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Diabetes Risk Reduction Program Leads to Broader Focus on Community Wellness

Monday, July 15, 2019   (0 Comments)
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By: Leigh Ann Hoffhines, Communications Manager, Rinehart Clinic, and Denise Weiss, Quality Director, Rinehart Clinic 

For three years running, the Rinehart Clinic in Wheeler, Oregon, has been helping patients take control of their type 2 diabetes and increase their (and the community’s) general wellness by: 

  • Taking a broad and interactive approach to patient education; 
  • Reducing barriers to accessing healthy foods and other wellness opportunities; and
  • Creating opportunities for participants to find the kind of supportive social networks we know play such an important role in health and wellness.

In 2017, Rinehart Clinic implemented a comprehensive Diabetes Risk Reduction program through a grant from the Columbia Pacific Coordinated Care Organization. The program focused on helping patients make strides in overcoming some of the risk factors of type 2 diabetes, like obesity and sedentary lifestyles, and called for a broad-based approach to patient care and strong support from the entire care team. 

One of the most important aspects of the program is helping to ease barriers patients may face–economic, emotional, or motivational–that can make it difficult for them to seek treatment. We are fortunate to have strong community partners who share our focus on community wellness, and who have worked with us to provide incentives that help ease the way to better health for our patients–incentives like free fitness and aquatics passes, vouchers for healthy foods, and farm-fresh organic vegetables. 



Participants in some of Rinehart Clinic's classes recieve free vegetables from a local organic farm.



It has been gratifying to watch the needle move in a positive direction as our participating patients are seeing lowered A1C numbers, lower blood pressure, healthier eating habits, and even weight loss. 

Based on our successes with this program, we knew if we could expand the program, it could have an even bigger impact on community health. Looking upstream, we identified obesity as an area of focus. We know that weight can impact diabetes, of course, but it also impacts heart disease and many other chronic health conditions.  


We were able to secure additional grant funding to focus more broadly on community wellness by addressing obesity. Our goal was to not only expand our class offerings, but also to offer them to a larger population base. This Community Wellness program was made possible with funding by the Columbia Pacific CCO Community Advisory Council and the Eugene Schmuck Foundation, a local charitable organization dedicated to serving nonprofits in North Tillamook County. The funding also allowed us to build on the existing partnerships with our community partners in the grant:  North County Recreation District, the Manzanita Farmers Market, Manzanita Grocery & Deli, and Moon River Farm, a local organic farm.


Using what we learned and focusing on the favorable outcomes from our first round, we kicked off 2019 by expanding access to physical activity for participants and planning a variety of classes. Some of the highlights include:

  • Prescriptions for Physical Activity – This is, hands down, the most effective strategy we have implemented. Our diabetes-focused program offered participants free passes to the local recreation center. We saw some success with the program, but an actual written prescription from a primary care provider helps spur the patient to “follow doctor’s orders.” By pairing the free fitness or aquatics pass with a prescription for physical activity, participation in the physical activity voucher program jumped from 10% to 55%. 
  • Incentives – All participants in the program receive (depending on the season), free passes to the local recreation center, free farm-fresh vegetables (thanks to a CSA share from a local organic farm), free vouchers for vegetables and other healthy foods at the local farmers market, or free vouchers for healthy foods at a local grocery store. 
  • Broad Class Offerings – The classes associated with this program cover a wide array of health-related topics, all of which include a focus on obesity as a component. They are reflective of the strengths of the team members teaching them, but many are also a nod to interest expressed by the community. Here are a few examples:
    • Mindfulness Meditation – Monthly classes taught by one of our Licensed Clinical Social Workers who has a background in Mindfulness Meditation. The sessions include discussions on mindful eating and stress reduction.
    • Diabetes Management – a six-week class taught by our Certified Diabetes Educator covering the basics of managing type 2 diabetes, offered twice a year. 
    • Intro to Fasting – a three-week class taught by Rinehart Clinic’s Doctor of Naturopathic Medicine, covering the health benefits of fasting. (This class was so popular we had to find a bigger venue to accommodate the interest, and participants requested a follow-up class.) 
    • Art of Eating – an interactive five-week class showcasing locally-grown organic produce taught by our Quality Director and one of our LCSWs. Participants learn first-hand the benefits of incorporating more vegetables into their diets. This class has become so popular we now hold it twice yearly: an early summer session and a late summer session. 
    • Medication Management Workshops – Twice a year, our Clinical Pharmacist holds brief workshops focused on ways to manage medications.


Dr. Andersen, Rinehart Clinic's Doctor of Naturopathic Medicine, taught an "Intro to Fasting" class that was very well received by participants



We are midway through the Community Wellness program, but early returns look very promising. We are seeing more people take advantage of the free physical activity passes and hearing good feedback about (and increased participation in) the classes. We survey participants at the end of each series, and are monitoring for changes in weight, mood, and diet. One of the most fulfilling outcomes we have seen from this program is the social interactions and networks that have formed among the participants. We know that social support and engagement are critical components of wellness in general, and when that support network is working together toward a common goal, there is a stronger likelihood of success. 


Stay tuned! We look forward to providing more details on the success of the program and lessons learned in the months to come. 


To read Rinehart Clinic's March 2018 NW Pulse article on their diabetes risk reduction program, click here





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