What’s New for Diabetes and Prediabetes

CHWTraining launched its Diabetes and Prediabetes more than six years ago, and it remains our top requested course. It’s not hard to understand why, as diabetes continues to grow in the U.S. and trigger a host of other chronic diseases.

Adults in the U.S. need diabetes support, especially now when the coronavirus brings new threats to communities and people who already have the disease. Without the proper education about diabetes, patient populations will only decline if trends continue on the path they’re on.

CHWs, Diabetes and Prediabetes

Community health workers, community care coordinators, health promoters and others are more important than ever in helping people understand their diabetes or prediabetes diagnoses and control it.

CHWs can advise on what diabetes is, how to interpret blood sugar levels, share healthy eating ideas and recipes, and give ideas for physical activity. They can also connect clients to professionals who can provide more support beyond a physical, such as dental workers and dietitians. They can also help vulnerable and minority communities who have statistically worse health outcomes from diabetes.

That’s why we created Diabetes and Prediabetes (and the Spanish language Diabetes y prediabetes) included it as part of our chronic illness learning track. As part of our latest updates to the course, we took a careful look at how things have changed with diabetes.

[Related: Add Chronic Illness training to any Learning Track]

Diabetes is on the Rise

The number of people with diabetes in the US is up. In the United States, an estimated 34.2 million people of all ages have diabetes. That number continues to rise. In 2018, about 1.5 million adults in the United States were newly diagnosed with diabetes, according to the CDC’s National Diabetes Statistics Report 2020.

[Source: CDC]

Diabetes is the seventh leading cause of death in the United States.

African Americans, Hispanic/Latino Americans, and Native Americans are at a higher risk for both type 2 diabetes and gestational diabetes. These health disparities gain an alarming momentum when you see that more African-American and Hispanic people are testing positive for COVID-19 and are being hospitalized at higher rates than whites.

Diabetes and COVID-19

Scientists and officials have revealed that most cases of the disease are mild. Most serious cases are in patients with underlying health conditions, such as hypertension, obesity, and diabetes.

This is a serious consideration in the US, because the CDC reports that 60 percent of U.S. adults have a chronic condition. More people in the ICU for COVID-19 had diabetes than any other condition.

Diabetes makes outcomes worse by weakening the immune system, especially if the infected person’s diabetes is not well managed.  This means that their bodies have to work even harder to fight off the infection.

Stress can cause another problem with immune defense systems and blood sugar levels. It can cause both to grow out of control. This can make diabetes even worse. The American Diabetes Association has more information on How COVID-19 Impacts People with Diabetes.

This is an opportunity for community-focused health workers to step in and help. By helping patients understand how to interpret their blood sugar readings and helping them eat nutritiously, they can both help them manage diabetes and boost their overall immune system.

Diabetes and Oral Health

The relationship between oral health and diabetes is more pronounced than many people realize. Good dental hygiene is associated with a lower diabetes risk, according to a study. On the other hand, people with a dental disease, such as periodontal (gum) disease, are at a higher risk of developing it. One surprising statistic says “In individuals missing 15 or more teeth, this risk increases to 21%.”

CHWs can help by educating clients and caregivers on good oral health habits, including frequent brushing, daily flossing, and avoiding sugary snacks. Many people are not seeing dental workers because of cancellations and coronavirus risks, which means they need to be extra vigilant with their oral hygiene to avoid the need of seeing a professional.

More information on oral health and its relationship with other chronic disease is in the course Oral Health Disparities.

Diabetes is bad for people in the U.S. more than ever before. Community health workers are more important than ever when it comes to avoiding and managing diabetes and prediabetes.

If you’re not including training about diabetes in your CHW workforce, start now. If you’re interested in building a diabetes education program for your team with these or other courses, contact us to learn how to add certified training to your program. Our team will be in touch ASAP to schedule a time to chat.

Image by Myriam Zilles from Pixabay

8 Helpful Tips for Running Better Virtual Trainings

For the health and safety of learning communities, it’s a good idea to host all training events online in the coming weeks.

The U.S. Centers for Disease Control and Prevention (CDC) and advice from the World Health Organization are advising people stay home as much as possible. You can still protect the health and safety of your staff while updating your training policy to host training events online.

Face-to-face trainings can make it feel easier to communicate and read the reactions of others in the room. But an online training, especially a webinar, can make it seem like you’re losing some of the participants.

Remote training sessions aren’t identical to in-person education, but there are ways to make them effective, productive—and lower your anxiety levels. Here are 8 top tips that will help you get more value out of your virtual training.

[Sign Up Now: Virtual Training Webinar]

8 Tips for Better Virtual Trainings

  1. Choose the Right Tool for the Training
  2. Make a Plan
  3. Consider Time Zones and Schedules
  4. Send a Welcome Message
  5. Navigate Spam Filters
  6. Practice, Practice, Practice
  7. Keep Learners Engaged
  8. Provide Contact with Mentors or Coaches

1. Choose the Right Tool for the Training

The most important decision when you move training online is what tool you’ll use to offer it. Different situations and materials call for different solutions.

If you’re doing a one-off training that takes no more than 1.5 hours, a webinar is a good choice, and you can use a tool like GoToMeeting, Join.me, Uber Conference, or Zoom. Learn more about a few popular video conferencing services.

If you need to repeat the training, need to offer certificates, or need more in-depth training, then self-guided online education is the solution you need. The fastest and easiest way to train your staff without being in the same room is through a learning and training subscription. Learning subscriptions are helpful so you’re not reinventing the wheel every time you train every community health worker.

A learning subscription lets you begin training within a few days. It’s a digital learning solution that provides 24/7 access to a complete catalog of interactive training courses and videos for anyone on your team who needs to build skills or meet training requirements. Learning subscriptions are helpful for existing and new hires because they make it easy to stay current as health recommendations are constantly changed and revised. Access to a continuous learning system like CHWTraining keeps staff connected to enhanced training or CHW certification requirements with each new update.

2. Make a Plan

Unless you’re a pro at holding online trainings, having a careful plan is the key to a smooth event. A project plan helps you assign tasks, collaborate with others, and remove stress for everyone. Even if you’re the only one holding your online training, you should plot out the sequence of events and when they should happen.

At a minimum, include these main categories in an elearning project plan, including task, milestone, and person responsible:

  • Registration
  • Text or content writing
  • Graphic design
  • Platform set up
  • Rehearsal
  • Follow-up

3. Consider Time Zones and Schedules

Nearly everyone has mixed up meeting times with someone in a different time zone. Consider time zones when you set your event, and think about when people are free.

You might even survey your learners to find out when it’s most convenient for them to meet. There are a lot of good scheduling tools out there, but we often use Doodle:

4. Send a Welcome Message

Welcome messages help you set expectations and highlight anything important when people are most attentive. Use your welcome message to give students a quick preview of the virtual training, give them contact information, state prerequisites, and give them major deadlines they can copy into their calendars.

5. Navigate Spam Filters

Spam filters are notorious for blocking messages from anyone, especially if your team works at a healthcare facility, which seem to have even more strict blocking measures. Double-down on your notifications and messaging by sending in multiple formats: email, automatic notification, Slack, text.

You might even reach out to your learners via their personal email addresses if possible, since so many people are home and might not have access to their work email accounts.

6. Practice, Practice, Practice

Before you step into that virtual classroom, know what you’re doing by practicing, multiple times if needed. This will give you a chance to try out new technology tools, new material, and be ready for unplanned events.

“Find a group of people who will support your learning curve and practice with the technology. Ideally you gather a group large enough to practice different features of the platform you’ve selected, such as organizing breakout rooms” advises Laura Wells, a trainer who regularly delivers leadership training around San Francisco in person. She has started delivering distance training sessions for clients, and is currently planning to deliver an exceptional virtual format of the Search Inside Yourself program (details at info@awakeinbusiness.com) for which she is a certified teacher. She needed to quickly get up-to-speed in April when one training was rapidly converted to an online format.

“Practicing saved the day,” she says.

“It’s tricky to switch smoothly between screen sharing of content to organizing breakout rooms without losing focus (yours and the participants). Going through that a few times in practice made it much less awkward during the live training,” Wells says. “I was so happy to get through the awkwardness with friends first! And that first April session received excellent evaluation marks from the participants.”

Some tools, such as GoToWebinar, let you start events in practice mode without leading a live session. Even if you fake your own practice mode, run through the event with other presenters, moderators, hosts, and organizers to perfect it before your learners show up.

“I also think a benefit of the practice session with friends is stress management. You don’t feel so alone in it. Sitting in your living room facilitating a training can feel a bit surreal,” Wells says. “It’s great to have the practice people already there in the room with you.”

7. Keep Learners Engaged

For some people, the idea of not being able to sit in the same room with an instructor is a big turn-off. “Remote” learning doesn’t have to feel far away if you focus on building community with your online group.

Encourage the instructor to introduce themselves to your staff and ask them to share information with one another. This will help build a personal rapport. It can also be helpful to build periodic conference calls into a course, or create virtual office hours, so participants can interact with the instructor. A mentoring structure can help too, if you can pair learners with experienced health workers.

Some other best practices for increasing engagement:

  • Ask early and often what participants think.
  • Offer rewards, such as certificates or CEUs.
  • Ask everyone to turn on their video cameras to help everyone connect with each other.
  • Remind participants to be in a quiet place, mute themselves when not speaking, and use a headset.

8. Provide Contact with Mentors or Coaches

If a health worker works in an office or clinic, they have regular contact with managers or coaches and can use new skills with their supervisors right away. Some remote workers don’t have regular access to supervisors or mentors, so what they pick up in class could sit stagnant. This is one of several hidden challenges of training remote learners.

If mentors aren’t in the learners’ communities, put them there, at least virtually. This could mean setting up phone calls with a coach to discussion implementation of the skills or requiring regular online check-ins through the forums or email. A little extra attention, and accountability, can make a big difference in a health worker implementing what they learned faster and better.

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10 Signs You Need to Make a Behavioral Health Referral

Life is full of stressful situations. Frontline health workers, such as community health workers or promotores, are used to supporting clients as they juggle health issues along with stressors like child care and work. That’s on a good day.

Now think about how clients and patients deal with the outbreak of a crisis like the coronavirus disease 2019 (COVID-19) on top of day-to-day anxieties. This means more people are worried about paying the water bill, eviction, varying family obligations, changes to daily routines, and job instability.

[Download Now: Behavioral Health Resources]

Chronic stress can come from many sources such as poverty, long-term sickness, or domestic violence, in addition to a global pandemic. Stress has a serious effect on a person’s overall wellness. It can increase the risk of heart disease and strokes. It can increase depression, anxiety, and more serious mental illnesses—all associated with heart disease and a lower immune system. Stress can also lead people to unhealthy choices with food and substances.

“It’s now 455 days since my last sip of alcohol, and right now it feels harder than it has done, in over a year,” Yvette Mayer, a leadership coach, said on LinkedIn. “The idea of buffering with a bottle of red wine is appealing. I know I’m very unlikely to be alone in this ‘urge’.”

Supporting clients and patients in controlling stress is critical.

Managing Stress

10 Signs You Need to Make a Behavioral Health Referral

CHWs might feel helpless when they see clients have difficulty dealing with these anxieties, but they can still help. It’s always an important for CHWs to support clients’ behavioral health. They can do some things like be an active listener, give suggestions for telehealth, and coach healthy living. Here are two:

  1. Manage stress for health from the California Department of Public Health has some simple tips
  2. Free Online Sobriety Support During Covid-19 from the Sober Señorita is a great resource to share with clients with alcohol abuse issues

Supervisors of CHWs and program managers should look out for signs of stress and burnout among their staff. These resources are helpful with clients and also internally.

But there are some more serious signs that CHWs need to refer clients to a behavioral health provider who can give more support. Making a referral for a mental illness like depression or severe anxiety is an important step. Mental health disorders, like any chronic disease, can be managed or avoided with early intervention.

10 Signs Someone Needs a Behavioral Health Referral

  1. Suicidal thoughts
  2. Trouble concentrating
  3. Lack of interest
  4. Restlessness
  5. Constantly checking news outlets or social media
  6. Changed sleep patterns
  7. Fatigue
  8. Distant or withdrawn
  9. Mood swings
  10. Diet changes

These are 10 signs community health workers can look out for if you suspect someone in your community is struggling and needs help:

1. Suicidal thoughts

If someone talks about killing or harming themselves, make a referral right away. Call the 24-hour Suicide Prevention Lifeline at
1-800-273-8255 or text 838255. Not everyone who has suicidal thoughts shows them, but you can certainly notice subtle remarks that may point to trouble.

2. Trouble concentrating

When someone has difficulty concentrating on daily activities, are confused, forget things, has trouble getting anything done, this can be a sign of depression, anxiety, or substance use.

3. Lack of interest

Another warning sign is a lack of interest in things that used to cause joy, and even personal care. This can show up as the person not bathing or eating, stopping their hobbies, neglecting their job or responsibilities, and disengaging from their daily routine.

4. Restlessness

Someone might not be able to sit still. They might constantly shake their leg, shift between their feet when standing up, or fiddle with things in their hand.

5. Constantly checks news outlets or social media

Panic-scrolling is a sign of anxiety. This is the constant need to refresh social media channels, even knowing that nothing has changed since the last time they checked.

6. Changed sleep patterns

Someone might complain of sleeping more than usual or not sleeping at all. Significant changes in sleeping patterns can be a sign of a mental health issue—and can in some cases make it worse.

7. Fatigue

Feelings of fatigue might have nothing to do with sleep patterns. Even with normal sleeping, someone can feel constant fatigue. Even without realizing it, someone might feel this way because of irregular sleep, waking up in the middle of the night, or not being able to enter a deep state of sleep.

8. Distant or withdrawn

People who are clinically depressed often feel like withdrawing from social activities. Being isolated is not only a sign of mental illness but it can also be a cause of mental illness. This is especially challenging when so many people are required to self-isolate to stop spreading the virus.

9. Mood swings

Even though it’s fairly normal to go between moods in a week or even a day, someone who’s struggling with anxiety, depression, substance use, or other serious mental illnesses may experience wild changes in their mood quickly.

10. Diet changes

Whether someone is overeating or restricting food intake, any drastic changes to their daily food habits are often a red flag. This is another symptom that could be a cause. A healthy diet, such as the Mediterranean diet or DASH diet, can help with mental health as well as a variety of other conditions—including virus immunity.


Does your team need training in behavioral health? Read about our Healthy Living learning track.

CHWTraining Adds “Cervical Cancer and HPV” to its Chronic Illness Online Course Library

Online training offers evidence-based guidance to community-focused health workers who support women in vulnerable populations, aiming to lower their risk of cervical cancer and HPV infection through preventive and early detection methods

Woburn, Mass., April. 3, 2020 – Talance, a trusted provider of curriculum development and training technology to the healthcare industry, has added a new online course to address disparities in cervical cancer rates based on socioeconomic factors. “Cervical Cancer and HPV” is ideal for community health workers, promotores, case managers, patient navigators, support staff, and volunteers.

This web-based course demonstrates ways women can lower their risk of Human Papillomavirus (HPV) infection and cervical cancer through prevention and early detection. HPV infections can cause precancerous cell changes, resulting in cervical cancer. The course content includes symptoms, risk factors, screening tests, diagnosis, and treatment. It also covers screening guidelines and information about the HPV vaccine. Finally, course takers will identify barriers to care and ways to address those barriers.

“Social determinants of health make a big impact on cervical cancer screening,” says Monique Cuvelier, president of Talance, Inc., and CHWTraining. “People who live in rural areas and who come from a low socioeconomic background simply don’t get screened for cancer enough, and they don’t get the HPV vaccine that can really help. Our mission is to end that.”

In most Western countries, cervical cancer is highly preventable, thanks to the general availability of screening tests and a vaccine to prevent HPV infections. According to the Centers for Disease Control (CDC), when cervical cancer is detected early, “it is highly treatable and associated with long survival and good quality of life.”

In many areas, women cannot access HPV screening, which means cases are going undetected. Lower rates of preventive screening mean worse health outcomes in underserved populations. Cervical cancer has been called “a disease of poverty.” A CDC study conducted from 2011 to 2015 compared the incidence and mortality rate of cervical cancer in the poorest and most affluent counties in the state of Ohio. Results showed that the rate of cervical cancer incidence was almost twice as high for women living in the poorest counties compared to their affluent counterparts, and the mortality rate was more than twice as high.

The CHWTraining course “Cervical Cancer and HPV” will teach health workers the skills and knowledge needed to reach and educate at-risk populations in poor communities. At the end of the course, health workers will be able to help connect women in such underserved communities with prevention and early detection resources.

About CHWTraining

CHWTraining provides online training technology tools to organizations that want to transform health in America’s communities by carefully coaching their workers. It’s perfect for training new employees who need core competencies or standardizing training for existing staff—on their own time. The assessment-based certificates confirm that participants can demonstrate their knowledge.

About Talance

At Talance, we believe we all have a civic responsibility to help build healthy communities. Since 2000, we’ve collaborated with educators, advocates, health practitioners, governments, and employers to drive positive, lasting change in the environments where people live and work. Talance delivers community health education and technology that is trusted by clients across the nation, who rely on our expertise to create custom curricula or tap into our original course library that is developed by a professional team of industry leaders.

Interested in educating your team in Cervical Cancer and HPV? Contact us to learn more at www.chwtraining.org/contact.

Related: Chronic illness education and training for teams

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