1. Competitive Grant Program: Year 2 Meeting 2

2. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 Jeanne M. Amos CC HH Data Coordinator Data Coordinator Training Workshop 201

3. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 Data Collection Overview Data Collection Forms Overview

4. SCREENING, REGISTRY, RECRUITMENT Ongoing until recruitment goals met BASELINE ASSESSMENTS DP: Within month before beginning curriculum HH: Within month before beginning case management INTENSIVE ACTIVITIES HH: Case management and HGHH Curriculum DP: DPP Curriculum and Lifestyle Coaching FOLLOW-UP ASSESSMENTS (DP ONLY) Within a month of completion of DPP Curriculum ANNUAL AFTER INTENSIVE ACTIVITY HH: Anniversary of Baseline Assessment DP: Anniversary of Follow-up Assessment ANNUAL (DECEMBER) Annual reports and Questionnaires ONE TIME TELEPHONE INTERVIEW Selected providers interviewed by CC 1 STEP ACTIVITY 2 3 4 5 6 7 OVERVIEW OF DATA COLLECTION

6. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 Registry Input Form (does not get submitted) http://www.uchsc.edu/ai/sdpi/common/forms/R1.H.03_HH_Registry_Input_Form.doc Community Screening Worksheet (every other Tuesday) http://www.uchsc.edu/ai/sdpi/common/forms/R6.H.03_HH_Community_Screening_Worksheet.doc Participant Consent (does not get submitted) http://www.uchsc.edu/ai/sdpi/common/forms/R4.H.03_HH_Example_Participant_Consent_Form.doc HIPAA B (does not get submitted) http://www.uchsc.edu/ai/sdpi/common/forms/R5.H.03_HH_Example_HIPAA%20B_Form.doc Participant Record Form (does not get submitted) http://www.uchsc.edu/ai/sdpi/common/forms/R2.H.03_HH_Participation_Record_Form.doc Recruitment Team Meetings Form (December) http://www.uchsc.edu/ai/sdpi/common/forms/R3.H.03_HH_Recruitment_Team_Meetings_Form.doc Step 1 Forms: Screening, Registry, & Recruitment

7. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 Baseline Assessment of Core Elements: Mock Form Participant Baseline Questionnaire (PBQ) Family Baseline Questionnaire (FBQ) Family Consent Baseline Assessment Forms

8. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 A way to do a pre-post comparison of whether the programs implemented the core elements and required intensive activities. We also needed to know whether the participant’s clinical and behavioral measures improved specific to the goals and targets in the core elements. All clinical measures are based on IHS standards. Baseline Assessment History

9. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 Baseline Assessment Purpose: –gather information related to implementation of Core Elements at baseline Development: –During collaborative process, reviewed, gave input, reviewed revisions… Content: –Physical, Clinical, Laboratory measurements –Health Behaviors and education around project goals –Medications Timing: –Within month prior to start of Intensive Activities Format: –Paper form, fill out with pencil Filled out by: –Project Coordinator or staff as assigned – usually case manager

10. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 Baseline Assessment of Core Elements (BACE) http://www.uchsc.edu/ai/sdpi/common/forms/B1.H.03_HH_Participant_Baseline_Assessment_of_%20Core_Elements.doc Mock Baseline Assessment of Core Elements Participant Baseline Questionnaire (PBQ) http://www.uchsc.edu/ai/sdpi/common/forms/B2.H.03_HH_Participant_Baseline_Questionnaire.doc Family Baseline Questionnaire (FBQ) http://www.uchsc.edu/ai/sdpi/common/forms/B3.H.03_HH_Family_Baseline_Questionnaire.doc Family Consent (does not get submitted) http://www.uchsc.edu/ai/sdpi/common/forms/B4.H.03_HH_Example_Family_Consent_Form.doc Step 2 Forms: Baseline Assessment

11. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 Case Management Team Meetings Form (December) http://www.uchsc.edu/ai/sdpi/common/forms/I1.H.03_HH_Case_Management_Team_Meetings_Form.doc Participant Attendance Form (December) http://www.uchsc.edu/ai/sdpi/common/forms/I2.H.03_HH_Participant_Attendance_Form.doc Individual Retention Form (December ) http://www.uchsc.edu/ai/sdpi/common/forms/I3.H.03_HH_Individual_Retention_Form.doc Step 3 Intensive Activities Forms

12. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 Participant Annual Assessment of Core Elements (PAACE) http://www.uchsc.edu/ai/sdpi/common/forms/A1.H.03_HH_Participant_Annual_Assessment_of_Core_Elements.doc Participant Annual Questionnaire (PAQ) http://www.uchsc.edu/ai/sdpi/common/forms/A2.H.03_HH_Participant_Annual_Questionnaire.doc Family Annual Questionnaire (FAQ) http://www.uchsc.edu/ai/sdpi/common/forms/A3.H.03_HH_Family_Annual_Questionnaire.doc Step 5 Annual after Intensive Activities Forms

13. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 Recruitment Activities Annual Report http://www.uchsc.edu/ai/sdpi/common/forms/AD1.H.03_HH_Recruitment_Activities_Annual_Report.doc Retention Activities Annual Report http://www.uchsc.edu/ai/sdpi/common/forms/AD2.H.03_HH_Retention_Activities_Annual_Report.doc Provider Annual Questionnaire http://www.uchsc.edu/ai/sdpi/common/forms/AD3.H.03_HH_Provider_Annual_Questionnaire.doc Organization Annual Questionnaire http://www.uchsc.edu/ai/sdpi/common/forms/AD4.H.03_HH_Organization_Annual_Questionnaire.doc Community Annual Questionnaire http://www.uchsc.edu/ai/sdpi/common/forms/AD5.H.03_HH_Community_Annual_Questionnaire.doc Step 6 Annual December Forms

14. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 2 Data Coordinator Training Workshop 201 Q & A Jeanne M. Amos Jeanne.amos@uchsc.edu 303-724-0423