2. Overview of the CVD Risk Reduction Demonstration Project Kelly Acton, MD, MPH, FACP IHS Division of Diabetes Treatment & Prevention

3. The CVD Risk Reduction Demonstration Project We know “what” but we don’t know “how”

4. The CVD Risk Reduction Demonstration Project  Core elements – “what”  Development of intensive intervention– “how”  Collaborative process  Standards of Care  Case Management

5. The CVD Risk Reduction Demonstration Project  8 Core elements - Intensive Intervention Identify eligible individuals with Diabetes Recruit individuals with diabetes to participate Initial physical exam and baseline measures Case Management approach to clinic visits

6. The CVD Risk Reduction Demonstration Project  8 Core elements – Intensive Intervention Treat CVD risk factors to recommended target levels Education on diabetes and CVD risk reduction – group or individual Gather data on required evaluation measures Target number of participants per year = 50

7. Diabetes Care & Outcomes Audit Source: IHS National Diabetes Program Statistics 1994-2003 A1C, % Mean A1C, 1994-2003 *p<0.0001 comparing mean HbA1 levels in FY94 and Y03 year

8. Diabetes Care & Outcomes Audit Source: IHS National Diabetes Program Statistics 1994-2003 A1C % Glycemic control, 1994-2003 *p<0.0001 comparing mean HbA1 levels in FY94 and Y03 year

9. Diabetes Care & Outcomes Audit Source: IHS National Diabetes Program Statistics 1994-2003 BP, mm Hg Mean Systolic & Diastolic BPs, 1994-2003 year

10. IHS Diabetes Care & Outcomes Audit Source: IHS National Diabetes Program Statistics 1994-2003 Mean Lipid Values 1994-2003 mg/dl year

11. The CVD Risk Reduction Demonstration Project  Less intensive intervention Community activities for people at risk for diabetes and cardiovascular disease and their families Focus on diabetes and cardiovascular disease risk reduction Tailor to community needs Evaluate activities

12. The CVD Risk Reduction Demonstration Project  Collaborative process  New way of doing business  Work outside our comfort levels

13. The CVD Risk Reduction Demonstration Project  Homework: review IHS Standards of Care for Diabetes Your recent (3-5 year) audit results NHLBI Curriculum – “Honoring the Gift of Heart Health”