COMMUNITY OPERATING PLAN

A. PROJECT DETAILS: Event: Diabetes Support Group Topic: Stress and Diabetes ______________________ Event Date: March 13th, 2104 Location: Cheshire Medical Center Intern Name(s): Claudia Gumina and Laura Gurvits Team Leader: Claudia Gumina Preceptor: Karen Balnis Person responsible for writing the COP: Claudia Gumina Meeting Dates Dates scheduled for planning and who attended. 03/04 Claudia Gumina 03/07 Claudia and Laura 03/09 Claudia and Laura 03/10 Claudia, Laura and Karen. 7 day meeting - Presentation materials to be reviewed with preceptor on 03/10. (This meeting must be scheduled at the beginning of the planning process. Meeting should be at least 7 days before presentation to allow for revisions as needed.) Evaluation meeting scheduled for: (Usually held directly after presentation but may be scheduled for later.)

B. NEEDS ASSEMENT: (Describe how you identified the topic you chose. Who did you talk with? Did you conduct a formal survey or have an informal conversation? Identify all additional information listed below.)
1. Identify site contact: Patti Schuman 2. Identify population a) Gender: Both, men and women. b) Age: 65+ c) Education level: varied - some with higher ed. degrees. 3. How topic was determined: The topic was determined after observing a group meeting at the beginning of January in which group members were heard worrying about medical bills, and high blood sugar. We decided that stress reduction would be a good topic since stress is a significant factor in blood sugar control. a) Other programs recently presented: low-carb recipes, carbohydrate counting b) What the audience knows: what diabetes is, initial diabetes education, what normal lab values are, what medications to take, different levels of diet knowledge.
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c) What the audience wants to know what is relevant Im following my diet so why are my glucose levels still high? How do I control glucose spikes? What other factors can affect my blood sugar? How can I manage these? d) Evaluate health literacy and other cultural issues Group members were all older adults who seemed to have different levels of knowledge regarding their diabetes. They had different education levels so it will be important to keep the presentation simple and easy to understand. The group members were varied in ethnicity, but similar in culture. 4. Setting tour of facility

Projector

Projector

Main Central Table

Door Door

Prep Area
a) Room size and set up (diagram) b) Presentation resources Availability of food prep area: There is a counter at the back of the room where things can be prepared if necessary. AV resources space available for visual teaching aids: There is a projector in the room that we can use for our presentation. 5. Day of week / time of day for presentation: Thursday at 6:30 PM 6. Duration: 45 min a) Attention span: 15-20 min b) Conflict with other activities for population: The presentation does take place late at night so the group participants might be tired and not want to leave their homes, also there have been weather related cancelations in the past so this could be an issue again. 7. Marketing potential whose responsibility: Patti will send an email to the group participants before hand. 8. Budget a) Will there be a charge: No b) Funds to cover supplies: $ 20 c) Cost of marketing: None 9. Best way/time to reach site contact for future plans; Through email- 9-5
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10. Write a community group focused PES statement based on your assessment

C. RESEARCH AND PLANNING: (Based on the results of the needs assessment, What did you do to prepare? How did you go about the development process? Who was involved? What resources did you use? How did you find them?) To prepare, I (Claudia) went to observe one of their meetings back in January and talked to the participants about different topics in which they would be interested. Laura and I met to discuss the topic and have done research to identify some of the most stressful factors in diabetes. We will demonstrate some relaxation techniques during our presentation so we had to look up simple, short activities. D. DEVELOPMENT: (Describe all components of the program or material, and the team member responsible for them. Include objectives, outline, activities, education materials and evaluation methods/materials. Explain how your presentation addresses different learning styles using the grid below. Attach a copy of the materials or any handouts/resources used for the program/presentation. For an educational material, how was this pilot tested? What changes were made?) Stress and Diabetes: Finding peace and managing our blood sugar levels Ice Breaker o Make-a-wish: Pass around an object and whoever has it gets to make a wish and possibly share their concerns about something. We will start talking about our own wishes. Relate their wishes to stress management and diabetes. Objectives o To understand the relationship between stress and diabetes o To be able to identify stressful factors that may negatively affects our lab values o To demonstrate stress-relieving techniques to control our blood sugars Content o Relationship between stress and diabetes: When you're stressed, your blood sugar levels rise. Stress hormones like epinephrine and cortisol kick in since one of their major functions is to raise blood sugar to help boost energy when it's needed most. Think of the fight-or-flight response. You can't fight danger when your blood sugar is low, so it rises to help meet the challenge. Both physical and emotional stress can prompt an increase in these hormones, resulting in an increase in blood sugars. At the same time, when you are living with diabetes you are exposed to many different stressful situations which can increase stress. So it becomes a cycle in which stress increases blood sugar and increased blood sugar levels lead to more stressful situations.

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o What increases stress? Sometimes, its obvious things like a sick family member. Sometimes, it can be something as simple as missing the bus in the morning. You should be aware of what increases your stress levels because just noticing can help manage it. What are some common things that increase stress for you? What is stressful about having diabetes? What are some new worries that you have? Summarize previous stuff and transition to ways to relieve stress o How can we lower our stress levels when living with diabetes? Take up a relaxing hobby that makes you focus on things you enjoy. What are some hobbies you enjoy? o Knitting o Singing o Playing with you pet o Take a long bath o Sipping a nice cup of tea o Volunteering o Spending time with your family Get a massage Exercise: 30 min-5 days a week 10 min at a time is fine. You can break it up in small sessions. What do you guys do for exercise? Think about how you feel after exercise Meditation Keeping a journal: Try to identify stressful factors in your life How you feel physically and emotionally How you acted and responded What you did to make yourself feel better. o Unhealthy ways of dealing with stress: Ask the participants what they do that is not so healthy. Stress eating. Using food as comfort is ok when it is once in a while. Activity o Tea drinking discuss mindfulness. Get them to use all their senses to enjoy the experience. Make sure tea doesnt have licorice. Evaluation o Goal setting: Have them discuss what they are going to do to manage stress Remind them how stress can increase their blood sugar and how we often only think about the physical stuff that affects our diabetes. HAVE A GOAL SETTING HANDOUT Remember that sometimes we cant control it, but we shouldnt add more stress to our lives

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Learning style Thinking Sensing/Feeling Analyzing Doing Visual learner

How did you meet this learners needs? Ice Breaker Mindful Eating Exercise What causes stress? Goal Setting Mindful Eating Exercise

Complete sections E & F after the presentation/event is complete. E. IMPLEMENTATION: (For a program or presentation, describe the setting, audience, number of participants, what you did to get ready and begin. Did the presentation go as planned? How did the audience react to the presentation?) For this presentation, we had 8 people come. To get ready, we had emailed Patti to have hot water and cups for us to serve the tea for the mindful eating exercise and brought some of our own materials including the tea. The presentation went well and we decided to sit and make it more comfortable and relaxed which help things move along. The audience was very interactive and used the presentation as a guideline for their discussion. F. EVALUATION: (What went well? What would you do differently/the same the next time or what would you change if you had more time? What problems did you encounter in the development? Using the results of your participant evaluation tool, assess the impact of your presentation. Discuss your impression of the effectiveness of this program or material for the target audience. Include a financial report as well as your recommendations to future interns.) The mindful eating exercise went really well and got other group participants talking about meditation and relaxation. We realized that some members of the group like monopolizing the conversation so we had to encourage others to talk as well. Our evaluation was well designed, but we were not able to use it as planned because the participants wanted to keep discussing the topic. In the future, I recommend interns try to read a bit about group management and being a moderator for an easier-flowing group discussion. Within one week of the presentation, provide internship preceptor with a completed COP, Presentation Evaluation Form, Handout(s), a Team Leader Report, and PDE. (PDE required for sites with 2 presentations or >20 hours.)

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