Heritage College program takes diabetes management to school

May 23, 2017

COMCorps member Anna Pfeiffer at school with Lyndsey Spencer.

Eleven-year-old Lyndsey Spencer seemed remarkably at ease as she pricked her fingertip with a needle.

“This tells me what my sugar is,” she explained, checking the blood sample with a hand-held meter. “If my sugar was above 100, then I would take a shot of insulin. But if it was low, I would just eat my lunch.”

Spencer, a fifth-grader from Carbon Hill, Ohio, was in a small kitchen area in the office of the Nelsonville-York Elementary School in Nelsonville, Ohio, where she’s a student. The blood glucose test is part of a regimen to manage her Type 1 diabetes while she’s at school. She gets encouragement and guidance in this daily task from Anna Pfeiffer, an AmeriCorps member with the Diabetes School Navigator program.

This program, which provides a type of service not widely available nationwide, is sponsored by the Diabetes Institute at the Ohio University Heritage College of Osteopathic Medicine and the Heritage College’s Community Health Programs.

Launched in fall 2012, it aims to help Athens County students with diabetes manage their disease at school and to help school staffers better understand how to control diabetes. “The main thing is for the schools and the school nurses to know they have a support system,” said Carole Merckle, BSN, RN, CDE, DTR, associate director of Community Health Programs and site supervisor for the program. “Our ultimate goal is to provide support, resources and training to ensure children with diabetes are not singled out and are safe at school.”

In a 2016 statement on in-school diabetes management, the American Association of Diabetes Educators noted that according to one study, more than 190,000 Americans under age 20 have diabetes – predominately Type 1 but with Type 2 growing more common. Type 2 typically develops later in life than Type 1, and results when the pancreas reduces its insulin production. Type 1 results when the pancreas produces little or no insulin. Southeast Ohio has Type 2 diabetes rates higher than the state and national averages.

“Because most youth spend a significant amount of their day in school and related activities, diabetes care in school is an important part of their diabetes management,” according to the AADE. “Health and safety of the student are placed at risk when medication, food and physical activity are not balanced. In addition, the ability to learn is compromised when blood glucose is not within a reasonable range.”

To prevent such outcomes, AmeriCorps member Pfeiffer serves as liaison among students, school nurses, physicians and parents, tagging along on doctor visits and making sure updates to medical management plans are promptly shared among the parties. She also helps students stick to their management routines. For school staffers, the program offers training so they’re better able to spot behavioral warning signs that may mean a child’s blood sugar is out of whack.

Pfeiffer admitted that the upbeat, self-confident Spencer – “a poster child for awesomeness” – makes her job easier by embracing self-management and getting plenty of exercise through sports.

Spencer likewise rated Pfeiffer as “awesome. She helps me with diabetes, and she does fun stuff for Kids’ Club” ­–  a monthly support group open to any student with diabetes, which focuses on providing education, support and fun activities for children and their families.

Through the Heritage College AmeriCorps program COMCorps, Pfeiffer makes regular visits to six schools in Athens County, working with 15 kids aged 4 to 16. This kind of regular, one-on-one support is an exceptional benefit for students trying to cope with diabetes at school and makes Pfeiffer a source of useful feedback for Heritage College staffers working to find better management strategies.

“We are fortunate to have this innovative program available to area students, as our Institute continues to seek ways to further support diabetes management efforts in our school systems,” said Darlene Berryman, PhD, RD, LD, executive director of the Diabetes Institute. “For example, Karie Cook, the director of grants and special projects with the Institute, recently received funding through the Athens County Foundation to provide online diabetes education programming and an accompanying handbook for all the school nurses in Athens County. A program like the School Navigator not only helps students, but also provides us with information on how to better help the schools.”

Pfeiffer was introduced to COMCorps as an undergraduate studying public and community health at Ohio University, when she interned with the program to meet a service learning requirement. After graduation, she applied and was hired; she’s now in her first year as a member.

She received two weeks of general COMCorps training, covering such areas as working with children, professionalism, and CPR/First Aid. On her own, Pfeiffer has sought additional training in mental health first aid and diabetes prevention lifestyle coaching; the coaching skills come in handy when dealing with kids who haven’t mastered how to gauge the carbohydrate content of a meal.

“Most of the kids have to check their sugars, write down everything they’re going to eat for lunch, count those carbs, and then take insulin based on how many carbs they’re going to have,” Pfeiffer explained. “And it’s shocking how many of them, regardless of how old they are, don’t know how to do it. So I help them help themselves, in knowing how to recognize carbs and do those calculations.”

Pfeiffer’s experience with COMCorps may stand her in good stead if, like many other members, she pursues a health care career after completing her service. She has already applied to a nursing program at Kent State University and for jobs in the community health field in Canton, Ohio. “I would love to continue working with patients with diabetes,” she said.

Merckle said the ongoing education and support provided by the School Navigator program helps makes diabetes less overwhelming to school staff and other students, so that having the disease doesn’t result in a child’s being left out of school activities.

“We want to make sure these kids are not singled out, that they can participate in everything everybody else does, and don’t end up spending their day in the nurse’s office,” she explained.

Spencer has even used her involvement with the program as a teachable moment for classmates. Asked whether it’s ever uncomfortable to have Pfeiffer coming to school with her, she said, “It was at first. But then we showed everybody in my class what we were doing. They asked questions like why was I diagnosed and what diabetes does.”

Programs that offer in-school diabetes management help like that of the Heritage College’s Diabetes School Navigator seem to be fairly rare. An official with the American Diabetes Association local office in Bridgewater, N.J., said the organization there is working on starting a comparable school-based program with AmeriCorps to serve three New Jersey counties. “We do have a similar program, but ours hasn’t quite launched yet,” said Executive Director Taran Connelly. She added that while she has heard of a few somewhat parallel efforts in scattered locations such as Georgia and Portland, Ore., ADA has no coordinated nationwide effort to sponsor these kinds of programs.

Students can be referred to the navigator program through becoming patients at the Diabetes & Endocrine Center at the Heritage College.  But any child with diabetes, including their support system, is encouraged to attend the “Kids Club” diabetes support group. More information can currently be obtained from Carole Merckle, at mercklec@ohio.edu or 740.597.1212. After the new school year begins, those with questions about Kids Club should contact COMCorps at 740.593.2432.