Fresh Start: Intersecting Culinary, Behavioral Support, and Social Determinants of Health to Optimize Diabetes Self-Management


To optimize diabetes self-management and glycemic control, multiple factors driving health outcomes must be addressed, including socioeconomic factors (40%, e.g., income/food insecurity), health behaviors (30% diet quality, physical activity), access and quality of health care (20% diabetes self-management education). This session will describe the Fresh Start program’s comprehensive approach that integrates individually established evidence-based strategies to address each area that predicts health outcomes and successful improvements in diabetes self-management and glycemic control. The program has demonstrated an average decline of 1.87% HbA1c observed within 4 months for individuals who participated in all components of the program. The Fresh Start program includes 3 synergistic components: 1) the provision of 9 group classes to address knowledge, skills and self-efficacy around food, diabetes self-management and physical activity; 2) one-on-one health coaching conducted over the phone for individualized nutrition and physical activity behavioral goal targets; 3) a produce prescription with complimentary recipes to promote access to healthful food. Speakers will expand upon the developed framework for needed community partnerships and best practices for implementation and evaluation to help replicate the program in other regions and settings. The potential to address other nutrition-related cardiometabolic conditions will also be outlined.

Learning Objectives

Distinguish between traditional diabetes self-management education, medical nutrition therapy for diabetes and the Fresh Start program’s comprehensive approach

Describe how the Fresh Start program layered evidenced-based strategies to build a synergistic care approach to optimize diabetes outcomes

Identify community partners and stakeholders, implementation and evaluation strategies to replicate the framework of the Fresh Start program in other communities or regions

Performance Indicators

9.2 Establishes, develops and implements program outlines and learning plans to meet the needs of individuals, groups, communities and populations

12.3 Designs and develops community and population health programs, interventions or initiatives to meet the needs of communities and/or populations

14.3 Applies principles of project management to achieve goals and objectives


Lauren Sastre

Assistant Professor

East Carolina University

Brandon Stroud

Social Clinical Researcher

East Carolina University


Zach Cordell

Assistant Teaching Professor

Arizona State University

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