1. Special Diabetes Program for Indians Competitive Grant Program SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program Technical Assistance Meeting Day 1 Baseline Activities

2. SDPI CGP Diabetes Prevention Program CORE ELEMENTS: DPP CURRICULUM PART 1 - BASELINE ACTIVITIES

3. 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

4. Previous Step – Recruitment, Screening, Enrollment Consent forms signed, Enrollment completed Prepare for Baseline –If first class of next group starts within 1 month after consenting immediately schedule Baseline activities –If first class of next group starts more than 1 month after consenting delay Baseline activities until 1 month before first class of next group Next Step – Baseline Activities SDPI CGP Diabetes Prevention Program

5. Baseline Activities - Overview “Baseline” – Definition and Purpose Types of Baseline Activities –Materials/Resources for Completing Baseline Activities Timelines and Scheduling of Baseline Activities SDPI CGP Diabetes Prevention Program Website/Materials/Resources Operations Manual –Glossary of Terms Clinical Guidelines Dr. Mandelin FAQs, TOTW Grantee Strategies, Challenges and Solutions Forms Baseline Assessment of Core Elements Participant Baseline Questionnaire Family Baseline Questionnaire Common Issues/Questions Confidentiality/Privacy in all areas

6. Baseline - Definition and Purpose What does “Baseline” Mean? Set of measures taken just before participant starts to receive an intervention (treatment or education) Purpose of Baseline for CGP Same measures taken just after intervention activities completed (outcomes measures) Before-measures compared to after- measures –to answer question: Did program cause desired change in participant’s health status? SDPI CGP Diabetes Prevention Program Website/Materials/Resources Operations Manual –Glossary of Terms

7. Types of Baseline Activities Clinical - labs, body measurements, ECG, physical exam/approval to exercise –Baseline Assessment of Core Elements (B1 or BACE) Participant view of his/her health, health behaviors, beliefs –Participant Baseline Questionnaire (B2 or PBQ) Family member’s view of participant’s health, health behaviors, beliefs –Family Baseline Questionnaire (B3 or FBQ) SDPI CGP Diabetes Prevention Program Website/Materials/Resources Operations Manual

8. Baseline Activities - Clinical Baseline Assessment of Core Elements (B1 or BACE) –Completed by project staff and providers Labs: blood glucose, lipids Body measurements: blood pressure, weight, height, BMI, waist circumference ECG: required – within 1 year before first class Physical exam and Approval to exercise –must be done by licensed provider (MD, DO, NP) –medical evaluation - exam/review of health systems, medical history, lab results, ECG –identify health issues that may impact ability to successfully participate –Based on the ECG results or other factors, may choose to conduct cardiac clearance SDPI CGP Diabetes Prevention Program Website/Materials/Resources Clinical Guidelines –Retention & Drop-Out Policy Dr. Mandelin Forms Baseline Assessment of Core Elements Common Issues/Questions Confidentiality/Privacy in collecting and submitting baseline measures Can PA do the physical exam? No access/not enough providers Provider must give lab results to participant Provider reluctance on grant requirements Scheduling providers, labs

9. Materials/Resources for Completing Baseline Assessment Operations Manual “Appendix N. Clinical Guidelines” Website “ Project Materials and Resources\ Clinical Guidelines and Tools” http://www.uchsc.edu/ai/sdpi/dp/resources/dp_resources.htm –Timeline for Physical Exams and Lab Results –DP OGTT/FBG Schedule –Guidelines for Screening Physical Exam –Chronic Diseases and Conditions –Exercise Stress Test Recommendations –IHS Guidelines for Care for Pre-DM –Retention and Drop-Out Policy (also in Appendices)Retention and Drop-Out Policy SDPI CGP Diabetes Prevention Program Website/Materials/Resources Website – items in –Clinical Guidelines –Operations Manual –Forms and Appendices –DP Forum (discussion board) TOTW (emails) Dr. Mandelin Common Issues/Questions Provider reluctance on grant requirements Scheduling providers, labs

10. Materials/Resources for Completing Baseline Assessment, continued Website: Project Materials and Resources –Measurement Calculators and instructions (BMI, waist/hip ratio, weight percent change, waist circumference) –Sample Pre-Diabetes PCC forms –Glossary of Terms (also in Appendices) –Dr. Mandelin contact info –FAQs –Grantee Strategies Website: Meetings –Grantee Challenges & Solutions Website: DP Forum (discussion board) Emails: Tips of the Week SDPI CGP Diabetes Prevention Program Website/Materials/Resources Website –Project Materials and Resources –Meetings –DP Forum (discussion board) TOTW (emails) Dr. Mandelin Common Issues/Questions How to measure waist circumference

11. Participant Baseline Questionnaire (B2 or PBQ) –Participant view of his/her health, health behaviors, beliefs –Completed by participant Family Baseline Questionnaire (B3 or FBQ) –Family member’s view of participant’s health, health behaviors, beliefs –Completed by a close family member/other support person Materials/Resources for Completing Baseline Questionnaires –To discuss with participant or family member Purpose where did these questions come from? –Talking points – PBQ, FBQ, BACEPBQ –Topic CitationsTopic Citations SDPI CGP Diabetes Prevention Program Website/Materials/Resources Operations Manual Topic Citations Talking Points Forms Participant Baseline Questionnaire Family Baseline Questionnaire Common Issues/Questions Confidentiality/Privacy in completing and submitting questionnaires Can person <18 be the support person? No family member near by - can friend do it? Participant doesn’t want to ask anyone to complete the FBQ?

12. Timelines and Scheduling of Baseline Activities Clinical Guidelines (On Website and in Operations Manual Appendix N) –DP OGTT/FBG ScheduleDP OGTT/FBG Schedule –Timeline for Physical Exams and Lab ResultsTimeline for Physical Exams and Lab Results –Retention and Drop-Out PolicyRetention and Drop-Out Policy 6-month rule Things to think about when scheduling baseline activities –Timelines –Workload –Provider availability –What can be done without provider –Scheduling/completing laboratory tests and ECG –Participant no-shows – process –Ideas for streamlining SDPI CGP Diabetes Prevention Program Website/Materials/Resources Operations Manual Dr. Mandelin FAQs, TOTW Grantee Strategies, Challenges and Solutions Common Issues/Questions Confidentiality/Privacy in completing and submitting baseline assessments and questionnaires one month just not enough time-are there exceptions? What about people who re- start the program with a new group?