Q&A with YMCA of Silicon Valley
About YMCASV:
YMCA of Silicon Valley has been listening and responding to the most critical social needs in our community for over 150 years.
They provide programs and services to strengthen the foundations of our community. They bring people together to nurture the potential of children and teens, improve our communities’ health and well-being, and create opportunities to give back. They welcome and serve people from all backgrounds, ages, capabilities and income levels, providing financial assistance to those in need, mirroring and celebrating the diversity of Silicon Valley.
Project Funded by The Health Trust:
To empower people living with pre-diabetes by providing the tools they need to improve their health and wellbeing, during COVID-19 and beyond. YMCASV has pivoted to launch virtual cohorts of their Diabetes Prevention Program, an evidence-based program that works to prevent or delay type-2 diabetes. Concurrently, the YMCASV is working on strengthening referral connections with healthcare providers. The Health Trust is proud to support this work with a Health Partnership grant, funded under our Focus Area of making chronic conditions more preventable and manageable.
Q1: Why is it important for the YMCA to address diabetes and pre-diabetes in our community?
The Y does this work because it is our mission to improve the health and wellbeing of our community – pure and simple. As long as zip code, race, ethnicity, education, employment, transportation and other determinants of health play a role in defining who is healthy in our communities, as long as health disparities and inequities exist, that is why we do it. We believe that all people should reach their greatest health potential. As long as type 2 diabetes can be prevented, our Y will be there for all.
Diabetes is a growing health concern across the nation. According to the CDC, approximately 1 in 3 U.S. adults has prediabetes, but 9 out of 10 people with prediabetes do not know they have it. In Santa Clara County, 46% of adults are estimated to have prediabetes or undiagnosed diabetes. A higher percentage of Latino (11%), African American (10%), and Vietnamese (10%) adults in Santa Clara County report being diagnosed with diabetes than White adults (8%).
Without intervention, up to 30% of those identified with prediabetes will develop type 2 diabetes within five years, and as much as 70% will develop the disease in their lifetime. Diabetes can cause serious health issues such as heart disease, stroke, blindness, kidney failure, and even lead to the loss of toes, feet, or legs. Diabetes has no cure, but prediabetes can be reversed.
The YMCA’s Diabetes Prevention Program helps adults at risk for type 2 diabetes reduce their risk for developing the disease by taking steps that will improve their overall health and well-being. The program provides a supportive environment where participants work together to achieve the program goals of reducing individual weight by 5-7% and building up to 150 minutes of moderate physical activity (the equivalent of brisk walking) per week for the purpose of reducing their risk for developing diabetes.
Q2: This grant allowed you to change the way you offer the Diabetes Prevention Program during the pandemic. How has this pivot positioned you to continue to integrate equity into your work?
This grant support from The Health Trust has allowed the Y to shift our Diabetes Prevention Program (DPP) to an online format during a time when in-person programs are not accessible or safe, ultimately increasing our ability to successfully reach patients with prediabetes in vulnerable populations.
Prior to the onset of the COVID-19 pandemic, the DPP was offered in an in-person classroom setting in a community location. Beginning in March 2020, the program could not continue to be delivered in-person, but the need for prediabetes education had not gone away. In fact, the CDC has found that underlying disease, such as obesity, diabetes and heart disease, can put you at greater risk for dying from COVID-19, therefore there has never been a more important time to address and reverse underlying health conditions.
Stay-at-home orders have placed unusual strains on people with chronic disease. These individuals might be exercising less, stress eating, and experiencing heightened anxiety or depression. Furthermore, inequities in the social determinants of health (access to quality healthcare, general health, education, economic stability, etc.) increase risk of severe illness from COVID-19 for low-income and certain ethnic populations, particularly Hispanic and African American populations, who are also at a higher risk for diabetes.
As COVID-19 has continued to impact communities locally and across the nation, the Y’s pivot to DPP distance learning has reduced barriers to participation during this pandemic as participants do not have to be physically located with the class, therefore mitigating transportation, childcare, and logistical concerns. In addition, the social and emotional effects of the pandemic have created a greater need for connection, now more than ever. Our virtual DPP provides a community for many people who would not otherwise have a group of peers for regular interaction and support. We have discovered that attendance for the virtual program has been very consistent and relationships have been built among participants who are seeking both a healthy lifestyle and a means of social connection.
Q3: Since starting this project, what are some of the accomplishments you are most proud of?
The pivot to virtual DPP has allowed us to serve a greater number of participants than would have been possible for our in-person model. Being able to participate in the program from home, and choose from a variety of days and times, has resulted in 94% of those who qualified as at-risk for diabetes to register for a class that fits their schedule. Of those who have registered, 78% are currently attending classes or are enrolled in an upcoming class. We are grateful to The Health Trust for supporting this work and are extremely proud to have an extended reach and impact on the health of our community through this project.
We are proud to continue to support our Spanish-speaking community by launching a robust, online class facilitated entirely in Spanish. Our bilingual coaches have been great assets in assisting with registration and helping participants become comfortable with accessing the technology and online platform. This class is experiencing excellent cohesion and retention, due to culturally competent coaching and delivery of the program in the participants’ home language.
Another project success made possible with support from The Health Trust has been the establishment of a laptop lending library. We knew, early on, that the pivot to online classes would lead to technology-related barriers. In anticipation of this, we included in our intake process questions about access to the internet and laptops/tablets in order to attend classes. The laptop lending library, combined with a partnership with Comcast to provide free Wi-Fi, allowed us to ensure that lack of technology has not prevented individuals with prediabetes from obtaining the education and support they seek to reduce their risk of disease.
We are also pleased to be able to support our participants by providing hard copies of program curriculum and resources. Many participants are not able to print the program materials, so we have worked hard to ensure that everyone who needs assistance in this way either has a place to pick up materials or has received them in the mail. Additionally, some participants do not have access to a scale, which is necessary for weekly weigh-ins. We are happy to be able to assist them by loaning digital scales for the duration of the program. It has been a team effort, with wonderful communication and collaboration from our Lifestyle Coaches, to facilitate the full and active participation of those who have limited access and resources.
Partnerships are key to the success of our program, especially when it comes to health equity. We are very proud to be receiving referrals for DPP from Valley Homeless Healthcare Program. We know it can be life-saving for people who are experiencing homelessness to receive necessary care and support. We are grateful that this project has allowed us to serve some of our more vulnerable community members so that they can access the education and be part of a community that improves and uplifts their health and wellbeing.
Q4: Looking forward, how has this project shaped future community-based programs for the YMCA, especially for communities who are disproportionately impacted by health disparities?
Beyond the duration of the pandemic, the ability to offer chronic disease prevention education in an online format will significantly increase the reach of our programs, leading to a greater impact on a population level.
We will continue to focus on reducing barriers to participation in order to address health equity and achieve participant outcomes in a number of ways, such as providing staff with further training on the social determinants of health, hiring culturally competent lifestyle coaches, delivering the program in the home languages of participants, pursuing CDC approval of curriculum translations, providing access to healthy fruits and vegetables through partnerships, providing YMCA memberships for access to community and physical activity, and continuing to provide the option for virtual participation in our chronic disease prevention programs where possible.
Our next step is to submit our application as a Medi-Cal provider. We are currently certified as a Medicare provider and we believe the next step in eliminating barriers is to provide programming as a Medi-Cal benefit.
Q5: How can the community support you or learn more about your work?
You can learn more about the YMCA’s Diabetes Prevention Program at www.ymcasv.org/dpp. Visit the YMCA of Silicon Valley at www.ymcasv.org, to find out about membership, as well as how to donate and volunteer.