNWS following a discharge from a diabetes-related hospitalization or from their primary care physician. To be included in the program participants must meet two requirements. They must be over the age of 60 and have a diagnosis of type 2 diabetes. Those meeting additional criteria will be eligible for shelf-stable medically tailored meals and other incentives.

The program is free of charge to all participants. A member of the BNWS team will be in contact with each participant along the way, to answer questions.

DIABETES EDUCATION

Each participant will be provided with a computer tablet that is pre-loaded with handouts and videos on several diabetes topics. Topics include medication management, healthy diet, exercise, and monitoring diabetes complications.

The diabetes educational materials provided to participants are designed in a simple and easily understood format with information clearly stated and in large print. Both written and visual materials are included, to accommodate different learning styles and to assist with understanding the information and successfully implementing it.

In addition to viewing and reading the educational materials, participants will be asked to complete a pre and post-survey each week, to determine their understanding of the information. They will then participate in virtual one-on-one visits with Registered Dietitians who will provide medical nutrition therapy (MNT), answer questions, and offer guidance and support.

ACCESS TO OUTSIDE RESOURCES

During or upon completion of the four-week program, participants will be enrolled in Diabetes Self- Management Programs (DSMP) provided by Area Agencies on Aging (AAAs). Attendance will be held virtually via the provided computer tablets. Participation in virtual classes helps to lessen the impact of social isolation and improve blood glucose control.

DSMP is a six-week program. Classes are taught by a trained certified diabetes educator and help to expand upon the education provided in the BNWS program. Topics include understanding diabetes, meal planning, being physically active, blood sugar monitoring, medication management, problem-solving, reducing risk for diabetes complications, coping with the emotional side of diabetes, and improving overall health and quality of life.

DSMP programs have been shown to help improve A1C levels, and have a positive effect on all aspects of diabetes. By improving diabetes management, DSMPs help to decrease diabetes complications and diabetes-related hospitalizations.

MEDICALLY TAILORED MEALS

For those meeting the criteria for medically tailored meals, shelf-stable, food will be provided weekly for four weeks. Each week participants will be issued a box of non-perishable food consisting of three meals and one snack per day, for six days. Condiments and utensils are included as well as menus, food preparation instructions, and recipes. No refrigeration is necessary for any of the ingredients and preparation requirements are basic measuring cups and microwave oven.

These medically tailored meals will meet the nutritional requirements of the Older Americans Act, Title II-C guidelines, and be designed to promote healthy blood sugar levels. In addition, the focus of the meals is on increasing the fiber content and limiting the amount of sodium each day. Participants will complete a daily survey to report their satisfaction with the meals for both taste and preparation ease.

Studies have shown that providing medically tailored meals upon discharge, reduces rehospitalizations and healthcare costs and improves the transition from hospital to home.

SUMMARY

The BNWS Healthcare to Community program is part of a collaboration with the Maryland Department of Health, the Maryland Department of Aging, and the Maryland Primary Care Program to improve diabetes statistics in the state of Maryland.

By providing diabetes education, Medical Nutrition Therapy by Registered Dietitians, and medically tailored meals to those in need, BNWS hopes to show that these interventions make a difference in improving diabetes outcomes. Upon completion of the program, referring primary care physicians may request an update on the participant’s success with the program, including any suggestions for needed follow-up or further referrals.

By targeting underserved older adults with the greatest social and economic need, BNWS hopes to improve diabetes outcomes, reduce hospitalizations and improve transitions from hospital to home.

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