Sign, diabetes just ahead


Chronic health conditions are the leading cause of death and disability in the United States. They are also the leading drivers of the nation’s $3.3 trillion in annual healthcare costs. In the United States, one in two adults has a chronic condition and one in four adults have two or more chronic conditions.

According to the Centers for Disease Control and Prevention, over 30 million individuals have been diagnosed with diabetes. One in three American adults has pre-diabetes and 90 percent of them are unaware of their health condition. November is Diabetes Awareness Month and provides the opportunity to promote the diabetes risk test and self-management education programs to develop healthy lifestyles.

Better Choices, Better Health South Dakota is an evidence-based prevention and health promotion program that addresses common issues faced by people with chronic conditions, such as diabetes, hypertension, pain and more. Workshops are designed to help caregivers and adults living with ongoing physical and/or mental health conditions. Each session provides information and tools to promote healthier choices, improve quality of life, boost self-confidence and inspire positive lifestyle changes.

Denise Kolba, RN, program manager for Great Plains Quality Innovation Network“As a leader for Better Choices Better Health workshops, I have the privilege of witnessing this group of people come together to support each other in their journey of becoming healthier and learning new skills needed in the day to day management of on-going health conditions. I am always amazed at the camaraderie that evolves during each workshop,” shared Denise Kolba, RN, MS, CNS, program manager for Great Plains Quality Innovation Network.


The program offers information on goal setting and problem solving, personal exercise plans, managing stress and depression, relaxation techniques, medication how-to’s, dealing with emotions and working better with your doctor and care team.

The Chronic Disease Self-Management Program (CDSMP) was originally developed at Stanford University more than 20 years ago and has rigorously reviewed development and data collection supported by grants from the National institutes of Health, the Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention. It has been implemented in 43 states and 18 other countries, including Canada, Australia, China, Japan, Norway and Great Britain.

Workshop participants show improvements in many areas.

  • Active lives: 41% improvement in time spent engaged in moderate physical activity
  • Less depression: 21% improvement in depression
  • Fewer sick days: 15% improvement in unhealthy physical days and 12% improvement in unhealthy mental days
  • Better quality of life: 6% improvement on health-related quality of life
  • Feel healthier: 5% improvement in self-reported health
  • Improved symptom management in 5 indicators:
    • sleep problems (16%)
    • shortness of breath (14%)
    • pain (11%)
    • fatigue (10%)
    • stress (5%)
  • Medication compliance: 12% improvement in medication compliance
  • Communication: 9% improvement in communication with doctors
  • Health literacy: 4% improvement in confidence filling out medical forms

CDSMP also helps achieve successful implementation of the medical home model, as defined by the National Committee on Quality Assurance (NCQA). Healthcare facilities who implement CDSMP are able to reach higher scores on the Patient Centered Medical Home Assessment by providing evidence of (1) linkage to community resources, (2) self-management support and (3) care coordination.

Great Plains Quality Innovation Network (QIN) continually partners with communities, healthcare facilities and healthcare professionals across the four-state region to promote chronic disease self-management education programs. Additional information and resources on diabetes self-management and care are available on the Great Plains QIN website.