1. Special Diabetes Program for Indians Competitive Grant Program SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program Orientation for New Staff Day 1 Data Requirements – Recruitment/Screening

2. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program Karen Wilde Rogers CC DP Data Coordinator Data Requirements Recruitment/Screening

3. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program Step 1 Recruitment/Screening/ Enrollment Forms Overview of Forms Overview of Forms

4. RECRUITMENT: 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 Anniversary of Baseline 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 4a AFTER-CORE ACTIVITIES (DP ONLY) Lifestyle Coaching and Reinforcement Activities

5. Recruitment/Screening/Enrollment Forms Recruitment Forms: Grantee Level Screening Forms: Participant Level Enrollment Forms: Participant Level SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program

6. Recruitment Team Meetings Form Recruitment Team Meetings Form (R3.D, Submit in DEC) Recruitment Activities Annual Report Recruitment Activities Annual Report (AD1, Submit in DEC) Recruitment Forms: Grantee Level SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program

7. Screening Forms: Participant Level Community Screening Worksheet Community Screening Worksheet (R6.D, submit only 2 nd pg) Registry Input Form Registry Input Form (R1.D, does not get submitted) –Registry Input Form Instructions (R1.D.03In)Registry Input Form Instructions Excel Registry Excel Registry (submit de-identified copy) –Excel Registry Instructions (R1.D.03InE)Excel Registry Instructions SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program

8. Screening Forms Common Submission Issues If Community Screening Worksheets are being used, please completely fill out and only submit the 2 nd page, only if a participant ID has been issued for the participant. Submitting Personal Health Information (PHI) in the Excel Registry. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program

9. Screening Forms: Helpful Hints Download the DPP Registry Guidelines document from the website.DPP Registry Guidelines Make a copy of your Excel Registry and run the Macro prior to sending it to the CC to avoid sending PHI. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program

10. Enrollment Forms: Participant Level Consent Form Consent Form (R4.D, does not get submitted to the CC) HIPAA B Form HIPAA B Form (R5.D, does not get submitted to the CC) SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program

11. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program SDPI CGP website http://www.uchsc.edu/ai/sdpi/sdpi_index.htm  Username: dp  Password: dp ☞ username and password are case sensitive Resources

12. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program

13. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program Operations Manual http://www.uchsc.edu/ai/sdpi/dp/data/dp_manual.htm Tip Of The Week (TOTW) Frequently Asked Questions (FAQs) http://www.uchsc.edu/ai/sdpi/dp/resources/dp_resources.htm Resources

14. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program CC DP Data Coordinator Karen Wilde Rogers karen.rogers@uchsc.edu 303.724.1422 Data Contact Resource

15. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program Data Requirements Recruitment/Screening Q & A