1. Semi-Annual Progress Report June 30, 2007 SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 1

2. 2 Overview Semi-Annual Progress Report –Data submitted through June 30, 2007 –2 reports: Overall – grant program results by site # only, not site names Grantee-specific data – separate report sent only to you –Purpose – to measure our progress over time –Important notes: Not all annual data have been submitted – data are very preliminary Represents data analyzed so far - many steps to get to this point Overall – good progress! SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 1

3. 3 267 AACE (A1) Annual Assessment 1486 BACE (B1) = Participants Baseline Assessment 2051 Individuals reported to have signed consent forms 4309 Individuals in Excel Registry HH: Recruitment, Participant Accrual, and Baseline/Annual Assessment Progress (November 1, 2005 – June 30, 2007) ** Data from 30 HH Grant Programs in which the majority of programs have completed 1 year of Intensive Activities as of June 30, 2007

4. 4 Figure 1.01: HH Monthly Actual Participant Accrual vs. Expected Accrual

5. 5 Figure 1.02. HH Monthly Actual Participant Accrual vs. Expected Accrual Adjusted by Date of First Intensive Activity

6. 6 Figure 1.03: HH Percent of BACE/B1 Submissions Goal (75) Achieved

7. 7 Figure 1.04: HH Percent of BACE/B1 Submissions Goal Achieved by Grantee’s User Population Size User Population categories: small 10,000.

8. 8 HH: Data Submission and Quality Data Submission –only 1 program missed more than 20 percent of scheduled data submissions Data Quality –the range of missing or invalid data on B1 forms for each grant program is 38.6% to 94.9% Timeline Compliance –51.0% of B1 forms did not meet timeline requirements Other (based on baseline participant numbers) –Percent of “expected” A1 forms received: 63.9% –Number of participants reported to be inactive: 9.1%

9. 9 Table 4B.01: HH Baseline Clinical Characteristics N Baseline Mean Weight (lbs)1414220.4 BMI141436.6 Waist (inches)139545.3 Hip (inches)139147.3 Waist to Hip Ratio13911.0 Data from January 1, 2006 to June 30, 2007 – most programs have completed at least one full year of intensive activities.

10. 10 Table 4B.01: HH Baseline Clinical Characteristics N Baseline Mean Systolic Blood Pressure (mm Hg)1414128.6 Diastolic Blood Pressure (mm Hg)141475.5 LDL (mg/dl)138299.9 HDL (mg/dl)141144.2 Triglycerides (mg/dl)1414188.2 Total Cholesterol (mg/dl)1414177.8 HbA1C (%)14137.6 Data from January 1, 2006 to June 30, 2007 – most programs have completed at least one full year of intensive activities.

11. 11 HH: Comorbidities at Baseline Diabetes + Percent High Blood Pressure66.4 Back Pain44.4 Depression26.3 Osteoarthritis24.8 Heart Disease18.4 Rheumatoid Arthritis11.7 Ulcer/stomach disease10.5 Lung Disease7.1 Anemia or other blood disease6.8 Kidney Disease4.2 Liver Disease2.4 Cancer1.8

12. 12 HH: Lifestyle Measurements Baseline (%) Physical activity at least 150 minutes per week25% Stages of change for physical activity – preparation stage36% Reported never drinking alcohol69% Reported drinking 4 or more times per week1 % Stages of change for alcohol use – contemplation stage50 % Never smoked50% Current smokers17% Participants spent 3-5 hours per day watching TV, sitting at a computer, or doing other sedentary activities 48%

13. 13 HH: Physical Activity Figure 4C.01: HH Baseline Minutes of Physical Activity per Week

14. 14 HH: Baseline Psychosocial Measurements Age 18-39Age > 60Scale – low to high Diabetes General Knowledge71640-100% Insulin Use Knowledge71560-100% Health Literacy Scale3.513.21-5 Percent correctly answered Health Literacy Questions 71660-100% Distress Scale2.11.671-5 Post Traumatic Stress41210-100% Anger Scale0.40.260.1-1.0 Hostility Scale0.370.250.1-1.0 Bold means higher in that age group

15. 15 HH: Baseline General Diabetes Knowledge Figure 4B.01: HH Baseline Rate of Correctly Answered General Diabetes Knowledge Questions

16. 16 HH: Baseline Psychosocial Measurements Age 18-39Age > 60Scale – low to high Perceived Health Competence Scale3.073.411-5 Coping Ability Scale3.133.321-5 Everyday Discrimination Scale2.11.841 (never) – 4 (often) Positive Family Support Scale2.041.791-5 Cultural Spirituality Scale3.63.961-5 Bold means higher in that age group

17. 17 HH: Baseline Ethnic Identity Figure 4D.09: HH Baseline Ethnic Identity Scale

18. 18 HH: Ability to Speak Tribal Language Figure 4D.10: HH Baseline Reported Ability to Speak Tribal Language

19. 19 HH: Baseline Importance of Spirituality Figure 4D.11: HH Baseline Importance of Spirituality

20. 20 HH: Baseline Cultural Spirituality Scale Figure 4D.12: HH Baseline Cultural Spirituality Scale

21. 21 HH: Annual December Data Provider Annual Questionnaire –Most hours spent on intensive activities, planning, and recruitment/screening, with variations by job/role Organizational Questionnaire –Organizational culture – dominant overall is “clan culture” – focus on keeping things running smoothly internally, with flexibility, concern for people and sensitivity to customers –Executive support scale – 2.26 score (1= no support, 5=strong support from executive management for SDPI program) –Competing values framework – HH scored high in 7 of 8 areas of organizational effectiveness, except growth & resource acquisition (diagram) Community Annual Questionnaire –58% strongly agree that this program was good for the community

22. 22 HH: Summary Report shows good progress overall! Useful baseline characteristics of participants Annual data available in next HH report Grantee-specific reports –Data specific to your program to compare to overall report –Make sure you explain the data and its context to anyone who reads it – careful to interpret if small numbers of participants in some cells –Confidentiality – consider who views the report Next Semi-Annual Progress Report –Data submitted as of 12/31/07 –Report in Spring 2008, likely at next grantee meeting SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 1

23. 23 Questions? SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 1

24. 24 HH Diet Survey Summary SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 1 To Decrease: –Bacon/sausage –Processed meats –Bread processed from flour –Frybread –Baked goods –Regular soft drinks –Add sugar/creamer to coffee/tea –Regular fat salad dressing –Fast food To Increase: –Whole grain bread –Fruit –Lettuce/green leafy salad –Cooked dried beans –Fish/chicken/game –Vegetables

25. 25 Why No Annual Data in This Progress Report? SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 1 We had not yet collected a full year’s worth of annual data. By 06/30/07, the CC only received 267 A1 forms, which is less than 30% of the B1 forms we received last year (961). Only 10 grantees submitted ≥ 10 A1 forms, and only 5 grantees submitted ≥ 15 A1 forms – if we had reported aggregate annual data in this progress report, it would have only represented the data from a few grantees, not a real overall picture.