Cities for Life Backgrounder One in three Alabamians born after 2000 will develop diabetes in their lifetime

.i Cities for Life is a community-based diabetes management program that will strive to help change these numbers. Birmingham, AL was selected for Cities for Life out of more than 50 cities, not only because Alabama has one of the highest rates of diabetes in the country, but also for its visible commitment to improving the lives of its citizens.ii Cities for Life is an innovative clinic-community pilot project initiated by the American Academy of Family Physicians (AAFP) Foundation, a national organization focused on advancing the values of family medicine, with support from Sanofi US. A key component of Cities for Life is the use of a patient navigator to work directly with family medicine practices to help create sustainable linkages between existing community resources and people living with diabetes or at risk for diabetes. The AAFP National Research Network (NRN), the country’s largest practice-based research network, will work closely with key community partners to help develop the patient navigation system and guide patients towards appropriate, accessible resources that facilitate a healthy lifestyle and diabetes management outside the exam room. Guidance also comes from the AAFP Foundation’s Peers for Progress program. Cities for Life is designed to be a grassroots program, optimizing the collective strength of Birmingham’s “medical neighborhood,” comprised of family medicine practices, health care and educational opportunities through the University of Alabama at Birmingham (UAB) and the many community resources that currently facilitate a patient’s efforts toward a healthier life. Key partners include:  UAB Department of Family and Community Medicine (UAB-DFCM)  Several family medicine practices recruited, selected and guided by UABDFCM throughout the Cities for Life project  UAB’s Diabetes Research and Training Center’s Community Engagement Core (DRTC-CEC)  UAB HealthSmart  YMCA of Greater Birmingham The key partners, representing both the community and the clinical perspectives, will make project decisions on implementation and sustainability through a Cities for Life Steering Committee. Designing a patient-centered link by way of a committed patient navigator process is the first step in assisting family medicine practices to help people living with diabetes and at risk for diabetes. Next steps include increasing awareness for community support through social marketing efforts and reaching out to additional diabetes resources via civic and community groups that are focused on peer support and self-management activities. Finally, the program will attempt to incorporate the principles of behavioral economics –
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The Cities for Life program is made possible with support from Sanofi US.

the personal and financial incentives for behavioral change – by connecting to local businesses that value the health of their employees and customers. Cities for Life will focus its efforts in the Southside, Southwest, Homewood, Titusville and West End communities, selected in order to best capture the full diversity of the city and the greatest need for diabetes management and prevention. A formal evaluation by the NRN will look carefully at all aspects of this pilot project, including:  A thorough process evaluation in order to understand the development and implementation of the Cites for Life model at the practice and community level, culminating in recommendations for dissemination of the model in other cities.  Patient metrics around diabetes management and prevention including clinical outcomes, self-efficacy and self-management, and interviews regarding the patient navigation process. In addition, changes will be assessed at the community level such as general awareness about the program. Stemming from the AAFP Foundation’s Behavioral Economics Roundtable on Diabetes Summary Report, which urged communities to develop comprehensive programs for better diabetes management, Cities for Life is the next step in transforming thought to action and capturing the collective strength of a community moving towards a healthier future. For more information about Cities for Life, visit www.aafpfoundation.org/citiesforlife

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Factors Affecting Benefit/Harm of Intensive Glucose Control in Type 2 Diabetes Reported [press release]. American Diabetes Association; June 16, 2009. P. 2, l.42-44. ii Factors Affecting Benefit/Harm of Intensive Glucose Control in Type 2 Diabetes Reported [press release]. American Diabetes Association; June 16, 2009. P. 2, l.42-44.

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The Cities for Life program is made possible with support from Sanofi US.