Physical Activity Programs Provide Support and Referral Pathway for Health Extension for Diabetes

February 21, 2024

Ellie Lane, MS, E-RYT, CPT

Rural Health and Nutrition Extension Agent, Clemson Cooperative Extension

Clemson Extension’s Rural Health and Nutrition Team educates South Carolinians on diabetes self-management practices through the Health Extension for Diabetes program (HED). HED is a 4-month diabetes self-management and support program for individuals diagnosed with diabetes. Participants receive diabetes education and support for improved self-management from a trained Health Extension Agent. Biweekly education sessions are facilitated traditionally and online that include risk-reducing practices (e.g., healthy eating and physical activity), medication and blood glucose management, and health resource navigation.

HED curriculum follows the Physical Activity Guidelines for Americans recommendations for adults to reach at least 150 minutes of moderate physical activity each week, while prioritizing a balance of aerobic, strength, and flexibility training. However, organized local and national physical activity programs are often expensive and offered infrequently. Inability to access physical activity support programs made it difficult for HED participants to maintain diabetes self-management behaviors. In response, our team developed three online physical activity support programs for HED participants and other stakeholders in South Carolina: (1) WalkSC, (2) Yoga for Every Body, and (3) Practical Strength.  

The WalkSC program was developed to satisfy recommendations for adults with diabetes to reach at least 150 minutes of moderate aerobic activity each week. Launched in spring 2020, the program encourages participants to increase their step count and time spent walking each week through weekly walking challenges. WalkSC comprises weekly step challenges across a span of 12 weeks—the end goal: to “virtually” walk South Carolina’s 500-mile Palmetto Trail. This program has been widely successful and has gained popularity locally and nationally. 

Health Extension for Diabetes recommends people with diabetes reduce stress to better manage blood glucose levels, and the Physical Activity Guidelines for Americans suggests adults with diabetes reach 1-2 days of balance and flexibility training each week. Yoga for Every Body (YEB) was launched in spring 2021 to address these recommendations; the program’s goals are to offer a consistent and accessible yoga practice facilitating stress management and increased physical activity across all age and health categories.

Lastly, it is recommended for adults with diabetes to reach 2-3 days of strength training per week to better manage blood glucose levels. Practical Strength was launched in summer 2023 to provide HED participants and SC stakeholders with a safe and effective strength training program appropriate for all ages and mobility levels.

Rural Health and Nutrition Team physical activity programs have reached wide audiences within South Carolina, and beyond, emphasizing their stand-alone value for health promotion and management. Importantly, these programs also facilitated cross-pollination of participants across Health Extension programming including HED. For example, at least 208 HED participants participated in one or more of the physical activity programs from 2020-2022, empowering them to continue to strive for sustainable diabetes self-management goals. Finally, the physical activity programs have increased HED recruitment, likely through targeted marketing of shared health goals. We conclude that increasing accessibility of physical activity programs within Extension has promoted chronic disease awareness, prevention, and management statewide and nationally.