2. Competitive Grant Program Data Collection Process/Forms Baseline Assessment Healthy Heart Project

3. 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 FIGURE 2: OVERVIEW OF DATA COLLECTION

5. Step 2 Flow Diagram

6. Baseline Assessment 3 Forms –Baseline Assessment of Core Elements (today) –Participant Baseline Questionnaire (tomorrow) –Family Baseline Questionnaire (tomorrow)

7. Baseline Assessment Purpose: –gather information related to implementation of Core Elements at baseline Development: –During collaborative process, reviewed first draft at last meeting, input reviewed, revision, input this month Content: –Physical, Clinical, Laboratory measurements –Health Behaviors and education around project goals –Medications Timing: –Within month prior to start of Intensive Activities –HH: can serve as the first Case Management Visit Format: –Paper form, fill out with pencil Filled out by: –Project Coordinator or staff as assigned – usually case manager

8. Review of Form Baseline Assessment of Core Elements (Appendix J)Baseline Assessment of Core Elements Instructions Data Flow