Work out every day for at least 30 minutes. Constrict your calorie intake. Go to bed at the same time every night. Cut out carbs and processed foods. No red meat, and absolutely no alcohol.

“Yikes!” one might think, after reading over this strict set of rules related to human health. When working toward a healthier lifestyle, “you don’t want it to be torture,” said April Payne, a Virginia Cooperative Extension agent.

“You know it’s going to be hard, but you want to have fun with it, too,” she said.

Payne is a lifestyle coach with the Virginia Cooperative Extension Diabetes Prevention Program, a lifestyle change program supported by the Centers for Disease Control and Prevention (CDC). She is among a group of more than a dozen Extension agents across Virginia trained to teach this 12-month group program that promotes the prevention of Type 2 diabetes through realistic and achievable health-related goals.

According to the CDC, more than 37 million Americans have diabetes and about 90 to 95 percent of them have Type 2 diabetes. The national organization has for decades worked to develop effective programs that can impact the trajectory of diabetes for people who are not yet diabetic.

Late last year, Extension was awarded full accreditation by the CDC as a provider of the Lifestyle Change Program. The status is awarded to organizations that achieve a certain quality standards. Normally awarded for a two-year period, Extension was awarded this recognition for five years because of the high retention of its participants.

Extension adopted the program in 2016, which is tied to the National Diabetes Prevention Program, an evidence-based initiative aimed to help people who have prediabetes and are at a high risk of diabetes. People who are at the highest risk are 45 years and older, are overweight or obese, and live sedentary lifestyles. Diabetes also has a higher prevalence in African American and Hispanic populations.

Participants meet as a group during weekly sessions with their lifestyle coaches, who serve more as facilitators than educators. Beyond the expected topics of weight loss and exercise, people share personal successes and challenges of staying on track with their goals. Many participants continue the conversations beyond meetings via Facebook and other social media platforms.

Connections and accountability are key to the program, said Extension Agent Clare Lillard, a lifestyle coach and the state liaison for the program. Lillard concluded her first course last year and is currently in the middle of her second.

“It’s been very successful and I think that’s because we have a lot of fun,” Lillard said. “Through our Facebook group, members share recipes, photos of what they’ve been cooking, and stay connected. Most importantly, they are being supported along this journey. To be successful, it must be a lifelong journey, so why not try to have fun with it along the way?”

Lillard, herself, is a Type 2 diabetic. She is hopeful that through her experience with the disease, she can inspire others to practice lifestyle changes that could prevent them from being diagnosed. Changes such as not worrying too much about if they indulge a little during the weekend, and instead, focusing on how they can adjust their exercise habits and food choices during the week.

Lillard and Payne have already made an impact, many of their students agree.

Karen Grace is a 68-year-old retiree from Culpeper. At a routine doctor’s appointment last year, it was discovered that she had a rising A1C level. That jolted her into action.

“I wanted to address it and learn how to get healthy before it went into full-blown diabetes,” Grace said.

So she enrolled in the Lifestyle Change Program last year.

“The program taught me the importance of exercise and healthy eating and that it's not too late to make changes in my lifestyle,” she said. “I also enjoyed the camaraderie among the group.”  

Another aspect of the program that participants enjoy is the fact that most classes have occurred virtually since the COVID-19 pandemic. It’s had its advantages, Payne said. In this virtual format, participants located in a part of Virginia that may not offer the program can join. A participant in Payne’s group recently relocated to Scotland. She still participates every week from abroad.

Extension specialist Carlin Rafie, an assistant professor in the College of Agriculture and Life Sciences’ Department of Human Nutrition, Foods, and Exercise, has been a big proponent of the program.

She joined Extension in 2015 with expertise in nutrition and chronic disease management. She worked closely with a core group of Extension to adopt the Lifestyle Change Program. She has been particularly impressed with how it measures outcomes.

“The neat thing about this program is the way the CDC is managing it,” Rafie said. “They have quality metrics and evaluate all the organizations and individuals conducting the program to ensure that the program is conducted with fidelity. This helps us ensure that we're not just doing a program. We are doing a program that's going to have an impact, and that’s exciting.”

Beyond the positive participant feedback, Rafie can verify that Extension’s offering of the Lifestyle Change Program has, indeed, made a tremendous impact.

“The full-accreditation achievement would not have been possible without our skilled and highly-trained coaches,” Rafie said. “We hope to engage more agents and participants and continue to expand this program throughout the commonwealth.”

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