Texas has a high prevalence of diabetes and an especially high incidence of diabetic complications such as amputations and renal failure. The statewide, age-adjusted diagnosed diabetic rate of 10.8/100 is the ninth highest rate in the country and has approximately doubled since the 1990’s1. Increasing collaboration between healthcare, public health, and other community stakeholders can help to improve the effectiveness of interventions to address diabetes.
The Public Health Foundation (PHF), with support from the Robert Wood Johnson Foundation, is using a
population health driver diagram framework to assist three Texas regions as they work to prevent and control diabetes within their communities.
Diabetes Population Health Driver Diagrams have been developed by each of the three Texas regions to meet each region’s unique needs. The driver diagrams are helping community stakeholders across sectors to collaborate by identifying and implementing interventions that can align their efforts to address diabetes prevention and control. In addition, the regions are using the driver diagrams to help them achieve greater health equity within their communities and improve the value of community health investments. Population health driver diagrams are living documents and will continue to be updated throughout the initiative as the regions explore new and innovative ways to address diabetes as a population health challenge.
On June 21, 2016, PHF hosted a meeting in San Antonio to bring together participants from all three regions to discuss their work to date, successes, and challenges, and share lessons learned. Each region shared a presentation about their initiatives, the most recent iteration of their Diabetes Population Health Driver Diagram, and fielded questions from colleagues. Two important themes emerged from this meeting. First, the diverse sets of drivers – and AIM statements – identified by the sites illustrated the rich versatility of the population health driver diagram to address a single health challenge within communities that are quite different. Second, cross-learning and sharing of lessons learned among communities that are addressing similar population health challenges provide energy, guidance, and helps prevent unsuccessful efforts for all those participating in those conversations.
Each Diabetes Population Health Driver Diagram is unique to the specific Texas region in terms of its AIM and the stated primary and secondary drivers. At the same time, the intended purpose and uses of the population health driver diagram are consistent among the regions: to serve as a framework for discussion and aligning actions across sectors to achieve a health objective, fostering collaboration, rather than competition, among community stakeholders. While one community chose to focus on public education as a strategy to prevent diabetes, another community chose to work with individuals identified as pre-diabetic with a focus on surveillance. Through the work of these three different regions that are tackling diabetes in remarkably different and unique ways, the versatility and effectiveness of the population health driver diagram is apparent.
The cross learning that took place at the meeting among the sites offered great value to those participating in this initiative. Jennifer Herriott, Assistant Director of Health for the San Antonio Metropolitan Health District explained, “The opportunity to come together in San Antonio with our colleagues from Austin and Houston to share lessons learned, showcase accomplishments, and discuss opportunities for continuing efforts to reduce diabetes through the Diabetes Population Health Driver Diagram Project was really fantastic.” Meeting attendees reported that they were leaving the meeting with new ideas about how to tackle this longstanding challenge, and that their resolve was renewed. Participants also shared that by meeting with their colleagues in other communities, they felt energized in addressing diabetes as a chronic and multifaceted health challenge. The participants were able to remind each other that their struggles are valid, and their successes should be celebrated.
As each of the three Texas regions continues to use their Diabetes Population Health Driver Diagram to develop and implement interventions for addressing their community’s needs to prevent and control diabetes, PHF will work with each region to develop the capacity and capability towards achieving their AIMs and continued learning across the regions.