Item - 2013.HL22.3

Type 2 diabetes is a serious chronic disease and continues to be a growing public health challenge. Over the coming decades diabetes rates are projected to rise due to the aging population and increasing rates of obesity. The estimated prevalence rate of diabetes for adults over the age of 20 is 8.1% for Toronto, as compared to 7.7% for the rest of Ontario.  Behaviour change and supportive environments that aim to increase healthy eating and physical activity, have the potential to prevent or delay development of type 2 diabetes in high-risk populations and to reduce the associated burden of ill health and healthcare costs.

This report provides an update on the evaluation of the Toronto Public Health (TPH) Diabetes Prevention Strategy (DPS) as requested by the Board of Health on November 21, 2011.

In 2009, the DPS began as a pilot in two neighbourhoods and six selected workplaces. The two neighbourhoods, Malvern and Jamestown - West Humber-Clairville (referred to as “Rexdale”) , were selected due to the high rates of diabetes and low levels of health services and community resources. The workplaces which were selected had ethnically diverse workforces and were from sectors where employees were more likely to have precarious employment and hence were potentially at higher risk for type 2 diabetes. In the third year, the DPS expanded citywide. The interventions included risk assessment workshops for type 2 diabetes, healthy eating and physical activity programs, peer-led diabetes prevention programs, public awareness campaigns and initiatives to help create environments that support healthy eating. The program directly reached almost 8,000 people over a three-year period, along with an estimated two million reached through the public awareness activities.

The evaluation findings showed that the DPS activities, in particular the Peer Leadership component, were effective in reaching communities at high-risk for developing type 2 diabetes. The DPS activities were also effective in increasing program participants' knowledge of risk factors for type 2 diabetes and promoting positive behaviour change to reduce their risk of developing type 2 diabetes.  Details of the evaluation methodology and results can be found in the "Diabetes Prevention Strategy 2009-2012: Evaluation Report", available at http://www.toronto.ca/health/diabetes/requirements/resources.htm

TPH's comprehensive approach, collaboration with community agencies and leveraging of community resources resulted in delivery of a program that was able to meet the needs of diverse cultures. The DPS program achieved positive results and can serve as a model for future interventions to promote the health of ethno culturally diverse communities of Toronto.

The DPS was funded by the Ministry of Health and Long-Term Care (MOHLTC) and Ministry of Health Promotion and Sport (MHPS) over the past four years. TPH was advised that, based on the program's success, funding will continue for an additional three-year period until 2016.  This will allow the continuation of the intensive and comprehensive diabetes prevention programs with populations most at risk for developing type 2 diabetes.