1. Competitive Grant Program: Year 2 Meeting 3

2. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Jeanne M. Amos HH Data Coordinator Jeanne.Amos@uchsc.edu 303.724.0423 DATA SUBMISSION PROCESS

3. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 A Quick Glance Data Submission Reference Card http://www.uchsc.edu/ai/sdpi/common/forms/HH%20Data%20Submission%20Reference%20card.ppt April 28, 2006 CGP: HH Data Tip of the Week: Data Submission reminders and updates

4. Data Submission Reference Card Step 1: Check completeness of each form you are submitting. Make sure to have NDPID #, Site #, and Participant ID # on each form. For scannable forms, check that all the fields in the Box are filled in and properly bubbled. Make a copy of each form to be submitted for your records. Step 2: Fill out the Tracking Log Sheet. Name your file like the following: 55201.1 – CC – HH Tracking Log Sheet phase 1 – 04.27.2006. Only include IDs/information of those participants for whom you are submitting forms. Step 3: Prepare the Excel Registry (Detailed instructions can be found on the website). Back up your working copy of the Excel Registry. Name your file like the following: 55201.1 – CC – HH Excel Registry ver 3 – 04.27.2006. Remove Protected Health Information (PHI) from your Excel Registry copy using the Macro. Step 4: Prepare the submission email. Name your e-mail subject line like the following: 45231.2 registry_log 04.27.2006. Attach both the Tracking Log Sheet and the de-identified Excel Registry files to your e-mail. Open the attached Excel Registry and double-check that it is de-identified. Print one copy of the Tracking Log Sheet for your own record. If you have forms to submit, print another copy of the Tracking Log Sheet to include in the package. Send the submission email on your scheduled dates (see your submission calendar). Step 5: Prepare the package. Only send a package in the mail if you have new completed participant forms to submit! Double-check that the forms to be submitted match those listed on the printed Tracking Log Sheet. Mail the package to the Data Coordinator at the Coordinating Center. Sample mailing labels are available on the website: http://www.uchsc.edu/ai/sdpi/hh/data/hh_data.htm.http://www.uchsc.edu/ai/sdpi/hh/data/hh_data.htm Note: On your scheduled submission dates you are required to submit the Tracking Log Sheet and de-identified Excel Registry via e-mail to the Coordinating Center, even when you have no completed forms or questionnaires to submit.

5. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 HH Tracking Log Sheet Phase 1 Data Submission Reference Card: Step 2

6. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 HH Tracking Log Sheet Phase 1 Data Submission Reference Card: Step 2

7. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Excel Registry and Tracking Log Sheet E-mail convention Data Submission Reference Card: Step 4 Always 2 attachments: Tracking Log Sheet and Excel Registry

8. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Automated Response NDPID#.site# registry_log 4.25.06 IMPORTANT – Registry_Log: not case sensitive, no typos This response is acknowledgment of your data submission. Your Excel Registry and Tracking Logsheet will be reviewed and, if there are concerns or questions, I will contact you. Thank you for your data submission. Have a good day! Jeanne _________________________________________________ Jeanne M. Amos Data Coordinator, IHS/DDTP CVD Risk Reduction Project SDPI Diabetes Prevention Program, CGP Coordinating Center American Indian & Alaska Native Programs/MS F800 Nighthorse Campbell Native Health Building 13055 E 17th Ave, First Floor/PO Box 6508 Aurora, CO 80045-0508 Office: 303.724.0423 Fax: 303.724.0332 E-mail: jeanne.amos@uchsc.edu jeanne.amos@uchsc.edu

9. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Data Submission Common Errors ► Misspelling registry_log in email subject line ► Missing NDPID # or site number (or typo in NDPID #) in email subject line or within Tracking Log Sheet ► Missing Submission Due Date in email subject line ► Incorrect Submission Date within Tracking Log Sheet (often date of last submission)

10. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Data Submission Common Errors (continued) ► Tracking Log Sheet lists extra Participant ID numbers – only list the Participant ID numbers of participants for whom you are sending checked forms – Does not include Community Screening Worksheets (R6) ► Missing Date of first case management visit when sending Baseline forms (B1,B2, B3) ► Mailing Tracking Log Sheet to CC when you have no forms to send at this submission ► Submitting incomplete form/forms – do not submit a form unless it’s completed - B1/B2/B3 should be sent in batches.

11. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Data Submission Small Group Activity: CHALLENGES AND SOLUTIONS (10 minutes)

12. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Annual / Annual December Forms

13. RECRUITMENT: SCREENING, REGISTRY, ENROLLMENT Ongoing until recruitment goals met BASELINE ASSESSMENTS HH: Within month before beginning case management INTENSIVE ACTIVITIES HH: Case management and HGHH Curriculum FOLLOW-UP ASSESSMENTS (DP ONLY) 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 OVERVIEW OF DATA COLLECTION

14. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Participant Annual Forms 12 months from 1 st Case Management Visit Participant ANNUAL Assessment of Core Elements (A1.H) http://www.uchsc.edu/ai/sdpi/common/forms/A1.H.03_HH_Participant_Annual_Assessment_of_Core_Elements.doc Participant ANNUAL Questionnaire (A2.H) http://www.uchsc.edu/ai/sdpi/common/forms/A2.H.03_HH_Participant_Annual_Questionnaire.doc Family ANNUAL Questionnaire (A3.H) http://www.uchsc.edu/ai/sdpi/common/forms/A3.H.03_HH_Family_Annual_Questionnaire.doc

15. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Annual December Forms Recruitment Team Meetings Form (R3.H) http://www.uchsc.edu/ai/sdpi/common/forms/R3.H.03_HH_Recruitment_Team_Meetings_Form.doc Case Management Team Meetings Form (I1.H) http://www.uchsc.edu/ai/sdpi/common/forms/I1.H.03_HH_Case_Management_Team_Meetings_Form.doc Recruitment Activities Annual Report (AD1.H) http://www.uchsc.edu/ai/sdpi/common/forms/AD1.H.03_HH_Recruitment_Activities_Annual_Report.doc Retention Activities Annual Report (AD2.H) http://www.uchsc.edu/ai/sdpi/common/forms/AD2.H.03_HH_Retention_Activities_Annual_Report.doc

16. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 ANNUAL DECEMBER FORMS Continued Participant Attendance Form (12.H) http://www.uchsc.edu/ai/sdpi/common/forms/I2.H.03_HH_Participant_Attendance_Form.doc Individual Retention Form (I3.H) http://www.uchsc.edu/ai/sdpi/common/forms/I3.H.03_HH_Individual_Retention_Form.doc

17. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 ANNUAL DECEMBER FORMS Continued Provider Annual Questionnaire (AD3.H) http://www.uchsc.edu/ai/sdpi/common/forms/AD3.H.03_HH_Provider_Annual_Questionnaire.doc Organization Annual Questionnaire (AD4.H) http://www.uchsc.edu/ai/sdpi/common/forms/AD4.H.03_HH_Organization_Annual_Questionnaire.doc Community Annual Questionnaire (AD5.H) http://www.uchsc.edu/ai/sdpi/common/forms/AD5.H.03_HH_Community_Annual_Questionnaire.doc

18. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Provider Annual Questionnaire (AD3) Providers who interact directly with the participants and who help implement the Intensive Activities will be asked to complete the questionnaire. The Coordinating Center will ask the grantees how many Provider Annual Questionnaires they need.

19. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Organizational Annual Questionnaire (AD4) A total of 10 staff from each grantee organization should be invited to complete the questionnaire. 7 who do NOT work directly for the Project - Someone who: 1.Serves as a top manager/administrator 2.Directs clinical services 3.Provides direct care 4.Manages the direct care providers 5.Provides clerical or support services 6.Works with patients in a therapeutic role 7.Provides social services

20. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Organizational Annual Questionnaire (AD4) A total of 10 staff from each grantee organization should be invited to complete the questionnaire. 3 who DO work directly for the Project - Someone who 8. Directs the Project 9. Collects data for the Project 10. Provides direct care to participants (separate individual from #3, last slide) This list will be provided on the first page of the scannable questionnaire.

21. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Community Annual Questionnaire (AD5) Each grantee will ask 5-10 key community stakeholders to fill out the questionnaire. Respondents will include members of the community who are knowledgeable about health issues in their community. This may include Tribal Leaders, Elders, educators or other leaders in the community.

22. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 COORDINATING CENTER VISIT (CCV)

23. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Coordinating Center Visit (CCV) Date of e-mail: May 26, 2006 Purpose of the Coordinating Center Visit (CCV): The purpose of the Coordinating Center Visit (CCV) is to observe your overall process/procedures and provide technical assistance.

24. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Coordinating Center Visit (CCV) Planned Activities Review the filing system, security protocol/procedures and access. Understand who is administering the forms and the general procedures for administration of forms. Identify the back-up plan for submitting forms to the CC in the absence of the data coordinator. Review forms due in December if needed (for sites visited prior to December). Provide Technical assistance (typically 1-2 hours, can be extended depending on the level of grantee needs).

25. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Data Submission Process Follow-up / Annual / Annual December Forms Coordinating Center Visit Q & A

26. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program: Year 2 Meeting 3 Jeanne M. Amos HH Data Coordinator jeanne.amos@uchsc.edu 303.724.0423