Scaling Evidence-Based Programs to Improve the Nation’s Health

Being a Scaling in Action presenter at the Social Impact Exchange Conference this year was rewarding for several reasons. First, it forced on me the discipline to tell the story of the decade-long evolution of the YMCA’s Diabetes Prevention Program in only 8 minutes! This wasn’t easy, but I appreciated the opportunity to refine my story. I’m now ready for “Shark Tank.”

Second, it gave me an opportunity to hear the inspiring story of three other successful program models that are worthy and ready to scale. Finally, it provided me a tremendous opportunity to share the merits of using a nonprofit network like the Y to nationally scale evidence-based programs that can alleviate pressing social issues like diabetes.

Through the Y movement’s 2,700 locations, the Y has the infrastructure to deliver high quality chronic disease prevention programs like YMCA’s Diabetes Prevention Program. More than 80% of the nation’s population lives within five miles of a Y and we maintain a national system for training and certifying staff. Both of these factors enable us to efficiently scale programs at the national level. However, having the network infrastructure to scale is only valuable if there are programs worthy to scale within it. The YMCA’s Diabetes Prevention program has proven to be one such program.

Hundreds of millions of dollars of research has proven that the program reduces new cases of diabetes by 58% for roughly 75% less than the cost of diabetes prevention programs delivered in a health care setting. In addition, reducing the number of cases of type 2 diabetes would save lives and significantly reduce the $116 billion in direct medical costs associated with diabetes every year. With more than 1 in 3 Americans with prediabetes, the need for this program is as pressing as ever. And because the Y has pioneered a way for third parties like insurers and employers to reimburse the Y for the program on a performance-basis, sustainability of such programs is within reach.

To achieve national scale, Y-USA needs $31.5 million. As of June 2014, we have already raised $13.1 million. I hope that sharing the story of the YMCA’s Diabetes Prevention Program at the Social Impact Exchange conference will inspire others to join our efforts to prevent diabetes.  That’s the ultimate reward of my participation.


Jonathan Lever is vice president of health strategy and innovation for YMCA of the USA.